Coxarthrosis, or degenerative disease of the hip joint, is one of the most serious pathologies of the musculoskeletal system. Due to the large size of the joint structure, pain and discomfort are more serious than when other joints are affected. The pathological consequences are also severe - if the destruction of the small bone joint causes a lot of discomfort, then arthrosis of the hip joint without treatment is a direct route to deformity. Only proper therapy, and sometimes surgery, will help a person not to lose the ability to walk.
What is hip osteoarthritis?
Coxarthrosis, osteoarthritis, arthrosis of the hip joint are synonymous for the same pathological process that occurs in the thigh area on one or both sides. In modern medicine, the pathology is also called osteoarthritis: it was previously believed that inflammation was not a feature of the degenerative process, but more accurate studies have shown otherwise. The affected articular cartilage tissue releases inflammatory elements (interleukins), so osteoarthritis is another correct term.
The disease is characterized by symptoms such as:
- Keep going, going from one level to another,
- Leads to constant pain, limited joint mobility,
- Causes deformation of the bone surface, destruction of part or all of hyaline cartilage,
- At a later stage, it is more characteristic of the elderly, but usually begins after 40 years,
- Pathological symptoms are present in 70% of people over the age of 75,
- Women are more likely to get this disease.
Joints are mechanisms in which there are parts that rub. Due to a decrease in the quality or quantity of lubrication (interarticular fluid), the contact surface wears. Small cracks appear on the cartilage, then they are destroyed, and instead of healthy tissue, calluses appear. Such growth does not allow the foot to move normally, its function is lost.
Causes of disease development
Arthrosis of the right or left thigh area can be primary or secondary, and the first option is typical for the elderly. The primary form of the disease developed over several decades, associated with age -related wear and tear and cartilage destruction.
Secondary coxarthrosis has other causes and can start even in young people. It is associated with the resulting inflammation (infectious, autoimmune), which gives impetus to the onset of pathology. Also, the cause may be trauma to the hip (bruises, dislocations, fractures). Other possible causes of the secondary form:
- Operation on this anatomical zone,
- Diabetes mellitus and other serious metabolic pathologies,
- hormonal diseases,
- Congenital, acquired forms of curvature and bone displacement,
- hip dysplasia in children
- Acetabular protrusion, femoral head necrosis,
- Systemic vascular disease, leading to deterioration in cartilage nutrition,
- Bone tuberculosis, rheumatoid osteoarthritis,
- Gout, Perthes disease,
- Tumors are benign and malignant.
Symptoms of hip arthrosis in any form will appear more quickly if risk factors act on the body:
- Persistent stress, nervous shock, depression and anxiety,
- Obesity, even moderate overweight,
- unprofitable offspring,
- Physical inactivity, sedentary work or certain professions with a high load on the joints,
- Excessive physical load (strength), professional sports.
Symptoms of the disease
Developing arthrosis of the hip joint and its symptoms should not be ignored. Even in its early stages, the disease makes itself felt, and, above all, pain. Pain in emergent and progressive arthrosis of the hip joint increases as the disease progresses from one stage to another. They appear in the thigh area, give to the knees, to the groin, even to the lower abdomen. Usually after sleep, the pain subsides, but at a later stage it may be present all the time. On palpation, pain is not always felt, as joint damage can begin with the inner part.
Other possible signs of illness:
- The reflections that appear when moving, sometimes even with a little,
- Lameness, changes in gait,
- Shorten the leg on the side where there is arthrosis of the hip joint,
- Stiffness of movement, limited rotation, leg movement.
As the development progresses, other pathological signs appear. So, palpation gives a sense of bone deformation, the presence of growths. During the examination, the doctor noted muscle atrophy, and the patient, even in normal life, had to move with crutches, crutches - because of pain and weakness of the limbs.
In general, pain and other clinical manifestations are highly dependent on stage. There are stages of coxarthrosis such as:
- First.Symptoms are mild, but early changes are already noticeable at diagnosis. Synovial fluid becomes thicker, its volume decreases, the cartilage structure changes towards the end of the stage. Small cracks appear, which the body tries to heal with the formation of small "corns".
- Second.The pain at this stage is quite pronounced, crackling, restriction of motor function is obvious. The pain syndrome radiates to other parts of the body, spreading to the rest of the legs. The picture shows: thinning of cartilage, narrowing of the distance between the bones, violation of the structure of the articular surface, sometimes - displacement of the bone head from the cavity. The number of bone growths (osteophytes) increases.
- Third.The pain becomes unbearable, one’s movement is very limited, many stop moving altogether. Cartilage is almost completely destroyed, muscles atrophy, joints are severely deformed. Bone osteophytes look like spikes and irritate nerve endings.
What are the risks and complications?
It is easy to understand that if, with a pathology such as arthrosis of the hip joint, symptoms and treatment are determined incorrectly, out of time, this threatens disability. Painful pain syndrome, inability to walk, the need for constant care - this is what awaits a person without treatment for this disease.
Defects in case of damage to the femur are established according to the severity of the disease, in the complete absence of opportunities for work, they give the first group. Such patients are indicated surgery - this is the only effective method of treatment in such conditions. But modern methods of operation can carry the risk of complications:
- contagious infections,
- thrombosis, thrombus embolism,
- Significant blood loss.
The overall proportion of complications is small - 0. 5-2%, but it happens. Often, there is an infection on the prosthesis, which then needs to be replaced with a new one. That is why after surgery it is important to carry out a course of treatment with antibiotics.
Diagnostic measures for arthrosis
It is recommended to seek help from a traumatologist, surgeon, orthopedist already at the first signs of damage to the femoral zone. Initially, if hip arthrosis is suspected, the doctor performs a physical exam:
- Feel the upper thighs, revealing pain points, bone osteophytes,
- Perform passive leg movements - flexion, extension, abduction and extension to determine the possible range of motion.
Instrumental diagnostics will help make a more accurate diagnosis and prescribe treatment for hip arthrosis. Radiography is usually performed - the cheapest and most available research method. It is recommended to take X-rays on modern devices, or replace them with CT scans, where the image quality is higher. CT provides comprehensive information on the condition of bones, cartilage, articular surfaces. If a detailed study of the soft tissue condition is needed (e. g. , when a nerve root is pinched), the specialist will prescribe an MRI.
Other possible diagnostic steps:
- joint ultrasound,
- arthroscopy,
- Blood tests for rheumatoid factors,
- tuberculin test,
- Biochemical analysis for suspected diabetes mellitus, gout.
It is very important to find the cause of secondary coxarthrosis, because without affecting it, it is impossible to stop the course of the disease.
Treatment of arthrosis of the hip joint - medications and physiotherapy
If the symptoms of the disease are implicit, and it does not pass the stage of irreversible change, conservative treatment will help the patient. Drug therapy will also be needed when the arthrosis of the hip joint has become severe - as part of the course of treatment.
How to treat hip arthrosis? There are drug correction programs for this disease:
- Non-steroidal anti-inflammatory drugs. Pills or injections will help relieve pain, inflammation. They should not be used uncontrollably - the cartilage’s own ability to regenerate will be reduced, moreover, the stomach and intestines suffer greatly from NSAIDs.
- Vascular medicine. Treatment in such a way helps to strengthen the nutrition of the cartilage and contributes to its recovery.
- Relax your muscles. Indicated for spastic pain in muscles caused by damage to the thigh area.
- Chondroprotectors. Osteoarthritis of the hip joint requires mandatory and months of taking such medications. It is also necessary to apply the form of injections in the course, including injections into the joint cavity. A more effective technique is the introduction of a hyaluronic acid preparation into the joints.
- Corticosteroids. Used in extreme cases in the form of intra-articular injections. Such treatment is necessary if symptoms become unbearable.
External agents (ointments, gels) for coxarthrosis are usually ineffective due to the deep location of the joint. But physiotherapy techniques are often used and provide serious relief from pain. UHF, laser therapy, magnetotherapy performed on the thigh area, UHF, massage performed. Also, with osteoarthritis, manual therapy is indicated, in some cases - joint traction.
Folk remedies for arthrosis
Many people use alternative treatments for this pathology, although arthrosis of the hip joint does not respond well to a variety of external methods. Only with a strong pain syndrome can compress with insulation applied to the sore spot, although this will be even more annoying. Treatment of complicated and advanced hip arthrosis is best done with oral medications:
- Pour 100 g of dried cinquefoil grass with 500 ml of vodka, insist in the dark for 10 days, take 30 drops three times a day to relieve inflammation,
- Make jelly every day, if there are no contraindications, always prepare jelly - the dish will serve no worse than chondroprotectors.
You can relieve pain with the help of such compresses. It is necessary to evenly mix honey, medicinal bile, ammonia, glycerin, apply on the joints, tie with a warm cloth. Leave the compress on for 3 hours, then rinse.
Other methods and operations
For the full treatment of osteoarthritis, it is very important to follow a proper diet, you need to leave out foods that interfere with the blood supply and affect the nutrition of the cartilage. These are smoked meats, vinegar, salty foods, fried foods, as well as foods with preservatives, trans fats. But there should be more meals with magnesium, potassium, iodine, calcium in the diet.
What is necessary to treat hip joint arthrosis is therapeutic exercise. Daily warm -up, special exercises in the supine position should be performed by all patients. For example, you need to slowly lift your leg and hold it on the floor for a few seconds. It is important to exclude sudden movements, to avoid long and fast walks - with coxarthrosis, this will only increase the progression of the disease. To unload the joints, you can use crutches, crutches, and orthopedic specialists can also recommend special orthoses to reduce the load.
Treatment of arthrosis of the third hip joint, the last stage is carried out only with the help of surgery, other methods are ineffective. In 95% of cases, the operation is successful, leg movement is fully restored. But prostheses are not permanent, their service life is up to 20 years, so surgery is a last resort. During arthroplasty, your own joint is replaced with an artificial joint, and arthrosis of the hip joint no longer threatens it.
Prevention of coxarthrosis
In order not to carry out complex pathological treatment, not to suffer from pain syndrome, it is important to start preventive measures from an early age. Prevention of coxarthrosis is especially important for those exposed to risk factors.
So that the blood supply to the cartilage is not affected, you should:
- Eat by including plant foods in the menu, adequate amounts of lean meats, cottage cheese, jellies, sour-milk foods,
- Quit smoking, don't abuse alcohol,
- During sedentary work, warm up regularly, do simple exercises,
- Leave the sedentary lifestyle and favor skiing, swimming and other low -intensity aerobic activities.
In order for a person not to be bothered by arthrosis of the hip joint, one should control weight, prevent obesity and the appearance of even 5-10 extra pounds - this seriously increases the load on the femoral area. Coxarthrosis can be prevented only with an integrated approach and a healthy lifestyle!