| Cause: Degenerative arthritis occurs with repeated (over) load when first the cartilage takes damage, and then the bone under the cartilage. Degenerative arthritis can in some instances cause an irritation of the synovial membrane which will result in concentration of fluid, swelling, reduction in mobility and pain in the joints. Degenerative arthritis in the ankle joint is often seen after repeated ligament injuries (outer ankle joint ligaments, inner ankle joint ligaments), where cartilage lesions in the ankle joint have occurred at the same time.
Symptoms: Pain in the joint with movement under load. Occasionally swelling in the joint.
Examination: Normal clinical examination is often sufficient. However, it is also often necessary to perform an x-ray (or ultrasound scan or MRI examination) to make the diagnosis. Ultrasound scanning will often reveal inflammation surrounding new bone development at the joint surfaces.
Treatment: Treatment comprises relief from the painful activities until the swelling has gone down, after which training can commence with the primary aim to strengthen the muscles surrounding the joint and retain joint mobility. There is no treatment which can restore the damaged cartilage (and bone). Cartilage transplants are, as yet, not suitable for general degenerative arthritis. In cases of swelling in the joint, and with inflamed new bone development at the joint surfaces, inflammation of the synovial membrane can be attempted subdued by using rheumatic medicine (NSAID), or by draining the fluid and injecting corticosteroid. The injections can be performed to advantage by utilising an ultrasound guided method. Pain without swelling of the joints is best treated with paracetamol. In severe cases of degenerative arthritis where there is pain when resting (at night), it may be necessary to fix the joint by operation.
Rehabilitation: Rehabilitation is completely dependent upon the degree of the degenerative arthritis and in which joints it is located.
Bandage: A supportive tape (Hollywood bandage) can be attempted to aid degenerative arthritis in small joints (toes) (tape-instruction). Tape provides no help to attacks in the ankle joint.
Complications: Degenerative arthritis which sits on the weight bearing parts of the joint is one of the most serious sports injuries, and often results in a termination of active sport. It is usually possible to continue sport activities with light strain on the joints (cycling, swimming), whereas it is advisable to participate in activities with great strains on the joint (running, ball games) with restraint. The diagnostic considerations in connection with degenerative arthritis include:
Special: Shoes with shock absorbing inlays will reduce the discomfort of degenerative arthritis.