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 articular structures, the pain and discomfort is much more serious than when other joints are affected. The consequences of the pathology are also severe - if the destruction of small bone joints causes a lot of discomfort, then arthrosis of the hip joint without treatment is a direct path to disability. Only the right 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 synonyms for the same pathological process that occurs in the thigh area on one or both sides. In modern medicine, pathology is also called osteoarthritis: it was previously believed that inflammation was not characteristic of degenerative processes, but more accurate studies have shown the opposite. Affected articular cartilage tissues release inflammatory elements (interleukins), so osteoarthritis is another correct term.
The disease is characterized by such signs:
- Steadily progresses, passing from one stage to another,
- Leads to persistent pain, limited joint mobility,
- Causes deformation of bone surfaces, partial or complete destruction of hyaline cartilage,
- In the advanced stage, it is more characteristic of the elderly, but often starts after 40 years,
- Symptoms of pathology are present in 70% of people over 75 years old,
- Women are more likely to suffer from 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 of the region of the right or left thigh can be primary or secondary, and the first option is typical for elderly people. The disease of the primary form develops over decades, is associated with age-related wear and tear and destruction of cartilage.
Secondary coxarthrosis has other causes and can start even in a young person. It is associated with the resulting inflammation (infectious, autoimmune), which gives impetus to the onset of pathology. Also, the cause may be a trauma to the hip (bruise, dislocation, bone fracture). Other possible causes of the secondary form:
- Operations on this anatomical zone,
- Diabetes mellitus and other serious metabolic pathologies,
- 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 the nutrition of cartilage,
- Bone tuberculosis, rheumatoid osteoarthritis,
- Gout, Perthes disease,
- Tumors are benign and malignant.
Symptoms of arthrosis of the hip joint of any form will appear faster if risk factors act on the body:
- Constant stress, nervous shocks, depressions and worries,
- Obesity, even moderate overweight,
- unfavorable heredity,
- Physical inactivity, sedentary work or certain professions with a high load on the joint,
- Excessive physical (strength) loads, professional sports.
Symptoms of the disease
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. Pain in the emerging 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 knee, to the groin, even to the lower abdomen. Usually after sleep, the pain subsides, but at an advanced stage it may be present all the time. On palpation, pain is not always felt, because joint damage can begin with deeply located parts.
Other possible signs of the disease:
- The crunch that appears when moving, sometimes even with a slight,
- Limping, change in gait,
- Shortening of the leg on the side where there is arthrosis 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, is forced to move with a cane, a crutch - due to pain and weakness of the limb.
In general, pain and other clinical manifestations are highly dependent on the stage. There are such stages of coxarthrosis:
- First.Symptoms are mild, but initial changes are already noticeable during diagnosis. The synovial fluid becomes thicker, its volume decreases, the structure of the cartilage changes towards the end of the stage. Small cracks appear, which the body tries to heal with the formation of small "corns".
- Second.Pain at this stage is quite noticeable, crunching, restriction of motor function is obvious. The pain syndrome radiates to other parts of the body, spreads down the entire 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 head of the bone from the cavity. The number of bone growths (osteophytes) is increased.
- Third.The pain becomes unbearable, a person is severely limited in movement, many stop moving altogether. The cartilage is almost completely destroyed, the muscles atrophy, the joint is severely deformed. Bone osteophytes look like spikes and irritate the nerve endings.
What are the risks and complications?
It is easy to understand that if, with such a pathology as arthrosis of the hip joint, the symptoms and treatment are determined incorrectly, out of time, this threatens with disability. Excruciating pain syndrome, inability to walk, the need for constant care - this is what awaits a person without treatment for this disease.
Disability in case of damage to the bones of the thigh is established according to the severity of the disease, with the 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 methods of operations can carry the risk of complications:
- infectious infection,
- thrombosis, thrombus embolism,
- Significant blood loss.
The overall proportion of complications is small - 0. 5-2%, but they do occur. Most often, there is an infection of the prosthesis, which then has to be replaced with a new one. That is why after the operation 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 conducts physical tests:
- Feels the upper part of the thigh, reveals points of pain, 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. Radiography is usually performed - the cheapest, available research method. It is recommended to take an x-ray on modern devices, 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 soft tissues is required (for example, when 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 will not be possible to stop the course of the disease.
Treatment of arthrosis of the hip joint - medicines and physiotherapy
If the signs of the disease are implicit, and it has not passed to the stage of irreversible changes, conservative treatment will help the patient. Drug therapy will also be needed when arthrosis of the hip joint has become severe - as part of a course of treatment.
How to treat arthrosis of the hip joint? There is a program of drug correction of the disease:
- Non-steroidal anti-inflammatory drugs. Pills or injections will help get rid of pain, inflammation. They cannot be used uncontrollably - the cartilage's own ability to regenerate will decrease, moreover, the stomach and intestines suffer greatly from NSAIDs.
- Vascular drugs. Treatment with such means helps to strengthen the nutrition of cartilage and contributes to its restoration.
- Muscle relaxants. Indicated for spastic pain in the muscles caused by damage to the thigh area.
- Chondroprotectors. Osteoarthritis of the hip joint requires mandatory and many months of taking such medications. It is also necessary to apply 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 if the 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 give serious relief from pain. UHF, laser therapy, magnetotherapy are done on the thigh area, UHF, and massage are performed. Also, with osteoarthritis, manual therapy is indicated, in some cases - joint traction.
Folk remedies for arthrosis
Many people use alternative treatment for this pathology, although arthrosis of the hip joint does not respond well to various external methods. Only with a strong pain syndrome can compresses with insulation be applied to the sore spot, although this will be more distracting. Treatment of complicated and advanced arthrosis of the hip joint is best done with oral medications:
- Pour 100 g of dry 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, in the absence of contraindications, regularly prepare jelly - dishes will serve no worse than chondroprotectors.
You can relieve pain with the help of such a compress. It is necessary to equally mix honey, medical bile, ammonia, glycerin, apply to the joint, tie with a warm cloth. Leave the compress on for 3 hours, then rinse.
Other methods and operation
For the full treatment of osteoarthritis, it is very important to follow the right diet, you will have to give up food that disrupts blood supply and impairs 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, calcium in the diet.
What it is necessary to treat arthrosis of the hip joint is therapeutic exercises. Daily warm-ups, special exercises in the supine position should be carried out by all patients. For example, you need to slowly raise your leg up and hold it above the floor for a few seconds. It is important to exclude sudden movements, to avoid long and fast walking - with coxarthrosis, this will only increase the progression of the disease. To unload the joint, you can use a cane, crutches, and an orthopedist can also recommend special orthoses to mitigate the load.
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 restored in full. But prostheses are not eternal, their service life is up to 20 years, so the operation is a last resort. During arthroplasty, your own joint is replaced with an artificial one, and arthrosis of the hip joint no longer threatens him.
Prevention of coxarthrosis
In order not to carry out complex treatment of pathology, 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 who are exposed to risk factors.
So that the blood supply to the cartilage does not suffer, you should:
- Eat with the inclusion of plant foods in the menu, a sufficient amount of lean meat, cottage cheese, jelly, sour-milk food,
- Stop smoking, do not abuse alcohol,
- At 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 disturbed by arthrosis of the hip joint, one should control body 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!