Coxarthrosis or arthrosis of the hip joint is a degenerative-dystrophic disease that leads to loss of elasticity and destruction of cartilage tissue, as well as premature wear of the joint of the same name.Osteoarthritis is considered an age-related problem, which is confirmed by world statistics: after 40 years, every second person is diagnosed, and closer to 70, pathology is detected in 80% of cases.Structural changes in the hip area occur 2.5 times more often in women than in men.
Causes of the disease
The hip joint is formed by the hip socket, which also includes the femoral head.The greater trochanter is attached to the joint head and is surrounded by a bursa containing a thick, mucous-like mass.It is the synovial fluid that nourishes the hip cartilages and ensures that they can slide between each other easily and without noise or pain.An age-related decline in the production of synovial fluid and a change in its viscosity are the main causes of osteoarthritis of the hip joint.
Coxarthrosis of movable joints in the hip area occurs when:
- Perthes disease.
- Hip dysplasia.
- Reactive or infectious coxitis.
- Metabolic disorders.Diabetes mellitus and gout can cause osteoarthritis.
- Chondromatosis of the joints.The disease is characterized by the formation of loose intra-articular bodies that damage hyaline cartilage.
- Mechanical injuries.These include a fracture or dislocation of the hip (including congenital), a rupture of the joint capsule and frequent microtraumas to the joints.
People who are overweight and have bad habits are at risk.In professional runners or weightlifters, the connective tissue wears out quickly and athletes are not immune to shifting joint cartilage and tears in the hip muscles.Osteoarthritis of the hip joint itself is not inherited, but structural features of the bone tissue or slow metabolism are genetically determined.
Course of the disease
In osteoarthritis, the large joints of the pelvis and knee joints are initially affected (gonarthrosis);You carry a huge burden when moving.During the exacerbation phase, acute osteoarthritis occurs, then palpation of the joint and hip tissue is accompanied by pain.Incomplete or incorrect fusion of the femur after an injury results in neoarthrosis or a false joint that is filled not with callus but with connective tissue.
There are arthrosis of the hip joint of the 1st, 2nd and 3rd degrees, each stage of the disease has its own characteristics:
- Osteoarthritis of the 1st degree develops slowly, without affecting the mobility of the joint structures, muscle tone is normal.In the early stages of coxarthrosis, the disease can only be recognized by x-rays.
- Second-degree osteoarthritis of the hip joint is accompanied by severe pain in the hip area, and a crunching noise can sometimes be heard in the joint.With osteoarthritis, it is difficult to rotate and move the hip to the side, the joint space narrows, and the tone of the hip muscles decreases.A contracture begins to form.
- With coxarthrosis of the 3rd degree, the pain syndrome is pronounced.Due to the atrophy of the muscles in the hip area and the expansion of the femoral neck, the leg shortens.When walking, the patient uses a support.Due to osteoarthritis, the joint space can disappear completely, which is then referred to as bone ankylosis.
In clinical practice, doctors regularly encounter an involving form of coxarthrosis (typical for older people) and post-infectious arthrosis of the hip joint.Patients taking corticosteroids and antidepressants are at risk of dyshormonal coxarthrosis;This form of osteoarthritis also affects the joints of women during menopause.In osteoarthritis, the inflammatory rather than degenerative process predominates in the hip joint.
If the etiology of the disease is not clear, it is called primary or idiopathic coxarthrosis.Usually the disease affects the joints of people who have exceeded the 50-year mark.Secondary osteoarthritis develops at a young age;As a rule, osteoarthritis of the left or right hip joint is diagnosed (unilateral coxarthrosis).
Symptoms
The symptoms of osteoarthritis of the hip joint do not initially bother the patient, only occasionally prolonged strain on the affected area or clumsy movements are a reminder of the problem.
Coxarthrosis of the hip joint manifests itself:
- Pain in the hip area.The intensity and type of joint pain depend on the stage of osteoarthritis and the weather conditions.
- Increased body temperature.With osteoarthritis of one or two hip joints, chills and joint swelling are observed.
- Weakening and subsequent atrophy of the muscles of the hip region.
- A noticeable crunch in the joints.A possible sign of coxarthrosis, but not necessarily.
- Lameness.The destruction of the hip bone due to osteoarthritis creates an unsteady “duck gait”.
Patients with coxarthrosis often experience pain that radiates to the kneecap.Therefore, an inexperienced doctor, after listening to the patient's complaints, can make a misdiagnosis and delay the recovery process for many months.
diagnosis
The diagnosis of osteoarthritis is made by a rheumatologist, traumatologist or orthopedist.After interviewing the patient, the doctor conducts an external examination of the hip area, examines the mobility of the legs and assesses the gait of the patient with coxarthrosis.
The most effective methods for diagnosing osteoarthritis include:
- General and biochemical blood test.
- Simple x-ray of the hip area.
- Ultrasound examination and MRI.
If infectious arthrosis of the hip joint is suspected, the volume of the synovial fluid is determined and its cellular composition is examined.To exclude the presence of autoaggressive antibodies in the body, the patient is sent for analysis of RF in blood serum.
How is osteoarthritis of the hip joint treated?
Treatment of arthrosis of the hip joint is selected taking into account the stage of coxarthrosis, the patient's age and accompanying diagnoses.Osteoarthritis grades 1 and 2 can be cured using an integrated approach: taking medications in combination with physiotherapeutic methods, massage and a special diet.
After the acute phase of coxarthrosis has ended, cardio training without running and jumping is allowed to treat the hip joint.
After the end of the acute phase of coxarthrosis, gentle gymnastic exercises with limited range of motion, cardio training without running and jumping are selected for the treatment of the hip joint.In the final stage, treatment of arthrosis of the hip joint is carried out in a sanatorium-resort area.
Drug treatment
Conservative treatment of the disease is aimed at relieving pain in the hip area and maintaining the functionality of the joints.The main goal is complete recovery or stable remission of coxarthrosis.
Treatment of osteoarthritis is not complete without the following:
- NSAIDs.Nonsteroidal drugs relieve pain and inflammation in the movable joint, but tablets have nothing to do with restoring the structure of hyaline cartilage in coxarthrosis.
- Vasodilators.The medication ensures the nutrient supply to the joints affected by osteoarthritis and eliminates congestion in the hip area.
- Chondroprotectors.Saturate the joint tissue with water, improving its lubricating properties.Stops the destruction of joint structures in the hip area.Glucosamine and chondroitin sulfate are components of many chondroprotectors.
- Gels and ointments for osteoarthritis.They have a warming, irritating or distracting effect.The drugs successfully cure arthrosis of the hip joints.
- To eliminate pain in the acute phase of coxarthrosis, it is recommended to inject steroid drugs into the joint cavity.
Compresses with medicinal bile increase the effectiveness of the listed remedies for arthrosis.If the lymphatic system is affected and there is a fever (infectious coxarthrosis), it is not possible to apply therapeutic bandages to the hip area.
Physiotherapy
Despite the deep location of the hip joints, physiotherapeutic methods bring relief from coxarthrosis.Popular physiotherapeutic procedures include electrophoresis, laser therapy and warming paraffin applications.Acupuncture improves the innervation of cartilage tissue and the function of internal organs.Phonophoresis with hydrocortisone for osteoarthritis combines the advantages of ultrasound and medical effects in the hip area.
Diet and nutrition
A special diet for coxarthrosis consists of low-fat foods and a high content of vitamins B, C, E, as well as calcium, potassium and magnesium.It is advisable to start every new day with a glass of freshly squeezed juice.Prefer boiled and stewed dishes.
The daily menu for arthrosis should consist of:
- dairy products.
- Fresh vegetables and fruits.
- Low-fat types of fish and meat.
- Whole wheat bread.
- Porridge cooked in water.
Exclude salty and spicy foods, nightshades, baked goods, smoked foods and carbonated drinks from your diet.When treating coxarthrosis, you should not buy ready-made food from supermarkets or semi-finished products.
Endoprosthetics
In the final stage of coxarthrosis, replacement of the affected joint with an artificial one is indicated.Before the operation, the patient must undergo a general blood and urine test, an ultrasound scan of the hip area and an ECG.
Main steps of the procedure:
- The surgeon cuts off the head of the femur and inserts a pin to connect it to the titanium femoral head implant.
- Part of the surface of the pelvic bone is removed and a polymer bed is placed in its place, which is connected to the titanium head.
The best way to attach dentures is with bone cement.If osteoarthritis affects the joints at a young age, cement-free fixation methods are sometimes used.
massage
The massage relieves muscle spasms and strengthens the ligaments in coxarthrosis.During the procedure, the patient with arthrosis should take a comfortable position and relax.First we rub the back (10 minutes), then we massage the sacrum-buttock area.Using circular movements of bent fingers, we knead the problem thigh in the direction of the lymph flow - from bottom to top.To slow down the development of arthrosis, the procedure is carried out three times a day.
Exercises and movement therapy
The level of stress on the hip joints in osteoarthritis is determined by the physiotherapist.It is advisable to carry out physiotherapy in a specially equipped room.Swimming in the pool or skiing accelerates the recovery of joints with coxarthrosis.
The method of combating arthrosis presented by the practicing rheumatologist P. V. Evdokimenko is becoming increasingly popular.Evdokimenko's gymnastics consists of static exercises to strengthen the hip muscles and stretches with minimal pressure on the affected area.For example, if you lie on your left side, bend your left leg at the knee and extend your right one, and then hold it in an elevated position for about 30 seconds, the muscles will begin to contract.With coxarthrosis, the task is performed in 5 approaches on each leg.
Folk remedies
Traditional methods of treating coxarthrosis are based on basic concepts about the properties of medicinal herbs.Before the development of the pharmaceutical industry, eucalyptus oils, cloves and fresh aloe juice were rubbed into painful joints for osteoarthritis.Celandine ointments relax the hip muscles and tendons.
Effective recipes for alternative medicine:
- Grind 200g of the roots of the white foot and fill it with pork fat (300-400g).Put on low heat, after 5-7 minutes the remedy for coxarthrosis is ready.Rub the cooled mass into the affected joint at night for 2 weeks.
- Whisk egg white with 1 tbsp.l.Flour.In case of arthrosis, the medicinal mixture should be applied to the hip area before bedtime.Don't forget to wrap the painful joint area with parchment paper and a woolen scarf.
Shilajit has an intensive strengthening effect and improves mobility of the hip joints.For arthritis and arthrosis, 5 g of Mumiyo is dissolved in 10-20 ml of water and 45 g of heated petroleum jelly is poured into it.The product is rubbed into the skin of the thigh with gentle movements.
Prevention
Prevention of arthrosis of the hip joint involves giving up bad habits, a sedentary lifestyle, extra pounds put a strain on the hip area and exceed the physiological limits of joint strength.Follow the daily routine and principles of PN for coxarthrosis and pay attention to your posture.An annual examination of the joints from the age of 30 helps to prevent the development of irreversible changes in the body of a patient with arthrosis.
Among the pathologies of the musculoskeletal system, arthrosis of the hip joint occupies a leading position.The disease affects the patient's quality of life and is the main cause of disability at a young age.Even if you were unable to protect yourself from coxarthrosis: don't despair - take action!