Ankylosis – a fixed joint after bone fusion brings a lot of inconvenience to the patient. The cause of articulation blockage is an injury or pathology of an inflammatory nature. The treatment is carried out with anti-inflammatory drugs and physiotherapeutic procedures. With complete immobilization, an operation is prescribed. Fixed joints give a lot of inconvenience to a sick person. The movements repeated in everyday life require a certain motor functionality. Ankylosis is characterized by complete immobilization. An irreversible condition can only be corrected surgically.
What is ankylosis?
Complete loss of joint mobility, developed after fusion of the articular ends of the bones. After the influence of a provoking factor, the joint freezes in a forced position, which affects the development of concomitant symptoms.
Fusion can occur in two types of tissue:
- bone ankylosis (true) when bone tissue is fused, is characterized by complete immobility, a person does not experience pain when trying to make a movement;
- the fibrous compound (pseudo-ankylosis) develops due to the proliferation of connective tissue, while sensitivity is maintained, and the patient feels pain in the fixed connection.
The ossification of the joint can occur in a favorable and uncomfortable position. If immobility appears in the knee joint in a bent state, a person will not be able to move around without a cane or crutches. This situation refers to disadvantageous compounds. If the lower limb with ankylosis is fixed in a straightened state, the patient will be able to walk and maintain efficiency.
Causes of appearance
Ankylosis develops with the following pathologies:
- joint damage with an outpouring of blood into the joint, complex intraarticular and open fractures;
- complication in the form of an abscess after an injury in the joint;
- long stay in a plaster cast;
- as a complication of hemophilia, which is accompanied by an accumulation of blood in the joint bag;
- chronic inflammatory diseases – arthritis, bursitis with purulent effusion;
- degenerative processes with severe deformation during arthrosis;
- post-traumatic period during which a person is on skeletal traction;
- infectious lesion in the joint.
Dystrophic processes during the period of the disease state destroy the cartilage layer in the joint bag. In acute conditions, connective tissue actively grows without prior destruction. Fibrous compounds fix the pineal gland, causing joint blockage.
If the cartilage tissue under the influence of dystrophic processes is destroyed, the bone tissue tends to harden and grow.
Fixed joint of bones due to the germination of bone tissue is inside the joint bag. Deformation with bone ankylosis is persistent and motionless.
A characteristic sign by which it is possible to suspect the development of ankylosis is a motionless deformed joint. Often, the deformation develops in an unnatural position, “disadvantageous” for the patient. When you try to move in the joint, a complete loss of functionality is observed.
In the initial stages, stiffness in the joint is observed, accompanied by soreness and swelling. Gradually, the joint stops moving and the limb or fingers freeze in the position in which the first signs of fusion appeared.
With bone ankylosis, the joint is painless. The proliferation of connective tissue is accompanied by pain, if the joint can perform swinging movements. A small swelling accompanies the process. If the inflammatory process continues in the joint, the symptoms characteristic of the disease that led to ankylosis may persist.
Recognizing the pathology is easy. When examining the affected joint, a change in the shape of the joint bag and a complete lack of movement are observed. Of the hardware methods, radiography or computed tomography is prescribed, which will allow a detailed examination of degenerative changes in the joint.
Therapeutic measures are aimed at restoring joint mobility. There are conservative methods carried out with the help of physiotherapy and medications, and surgical treatment with the replacement of the joint with an artificial joint.
Of the drugs, non-steroidal anti-inflammatory drugs (Ketorolac, Diclofenac, Indomethacin) are prescribed to relieve pain and inflammation, but only a doctor can prescribe them. Steroid hormones (Hydrocortisone, Prednisolone) are introduced into the cavity of the damaged joint to prevent the pathogenic effect of pathogenic microorganisms.
Physiotherapeutic procedures are prescribed in the form of electrophoresis with drugs (lidocaine for pain relief, potassium iodide for resorption of connective tissue), therapeutic effects with laser rays.
If the joint has retained little mobility, a set of exercises is prescribed to develop the joint. This method is suitable for fibrous bone growth. Performing swinging joint movements for therapeutic purposes is carried out with preliminary anesthesia.
Bone ankylosis cannot be developed, in this case a surgical operation is indicated:
- Arthroplasty – forced separation of two bones with subsequent excision of overgrown tissues. Cartilaginous tissue is replaced with artificial layers, the field of which merges in the right direction. This method is well suited for the treatment of fibrotic ankylosis. A full restoration of functionality after the operation does not occur, but it is possible to carry out daily simple movements for personal care.
- Endoprosthetics – excision of a fused joint and its replacement with an artificial prosthesis. An operation can restore the joy of movement to a once-aching joint.
After surgical treatment, a long rehabilitation period follows. If rejection has not occurred, and the joint has taken root, after six months a person will be able to lead a normal lifestyle.
The main disadvantage of the operation is the high cost of the operation, for older people with heart disease, the need for anesthesia may become a contraindication, and no one can give a % guarantee that the prosthesis will take root.
In order for the joints to remain mobile, measures must be taken to prevent ankylosis:
- timely treat diseased joints;
- regular physical education;
- avoid injury;
- to carry out the development of joints after injury in the class of therapeutic exercises;
- preventive massage courses are recommended once every six months;
- in case of unpleasant discomfort in the joint, seek medical help immediately.
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