Cartilage damage in the ankle joint
When the "shock absorber" suffers
The ankle takes a heavy load every day – with every step, several times body weight bears on a comparatively small joint surface. So that these loads can be cushioned, the joint surfaces are covered with smooth, elastic cartilage. This tissue acts like a shock absorber and allows the parts of the joint to glide over each other with little friction.
Cartilage damage in the ankle joint means that this protective gliding surface is partly or completely destroyed. The bone underneath, the joint capsule and neighbouring structures can be affected as well.
Causes of cartilage damage
Cartilage damage can arise from various triggers
- Injuries or inversion injuries (with a torn ligament, for example)
- Fragments of bone broken off in an accident (osteochondral lesions)
- Chronic overloading, for instance with deformity, instability or intensive sport
- A disturbed blood supply to the talus (avascular necrosis of the talus)
- The early stage of osteoarthritis
Symptoms
Cartilage damage often develops gradually and goes unnoticed at an early stage, because cartilage has no direct blood supply and is not sensitive to pain. Symptoms only appear once the damage reaches deeper, the adjoining bone is affected or inflammation sets in.
Pain
Pain occurs above all when walking, running or after longer activity. At first only after loading, later at rest as well.
Swelling
After sporting or everyday activity the joint can swell – caused by irritation of the joint lining or a build-up of fluid in the joint.
Locking
Fragments of cartilage or bone (loose bodies) in the joint can cause sudden catching, locking or snapping with certain movements.
When should you see a doctor?
Cartilage damage in the ankle often develops gradually. At first the symptoms are usually non-specific – but the longer a defect goes untreated, the greater the risk of lasting damage to the joint.
You should always have your ankle assessed by a doctor if you have repeated or persistent pain, if the joint swells regularly, or if your movement becomes restricted. A feeling of catching or locking with certain movements can also point to cartilage damage. The same applies if you can no longer load the joint without pain after an injury.
The sooner the cause is identified and treated specifically, the better the chances of preventing consequences such as osteoarthritis of the joint.
Treatment options for cartilage damage in the ankle joint
Treatment depends on the extent, position and depth of the cartilage damage, and on age and activity level. The aim is to reduce the pain, keep the joint functional for as long as possible and avoid or delay osteoarthritis – particularly in young, active patients.
Treatment options
Non-surgical and surgical – we will find the right approach for you
Rest and reducing the load
Avoiding jumping and impact loads, if necessary crutches for a time or a reduction in sporting activity
Physiotherapy
Building up the muscles that stabilise the joint, training movement patterns and improving coordination.
Pain relief and anti-inflammatory treatment
With NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen or diclofenac, for example.
Individually made insoles or supports
To take mechanical load off the affected area.
PRP treatment (autologous conditioned plasma)
ACP treatment (autologous conditioned plasma) is a modern, biological method that supports healing in cartilage damage, osteoarthritis and joint inflammation. Blood is taken from the patient, prepared and injected specifically into the affected joint.
Arthroscopic debridement
Rough, frayed cartilage is smoothed and loose parts removed. The aim: to reduce mechanical irritation and stop the joint catching.
Microfracture (bone marrow stimulation)
Small holes are made in the bone beneath the defect in order to let stem cells in from the bone marrow. These form a replacement fibrous cartilage.
Minced cartilage
The minced cartilage technique is an innovative, biological method for treating locally limited cartilage defects – in the ankle joint as well. It is an alternative to classic cartilage cell transplantation, particularly for small and medium-sized defects.
Chondro-Gide® for cartilage damage
Chondro-Gide® is a special, biodegradable two-layer membrane used in surgical cartilage treatment – particularly in combination with autologous chondrocyte implantation (ACI) or matrix-assisted ACI (MACI). It can also be used to support other methods such as microfracture.
Our foot specialists
Experienced consultants for cartilage damage and foot surgery
