Coxarthrosis or degenerative disease of the hip joint is one of the most serious pathologies of the musculoskeletal system. Because of the size of the joint structures, the pain and discomfort is much more severe than when other joints are involved. The consequences of pathology are also serious - if the destruction of small bone joints causes great discomfort, then without treatment, arthrosis of the hip joint is a direct path to disability. Only the right therapy, sometimes an operation, helps to keep the ability to walk.
What is hip osteoarthritis?
Coxarthrosis, arthrosis, arthrosis of the hip joint are synonyms for the same pathological process that occurs in the thigh area on one or both sides. In modern medicine, the pathology is also called arthrosis: it was previously believed that inflammation was not characteristic of degenerative processes, but more detailed studies have shown the opposite. Affected articular cartilage releases inflammatory elements (interleukins), so osteoarthritis is another correct term.
The disease is characterized by such signs:
- progresses steadily, passing from one stage to another,
- Leads to persistent pain, reduced mobility of joints,
- Causes deformation of bone surfaces, partial or complete destruction of hyaline cartilage,
- In the advanced stage, it is more characteristic of older people, but often begins only after 40 years,
- Pathological symptoms occur in 70% of those over 75 years old,
- Women are more often affected by the disease.
A joint is a mechanism in which there are rubbing parts. Due to a decrease in the quality or quantity of lubrication (interarticular fluid), the contact surfaces wear out. Small cracks appear on the cartilage, later they are destroyed, and instead of healthy tissue, a callus appears. Such growths do not allow the leg to move normally, its functions are lost.
Reasons for the development of the disease
Arthrosis in the area of the right or left thigh can be primary or secondary, and the first option is typical for older people. The primary form of the disease develops over decades and is associated with age-related wear and tear and cartilage destruction.
Secondary coxarthrosis has other causes and can begin in young people. It is associated with the resulting inflammation (infectious, autoimmune), which stimulates the onset of pathology. The cause can also be hip trauma (bruise, dislocation, fracture). Other possible causes of secondary mold:
- operations on this anatomical zone,
- Diabetes mellitus and other serious metabolic diseases,
- hormonal diseases,
- congenital, acquired forms of curvature and displacement of bones,
- Hip dysplasia in a child
- protrusion of the acetabulum, necrosis of the femoral head,
- Vascular diseases of a systemic nature, leading to a deterioration in cartilage nutrition,
- bone tuberculosis, rheumatoid osteoarthritis,
- gout, Perthes disease,
- Tumors are benign and malignant.
Symptoms of osteoarthritis of the hip joint of any form appear faster when risk factors act on the body:
- Constant stress, nervous shocks, depression and worries,
- obesity, even moderate overweight,
- unfavorable heredity,
- Lack of exercise, sedentary work or certain jobs with high joint strain,
- Excessive physical (strength) stress, professional sports.
symptoms of the disease
A developing arthrosis of the hip joint and its symptoms cannot be overlooked. Even at an early stage, the disease makes itself felt and, above all, pain. The pain associated with developing and progressing arthrosis of the hip joint increases as the disease progresses from one stage to another. They appear in the thigh area, reach to the knee, to the groin, even to the lower abdomen. The pain usually subsides after sleeping, but in advanced stages it can be constant. Pain is not always felt on palpation, since joint damage can begin with deep-lying parts.
Other possible signs of the disease:
- The crunch that occurs when moving, sometimes even with a slight,
- limping, changing gears,
- leg shortening on the side of osteoarthritis of the hip joint,
- Stiffness of movements, limited rotation, movement of the leg.
As development progresses, other signs of pathology appear. So, palpation gives a feeling of deformation of the bone, the presence of growths. During the examination, the doctor notes muscle atrophy, and the patient, even in ordinary life, has to move with a cane, a crutch - due to pain and weakness of the limbs.
In general, pain and other clinical manifestations are highly stage dependent. There are such stages of coxarthrosis:
- First.The symptoms are mild, but the first changes are already noticeable during the diagnosis. The synovial fluid thickens, its volume decreases, the structure of the cartilage changes towards the end of the stage. Small cracks develop, which the body tries to heal by forming small "corns".
- Second.Pain at this stage is clearly felt, crunching, restriction of motor function is obvious. The pain syndrome radiates to other parts of the body, spreads throughout the leg. The picture shows: thinning of the cartilage, narrowing of the distance between the bones, violation of the structure of the articular surfaces, sometimes - displacement of the bone head from the cavity. The number of bone growths (osteophytes) is increased.
- third partyThe pain becomes unbearable, a person is severely limited in movement, many stop moving. The cartilage is almost completely destroyed, the muscles atrophy, the joint is 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, the symptoms and treatment are incorrectly determined too late, then this threatens with disability. Excruciating pain syndrome, inability to walk, constant need for care - this is what awaits a person without treatment of this disease.
Disability with damage to the femurs is determined by the severity of the disease, with a complete absence of the opportunity to work, they give the first group. Such patients are shown surgery - this is the only effective method of treatment in such a situation. But even modern surgical methods can harbor the risk of complications:
- contagious infection,
- thrombosis, thrombus embolism,
- Significant blood loss.
The overall percentage of complications is small - 0. 5-2%, but they do occur. Most often, the prosthesis becomes infected, which then has to be replaced with a new one. That is why it is important to have antibiotic treatment after the operation.
Diagnostic measures in arthrosis
It is recommended to seek help from a traumatologist, surgeon or orthopedist at the first signs of damage to the femoral zone. If osteoarthritis of the hip is suspected, the doctor will first carry out physical examinations:
- Palpates upper thigh showing pain points, bone osteophytes,
- Performs passive leg movements - flexion, extension, abduction and adduction to determine the range of possible movements.
Instrumental diagnostics will help to make a more accurate diagnosis and prescribe treatment for arthrosis of the hip joint. As a rule, radiography is performed - the cheapest available research method. With modern equipment, it is recommended to take an X-ray or replace it with a CT scan, where the quality of the images is much higher. CT provides comprehensive information about the condition of bones, cartilage, articular surfaces. If a detailed study of the condition of the soft tissues is required (for example, if a nerve root is pinched), the specialist will prescribe an MRI.
Other possible diagnostic measures:
- joint ultrasound,
- arthroscopy,
- blood test for rheumatoid factor,
- tuberculin tests,
- 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 osteoarthritis of the hip joint - medication and physiotherapy
If the signs of the disease are implicit, and the stage of irreversible changes has not yet been reached, then conservative treatment will help the patient. Drug therapy is also required for severe arthrosis of the hip joint – as part of a cure.
How is osteoarthritis of the hip joint treated? There is a program for drug correction of the disease:
- Non-steroidal anti-inflammatory drugs. Pills or injections will help get rid of pain and inflammation. They cannot be used uncontrolled – the cartilage's ability to regenerate itself decreases, and the stomach and intestines also suffer greatly from NSAIDs.
- vascular drugs. Treatment with such funds will help strengthen the nutrition of the cartilage and contribute to its restoration.
- muscle relaxants. Indicated for spastic pain in the muscles caused by damage in the thigh area.
- chondroprotectors. Arthrosis of the hip joint requires the mandatory and long-term intake of such drugs. It is also necessary to use injectable forms in courses, including injection into the joint cavity. An even more effective technique is the introduction of hyaluronic acid preparations into the joint.
- corticosteroids. Used in extreme cases in the form of intra-articular injections. Such treatment is necessary when the symptoms become unbearable.
External remedies (ointments, gels) for coxarthrosis are mostly ineffective due to the deep location of the joint. But physiotherapeutic techniques are often used and seriously relieve the pain. UHF, laser therapy, magnetic therapy are performed in the thigh area, UHF, massage are performed. Also, with arthrosis, manual therapy is indicated in some cases - joint traction.
Folk remedies for osteoarthritis
Many people use alternative treatment for this pathology, although osteoarthritis of the hip joint does not respond well to various external methods. Only with a strong pain syndrome, compresses with insulation can be put on the sore spot, but this is more annoying. Treatment of complicated and advanced arthrosis of the hip joint is best done with oral medications:
- Pour 100 g of dry cinquefoil with 500 ml of vodka, insist 10 days in the dark, take 30 drops 3 times a day to relieve inflammation.
- Make jelly every day, if there are no contraindications, prepare jelly regularly - dishes are no worse than chondroprotectors.
With the help of such a compress, you can relieve pain. It is necessary to evenly mix honey, medicinal bile, ammonia and glycerin, apply to the joint and tie with a warm cloth. Leave the compress on for 3 hours and then rinse.
Other methods and operation
Proper nutrition is very important for the full treatment of arthrosis, you need to abandon foods that disrupt blood circulation and affect cartilage nutrition. These are smoked meats, vinegar, salty foods, fried foods, as well as foods with preservatives, trans fats. But there should be more dishes with magnesium, potassium, iodine and calcium in the diet.
What is necessary for the treatment of arthrosis of the hip joint is therapeutic exercises. Daily warm-up exercises, special exercises in the supine position should be performed by all patients. For example, you need to slowly raise your leg and keep it off the floor for a few seconds. It is important to exclude sudden movements, to avoid long and fast walking - with coxarthrosis, this will only accelerate the progression of the disease. You can use a cane and crutches to relieve the joint, and an orthopedist may also recommend special orthotics to relieve the stress.
Treatment of arthrosis of the hip joint of the third, last stage is carried out only with the help of surgery, other methods are ineffective. In 95% of cases, the operation is successful, leg movements are fully restored. But prostheses are not eternal, their lifespan is up to 20 years, so surgery is the last resort. With endoprosthetics, your own joint is replaced by an artificial one and there is no longer any risk of arthrosis of the hip joint.
Prevention of coxarthrosis
In order not to carry out complex treatment of the pathology and not suffer from pain syndrome, it is important to start preventive measures at an early stage. Prevention of coxarthrosis is especially important for those who are exposed to risk factors.
So that the blood circulation in the cartilage does not suffer, you should:
- With the inclusion of plant foods in the menu, eat a sufficient amount of lean meat, cottage cheese, jelly, sour milk food,
- stop smoking, do not abuse alcohol,
- With sedentary work, regularly warm up, do simple exercises,
- Give up a sedentary lifestyle in favor of 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 body weight, prevent obesity and the appearance of even 5-10 pounds - this significantly increases the load on the thigh area. Coxarthrosis can only be prevented with a holistic approach and a healthy lifestyle!