Osteoarthritis of the hip joint

coxarthrosis(Osteoarthritis of the hip joint) is a type of deforming osteoarthritis of the joints, which is a chronic, non-inflammatory disease affecting the hip joints (one or both at the same time). This disease has a degenerative-dystrophic character. This means that the cartilage that makes up the hip joint undergoes degenerative changes, while the surfaces of the bones also change. In addition, bone overgrowths (osteophytes) form, the joint deforms, the volume of movement in the affected joint decreases, and they become extremely painful and uncomfortable.

The hip joint is one of the largest joints in our body. It is thanks to him that a very important motor function is carried out in the human body and he is also responsible for our body being able to move. When the hip joint gets sick, it affects the entire body and prevents a person from living peacefully, walking, not to mention sports. Very often we see elderly people who are dependent on a cane due to a disease of the hip joint.

Despite the fact that the hip joint is extremely massive and strong, at the same time it is quite vulnerable, especially over time. Pain in the hip joints significantly reduces the quality of human life.

Coxarthrosis (arthrosis of the hip joint)is in second place among arthrosis of the joints in terms of frequency of diagnosis after gonarthrosis (arthrosis of the knee joint).

Classification of coxarthrosis (arthrosis of the hip joint)

It happenscoxarthrosisboth primary and secondary.

• The main cause of primary coxarthrosis is the inevitable wear and tear of the hip joints over the course of life and mostly affects people over the age of 40.
• The causes of secondary coxarthrosis are usually the following diseases: congenital dislocation of the thigh, necrosis of the hip bone in the area of his head, Peters' disease, traumatization of the previous hip joint, inflammatory diseases of the hip joint. IncludedOsteoarthritis of the hip jointcan affect either one joint separately or both.

There are several types of coxarthrosis:

• Dysplastic (is a congenital pathology and is characterized by underdevelopment of the joint).
• Involutive (typical of people of older age class and associated with age-related changes).
• Post-infectious (it was preceded by purulent or purulent-allergic rheumatoid arthritis).
• Disease due to Peters disease (development of osteochondropathy in the femoral head).
• coxarthrosisdue to trauma (fractures of the neck and head of the bone (femur)).
• Coxarthrosis due to metabolic disorders (metabolism).
• Dishormonal (prolonged intake of glucocorticosteroids, antidepressants).
• Idiopathic (whose cause could not be established).

Symptoms of coxarthrosis (arthrosis of the hip joint)

In order to correctly describe the symptoms of coxarthrosis, one should at the same time consider the stages of the disease, because the symptoms depend on the stage of the disease.

Stages of coxarthrosis (arthrosis of the hip joint)

There are three stages of coxarthrosis (arthrosis of the hip joint):

• 1st stage of coxarthrosis. This is the initial stage of the disease when symptoms are still mild. The joint at this stage does not hurt very much, and pain appears only after physical exertion, such as walking. B. when lifting heavy objects or when jogging and hiking over long distances. After the person rests, the pain goes away. Lameness can also occur if the patient walks more than two kilometers, for example. Increases pain when climbing stairs. The motor volume of the joint decreases slightly or remains the same. The X-ray examination can only show small changes in the bone structures.
• 2nd stage of coxarthrosis. This stage develops without treatment of the first stage. In addition to the above symptoms, there is a specific cracking (crunching) sound in the joint. The pain intensifies and begins to radiate to the groin and may also spread to the thighs and knees. At this stage, not only strong, but also any movement can cause pain symptoms, even a light load on the hip joint. Even getting out of bed or twisting your upper body can cause pain. There is tension in the periarticular muscles that does not go away even at night, so patients often complain that the thigh hurts at night. A person can also begin to limp after short walks (up to 500 meters). At this stage, the disease already forces you to rely on a stick when walking. The restriction of movement in the joint increases. According to the results of X-ray diagnostics, the resulting osteophytes are determined.
• 3rd stage of coxarthrosis. The last stage of the disease. At this stage, the pain becomes permanent and torments the patient. Any movement, even the weakest, increases the pain symptoms many times over. At this stage, the hip joint is completely immobilized. Muscle mass in the thighs and buttocks is reduced due to muscular dystrophy, which is very noticeable. The impossibility of the patient standing directly while the body becomes crooked is characteristic. Any arthrosis leads to the formation of a contracture (bending position), in this case the contracture also arises from the fact that the muscle fibers are under constant tension while the leg on the side of the lesion becomes shorter. As a result of immobilization of the hip joint, the entire leg ceases to perform its motor function, which has a very negative effect, leading to its osteochondrotic lesion. In addition, the spine also suffers, there is discomfort and pain in the sacral area.

Causes of coxarthrosis (arthrosis of the hip joint)

The main causes of coxarthrosis:

• Age-related changes in the joint. Typical for older people. The hip joint wears out over time, ceases to perform its functions over time, "dries up", which leads to a decrease in its shock-absorbing function and the friction of the bones that form the joint against each other.
• Hip joint injury. The most common injury in people in this age group is a femoral neck fracture, which without proper treatment can become disabling. The joint can be injured at any age, but older people suffer from it more often.
• Disturbed metabolism. This is typical of people with a history of metabolic disorders and diseases associated with impaired metabolism.
• Violation of hormonal status. It is more characteristic of women, especially those who have been taking antidepressants and glucocorticosteroids for a long time.
• Hereditary anomalies in the development of the musculoskeletal system, as well as congenital anomalies. Unfortunately, at the moment, a fairly large number of children are born with congenital pathologies of the musculoskeletal system and nervous system. As for the abnormalities in the development of the hip joint, this can include its dysplasia, in which several structures of the joint fail to develop.
• systemic arthritis. Damage to multiple joints can also result in damage to the hip joint. In this case, one of the main risk factors is the presence of an inflammatory process.
• Rheumatic diseases and chronic arthritis. All of these can also lead to hip joint pain. Such diseases that cause pain in the examined joint include: rheumatism; Rheumatoid arthritis; spondyloarthropathy; juvenile rheumatoid arthritis.
• The defeat of osteochondrosis. Osteochondrosis of the spine is a fairly common and serious disease that, in addition to the spine, can "disable" other structures of our body, especially the hip joint.
• muscles and ligaments of the joint. Damage to these structures can also be the result of degenerative and dystrophic processes in the hip joint.
• Infectious lesions of both the joint itself and the femur. Such lesions are very serious, since they have serious consequences and are sometimes difficult to treat. Osteomyelitis can occur, which simply "eats" or "dissolves" bone tissue. Tuberculous lesions can also occur, and more often such localization occurs in children of the prepubertal period. Pelvic abscess, which is more commonly the result of an untreated or poorly treated infectious process, e. g. B. in appendicitis, inflammatory processes, especially when it comes to the female genital organs (ovarian disease), the development of an abscess in the area of the ischiorectal cavity, which leads to gait disorders (lameness). In most cases, pain and lameness are the result of compression or damage to nearby nerves (sciatica or obturator).
• Neoplasms of a malignant nature. Very rarely, malignant neoplasms affect the hip joint and the bones surrounding it, because metastases from other malignant areas, such as breast or lung cancer, are more often the cause of the disease.
• Narrowing of the lumen of the aorta and iliac arteries (their stenosis and occlusion). At the same time, the joint receives less and less nutrients necessary for normal functioning, which leads to its degeneration.

Risk group for coxarthrosis (arthrosis of the hip joint)

The main risk group can include the following categories of people and harmful factors:

• Elderly people. This disease is typical for older people, old people, because there are degenerative processes that occur precisely in this age period.
• Feminine. According to statistics, women are more prone to problems with the hip joints.
• People who are overweight or obese.
• Previous trauma to one or both hip joints.
• Hereditary predisposition to this type of diseases and congenital anomalies in the development of the hip joint.
• The presence of infectious lesions in the past, such as abscesses, aseptic necrosis of the head of the hip bone, osteomyelitis, and so on.
• Hard physical work.
• Summer residents who have an extremely high risk of developing coxarthrosis.

Prevention of coxarthrosis (arthrosis of the hip joint)

The main measures for the prevention of coxarthrosis are as follows:

• Measured physical activity. It is important to do gymnastics and knead the joint in order to prevent the development of pathological processes in it and its slower aging. This will help improve the condition not only of the hip joint, but of the body as a whole.
• If there are metabolic disorders, they should be corrected. To do this, you should contact a specialist.
• Watch your weight. Do not forget that the hip joint already carries a large load, almost the entire body, so you should not interfere with it in order to perform its functions. In addition, a lot of weight puts so much pressure on the joints that they gradually collapse. Overweight people are also prone to metabolic disorders.
• Avoid sharp twists of the body, especially if you are not warmed up and unprepared. This will prevent you from injuring the head and neck of the femur.
• Of course, it is better to choose the type of sport in which the joint injuries are the least dangerous, such as swimming or yoga, especially if there are hereditary predispositions or developmental disorders.
• Predisposition to joint diseases implies careful management of them and regular visits to the doctor in order not to miss the possible development of a disease or other pathological process in the joint.
• When a child is diagnosed with hip dysplasia, they should be treated, and right away! It is better to keep the child immobilized for a few weeks at a young age than to suffer all his life.
• Timely treatment of infectious diseases, especially those that threaten to spread to the hip joint.

Diagnosis of coxarthrosis (arthrosis of the hip joint)

When diagnosing coxarthrosis, it is very important to find the cause that caused it. Because as we discussed above, there are many reasons, they are varied andTreatment of hip arthrosis, will differ radically. Sometimes it's not that easy and sometimes it's not even possible. The main focus is on studying the manifestations of the disease and choosing an appropriate treatment.

First, the patient is carefully questioned by the doctor, examining in detail the ailments, the causes of the disease, the hereditary burden, the presence of injuries, etc. It is very important to have the complaints described above and how long they have been observed in the patient.

After the conversation, the doctor personally examines the affected area for the presence of inflammatory changes, trophic changes, malformations, shortening of the limbs, asymmetries, etc. And children may have a "click" symptom.

An important point is additional methods of examination - computed and magnetic resonance imaging, ultrasound and X-ray examination, as they contribute to the final diagnosis. This point is of great importance in the differential diagnosis of coxarthrosis from other diseases of the hip joint.