Arthrosis of the hip joint (coxarthrosis) is a chronic, gradually progressive disease. Failure to provide timely and correct treatment can lead to complete loss of motion. The end indicates that there is not an inflammatory, but a degenerative process.
The symptoms of this disease vary depending on the stage. To begin with, this is a barely noticeable discomfort that occurs while walking and exercising. Possibly manifestation in the form of slight pain in the hip region, which disappears at rest. In this case, pain can be felt not only in the thigh, but also in the groin or knee.
Coxarthrosis is usually a process that has lasted for many years and is characterized by gradual change in the cartilage, followed by deformation of the bones and loss of joint functionality. It mainly affects people after 40 years of age, but also very young patients.
Causes of occurrence
Why does osteoarthritis of the hip joint occur and what is it? The causes of coxarthrosis can be different, but the picture of the disease is always the same. It all starts with a change in the articular cartilage, which is thinning and losing its ability to take loads. The body compensates for the layering of cartilage tissue by creating bone growth along the edge of the articular surfaces, which leads to deformation of the joints and bones to varying degrees.
The main causes of this joint disease:
- Injuries. Such a cause may not be a major lesion, but in many cases the development of the disease is influenced by chronic microtraumas that contribute to the cracking and thinning of the cartilage. They also affect the rupture of the joint capsule, which leads to the accumulation of many injuries. Often, repetitive microtrauma is a precursor to the occurrence of such a disease.
- Excessive loads, which lead to systematic microtraumas and joint injuries. Most often it occurs in people who are involved in hard physical work or professional athletes. In this case, treatment without lifestyle changes or physical activity restrictions is also ineffective and often associated with relapse.
- Hereditary disposition. These include abnormalities in the development of the femoral head itself, underdevelopment of the articular elements, etc. In this case, so-called dysplastic arthrosis of the hip joint occurs.
- Diseases. For example, if not properly treated, arthritis can develop into osteoarthritis over time. This is due to the fact that during arthritis, the properties of cartilage tissue change and blood circulation is impaired. This gradually leads to the development of a degenerative process.
- Overweight. Excessive body weight, even when walking, puts stress on the joints that exceeds their physiological strength limits.
Depending on the cause of the disease and its pathogenesis, there are two main types of osteoarthritis of the hip joint.
- Primary coxarthrosis. In this case, the disease develops very slowly and begins with a violation of the blood supply to the tissues. The reasons for the development of this type of osteoarthritis lie in metabolic disorders, which are more common in people over 50 years of age. Primary osteoarthritis of the hip joint is the most commonly diagnosed.
- Secondary coxarthrosis. In this case, the disease develops against the background of systemic inflammatory lesions of many joints in the body. Inflammation can be both infectious and autoimmune.
In the initial stage of coxarthrosis, patients are only concerned with minor pain or discomfort in the articulation area. Often times, such signs are ignored, so the disease progresses.
Symptoms of osteoarthritis of the hip joint
Coxarthrosis of the hip joint, the symptoms of which cannot be ignored, can have serious consequences. There are several main signs of the disease, depending on the stage of the disease:
- Pain in the joint area is the most obvious symptom with which a hip joint disease can be assumed. The intensity and nature of the sensations usually depend on the stage.
- The limitation of mobility of the limbs is also a symptom of coxarthrosis. The early stage is characterized by a feeling of "stiffness" of the joint that disappears after some effort.
- A weakening of the thigh muscles can be observed as early as the second stage of the disease and extends to the third stage to complete the atrophy.
- Changes in leg length due to pelvic deformities are characteristic of "advanced" osteoarthritis.
- Lameness or changing gait are very likely signs of bone deformity.
- A clear crunch in the joint is not always a sign of osteoarthritis. Usually considered when other symptoms are present.
The main symptom of coxarthrosis is pain, the type, duration, location and intensity of which depend on the stage of the disease.
Arthrosis of the hip joint 1 degree
This stage of the disease is characterized by pain in the joint and hip, sometimes in the knee, that appear after physical exertion and subside after rest. The mobility of the joints is not restricted and there are no gait disorders.
Coxarthrosis 1st degree is the initial stage of the disease, the treatment of which begins. It is still possible to stop the process of destruction and deformation of the joint and fully retain its functions. Unfortunately, due to mild joint pain, many do not find it necessary to see a doctor while the disease has progressed in the meantime.
Arthrosis of the 2nd degree hip joint
It seems clearer - the pain intensity increases, it does not only occur after training, but there is also a restriction in motor functions at rest. In particular, coxarthrosis is characterized by difficulties in pronation (internal rotation of the hip) and abduction, and a contracture forms.
The X-ray examination shows a narrowing of the joint space and the appearance of bone growth on the surfaces. The acetabulum and femoral head are deformed. The muscles of the thigh begin to atrophy on the side of the lesion, and the pain syndrome spreads downward, encompassing both the knee joint and the groin (it is important to understand that this is not accompanied by degenerative changes in the knee joint).
3rd degree hip arthrosis
The signs of the disease are pronounced and permanent. The pain syndrome catches up at night. The patient uses the support when walking. The muscles of the lower leg and upper leg gradually atrophy, and a sick person's diseased leg becomes much shorter.
Often the joint space disappears completely from the 3rd degree and the joints grow together into a single bony structure. This is shown in the photo. As a result, complete immobility of the joint occurs.
X-rays show extensive bone growth from the roof of the acetabulum and femoral head, a sharp narrowing of the joint space. The femoral neck is significantly widened and shortened.
Diagnosis
Before figuring out how to treat arthritis of the hip joint, you need to make a correct diagnosis. If coxarthrosis is suspected, a person is referred for a biochemical blood test - if disease is present, patients have a slight increase in ESR, globulins, immunoglobulins and seromucoids.
The next step in detecting osteoarthritis is an X-ray. The following is displayed:
- Cartilage ossification,
- Bone growth at the cartilage border,
- reduces the distance between the joints,
- Thickening of the bone tissue under the cartilage.
Unfortunately, the x-ray photo does not allow you to see the joint capsule and cartilage itself. If information about these soft tissues needs to be obtained, the patient is referred for tomography.
Treatment of osteoarthritis of the hip joint
When diagnosing osteoarthritis of the hip joint, treatment depends directly on the stage in which the disease is. The general treatment regimen provides for the achievement of the following goals:
- eliminates pain and discomfort in the area of the painful joint;
- adjust the nutrition of the intra-articular cartilage and start the process of its recovery;
- eliminates the lack of intra-articular fluid;
- activates microcirculation in the tissues of the joint;
- eliminates the increased stress on the hip joint;
- strengthens the muscles that surround, protect and support the joint;
- prevents deformation and increases the mobility of the hip joint.
All of this can only be achieved with the help of an integrated approach that should include not only drug therapy but lifestyle changes to eliminate the risk factors for coxarthrosis.
- In the third stage of the disease, treatment includes surgery in which the joint is replaced with an endoprosthesis while part of the prosthesis is implanted in the femur and part in the pelvic bone. The operation is quite complicated, time consuming, and requires a long period of rehabilitation.
- For degrees of arthrosis I and II of the hip joint, the treatment is carried out without surgery. Uses: nonsteroidal anti-inflammatory drugs, muscle relaxants, chondroprotectors, vasodilators, hormonal steroid drugs, topical drugs - ointments, lotions, compresses.
All of these drugs are prescribed exclusively by the attending physician. Some are effective by injecting directly into the affected joint area. Such injections can only be given by qualified medical personnel. Self-medication is therefore strictly not recommended.
Non-drug methods
In addition to drug use, doctors also recommend non-drug methods of treating the disease. These include the following treatments for this disease:
- physiotherapy;
- massage;
- common breeding;
- diet.
Physiotherapy for osteoarthritis includes the following treatments:
- magnetic field therapy;
- UHF and ultrasound therapy;
- Aeroion and electrotherapy;
- inductothermia;
- light therapy;
- Application of laser technology.
All of these methods can only be used to improve the blood supply to the joints and relieve cramps.
drug therapy
The combined treatment of hip osteoarthritis includes the appointment of the following groups of drugs:
- Non-steroidal anti-inflammatory drugs, all relieve pain, reduce inflammation, but do not restore cartilage tissue.
- Chondroprotectors. Nutritional preparations for cartilage. Accelerate your recovery. Important in the 1st 2 phase of osteoarthritis treatment. In grade 3 of the disease, the cartilage is already destroyed and these drugs are useless. It takes a long time to take medication and take multiple courses.
- Muscle relaxantseliminate muscle cramps in the area of diseased joints and improve the blood supply to the tissue.
- Ointments and creams. Healing ointments are means of relieving the condition of a sick person, but they do not contribute to full recovery. Warming ointments work well. They irritate the skin receptors and thereby relieve pain. Warming ointments also work to restore increased blood flow to the tissues and muscles around the affected joint.
- Injections of steroids into the joint cavity, injections of these drugs are prescribed to relieve the exacerbation of the disease and get rid of severe pain.
- Vasodilatorsexpand blood vessels in and around the joint cavity, thereby improving the supply of nutrients that are required for tissue repair.
You don't have to rely on folk remedies. However, some healers recommend the tincture of lemon, garlic, or celery root for treating joints and bones.
Massage in the treatment of coxarthrosis
In the case of deforming osteoarthritis of the hip joint, the massage treatment delivers good results. Massage against coxarthrosis is a very effective and useful method. It is advisable to have the massage done by a good specialist and as often as possible.
Its action is aimed at improving blood circulation, strengthening muscles, relieving painful cramps, swelling and muscle tension, as well as increasing diastasis between the articular elements of the joint.
In the absence of a professional masseur, the massage can be done by yourself. The arthrosis massage can be carried out both manually and with the help of various massage devices and even a water jet (hydrokinesis therapy).
Gymnastics
The treatment of osteoarthritis of the hip joint through physical education consists in achieving two goals: increasing the mobility of the legs and preventing muscle wasting. All standard complexes of exercise therapy for coxarthrosis also have a general strengthening character and have a positive effect on the entire body.
The complex of gymnastic exercises is prescribed by a specialist. The first physical therapy sessions should be supervised by a doctor. He will show you how to correctly perform every movement and monitor the correct load on the hip joints.
Diet
Important recommendations:
- prefer porridge on the water.
- Eat enough animal protein: fish (except salted), poultry, beef.
- Eat at least 5 servings of vegetables per day (one serving is 100 grams, can be used as a side dish).
- Dairy products are required: cottage cheese, yogurt, fermented baking milk.
- Eliminate alcohol, coffee, and strong black tea.
- Eliminate sweet, starchy foods.
- Eat small but frequent meals.
The diet reduces the stress on the hip joints and provides them with everything that is necessary for tissue repair.