Coxarthrosis or arthrosis of the hip joint is a degenerative-dystrophic disease that leads to loss of elasticity and destruction of cartilage tissue, premature wear of the joint of the same name.Arthrosis is considered an age-related problem, which is confirmed by world statistics: after 40 years, every second person is diagnosed, and close to 70, the 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 acetabulum, which includes the head of the femur.The greater trochanter is attached to the articular head, surrounded by a synovial bursa with a thick mucosa-like mass.It is the synovium that nourishes the hip cartilages and ensures easy sliding between them, without noise and pain.An age-related decrease in the production of synovial fluid and a change in its viscosity are the main causes of hip joint arthrosis.
Coxarthrosis of the movable joints in the hip area occurs when:
- Perthes disease.
- Hip dysplasia.
- Reactive or infectious coxitis.
- Metabolic disorders.Diabetes mellitus and gout can provoke arthrosis.
- Joint chondromatosis.The disease is characterized by the formation of loose intra-articular bodies that damage the hyaline cartilage.
- Mechanical injuries.This includes a fracture or displacement of the hip (including congenital), rupture of the joint capsule and frequent microtrauma of the joints.
People who are overweight and have bad habits are at risk.In professional runners or weightlifters, connective tissue wears down quickly, and athletes are not immune to articular cartilage displacement and hip muscle tears.Osteoarthritis of the hip joint itself is not hereditary, but structural features of bone tissue or slow metabolism are genetically determined.
The course of the disease
First of all, arthrosis affects the large joints of the pelvic bones and knee joints (gonarthrosis);they are the ones who carry a heavy load when moving.During the period of deterioration, acute arthrosis appears, then palpation of joint and hip tissue is accompanied by pain.In case of incomplete or incorrect fusion of the femur after an injury, neoarthrosis or false joint is formed, filled not with callus, but with connective tissue.
There are degrees 1, 2 and 3 hip joint arthrosis, each stage of the disease has its own characteristics:
- Grade 1 arthrosis develops slowly, without affecting the mobility of joint structures, muscle tone is normal.In the early stage of coxarthrosis, the disease can only be detected by x-ray.
- Osteoarthritis of the hip joint of the second degree is accompanied by severe pain in the hip area, sometimes a cracking sound is heard in the joint.With arthrosis, it is difficult to rotate the hip and move it to the side, the joint space narrows and the tone of the hip muscles weakens.A contracture begins to form.
- With coxarthrosis of the 3rd degree, the pain syndrome is pronounced.Due to the atrophy of the muscles of the hip region and the expansion of the neck of the femur, the leg is shortened.While walking, the patient uses support.Due to arthrosis, the joint space can completely disappear, in which case they speak of bony ankylosis.
In clinical practice, doctors regularly encounter a type of involutive coxarthrosis (typical for the elderly) and post-infectious arthrosis of the hip joint.Patients taking corticosteroids and antidepressants are at risk of dyshormonal coxarthrosis;this type of arthrosis also affects the joints of women during menopause.With arthrosis-arthritis, the inflammatory and non-degenerative process prevails in the hip joint.
If the etiology of the disease is not determined, it is a matter of primary or idiopathic coxarthrosis.Usually the disease affects the joints of people who have crossed the 50-year mark.Secondary arthrosis develops at a young age;As a rule, arthrosis of the left or right hip joint (unilateral coxarthrosis) is diagnosed.
Symptoms
Symptoms of arthrosis of the hip joint do not bother the patient at first, only the occasional prolonged loads on the affected area or difficult movements remind of the problem.
Coxarthrosis of the hip joint is manifested:
- Pain in the hip area.The intensity and nature of joint pain depends on the stage of arthrosis and weather conditions.
- Increased body temperature.Chills and swelling of the joints are observed with arthrosis-arthritis of one or two hip joints.
- Weakening and subsequent atrophy of the muscles of the hip region.
- A distinct cracking sound in the joint.A possible sign of coxarthrosis, but not mandatory.
- The limp.Due to the destruction of the hip bone with arthrosis, an unsafe, "duck" gait is formed.
Those who suffer from coxarthrosis often experience pain radiating to the knee cap, so an inexperienced doctor, after listening to the patient's complaints, can make a wrong diagnosis and delay the recovery process for many months.
Diagnosing
Arthrosis is diagnosed by a rheumatologist, traumatologist or orthopedist.After interviewing the patient, the doctor performs an external examination of the hip area, studies the mobility of the leg and evaluates the gait of the patient with coxarthrosis.
The most effective methods for diagnosing arthrosis include:
- General and biochemical blood test.
- Plain X-ray of the hip area.
- Ultrasound and MRI examination.
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 the blood serum.
How is arthrosis of the hip joint treated?
Treatment for arthrosis of the hip joint is selected taking into account the stage of coxarthrosis, the patient's age and accompanying diagnoses.Grade 1 and 2 arthrosis can be cured using an integrated approach: taking pharmaceutical drugs in combination with physiotherapy methods, massage and a special diet.
After the end of the acute period of coxarthrosis, cardio training is allowed without running and dancing for the treatment of the hip joint.
After the end of the acute period of coxarthrosis, soft gymnastic exercises with a limited range of motion, cardio training without running and dancing are selected for the treatment of the hip joint.In the final stage, treatment of arthrosis of the hip joint takes place in a sanatorium-resort environment.
Drug treatment
The conservative treatment of the disease is aimed at relieving pain in the hip area and preserving the functionality of the joints.The main goal is complete recovery or stable remission of coxarthrosis.
The treatment of arthrosis is not complete without the following:
- NSAIDs.Nonsteroidal medications relieve pain and inflammation in the mobile joint, but tablets have nothing to do with restoring the structure of hyaline cartilage in coxarthrosis.
- Vasodilators.Medicines ensure the delivery of nutrients to joints affected by arthrosis and eliminate overload in the hip area.
- Chondroprotectors.They saturate the joint tissues with water, improving its lubricating properties.Stops the destruction of articular structures in the hip area.Glucosamine and chondroitin sulfate are part of many chondroprotectors.
- Anti-arthrosis gel and ointment.They have heating, irritating or distracting effects.Medicines successfully cure arthrosis of the hip joints.
- It is recommended to inject steroid drugs into the joint cavity to eliminate pain in the acute phase of coxarthrosis.
Medical bile compresses increase the effectiveness of the listed means for arthrosis.Therapeutic bandages cannot be applied to the hip area if the lymphatic system is affected and there is a fever (infectious coxarthrosis).
Physiotherapy
Despite the deep location of the hip joints, physiotherapy methods bring relief from coxarthrosis.Popular physiotherapeutic procedures include electrophoresis, laser therapy and paraffin applications for heating.Acupuncture improves the innervation of cartilage tissue and the functioning of internal organs.Phonophoresis with hydrocortisone for arthrosis combines the advantages of ultrasound and medicinal 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 recommended to start each new day with a glass of freshly squeezed juice.Give preference to boiled and steamed dishes.
The daily menu for arthrosis should consist of:
- Dairy products.
- Fresh vegetables and fruits.
- Low-fat varieties of fish and meat.
- Wholemeal bread.
- Porridge cooked in water.
From your diet, exclude salty and spicy foods, at night, baked products, smoked foods and carbonated drinks.When treating coxarthrosis, you should not buy ready-made foods from supermarkets or semi-finished products.
Endoprosthetics
Replacement of the affected joint with an artificial one is indicated in the last stage of coxarthrosis.Before the operation, the patient must undergo general blood and urine tests, ultrasound of the hip area and ECG.
Main stages of the procedure:
- The surgeon cuts the femoral head and inserts a pin to connect to the titanium femoral head implant.
- Part of the surface of the pelvic bone is removed and a polymer bed is attached in its place, which is connected to the titanium head.
The best way to fix dentures is with bone cement.If arthrosis affects the joints at a young age, cementless fixation methods are sometimes used.
Massage
Massage relieves muscle spasms, strengthens the ligamentous apparatus in case of 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 sacro-gluteal area.Using circular movements of bent fingers, we knead the problematic thigh in the direction of the lymphatic flow - from bottom to top.To slow down the development of arthrosis, the procedure is performed 3 times a day.
Exercise and exercise therapy
The level of load on the hip joints during arthrosis is determined by the physiotherapist.It is advisable to engage in physical therapy in a room specially equipped for this purpose.Swimming in the pool or skiing will speed up the recovery of joints with coxarthrosis.
The popularity of the method of fighting arthrosis, which was introduced by the practicing rheumatologist P. V. Evdokimenko, is growing.Evdokimenko's gymnastics consists of static exercises to strengthen the thigh muscles, stretching 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, then hold it in an elevated position for about 30 seconds, the muscles will begin to contract.For 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 plants.Before the development of the pharmaceutical industry, eucalyptus oils, cloves and fresh aloe juice were rubbed into sore joints for osteoarthritis.Celandine ointments relax the muscles and tendons of the hips.
Effective recipes of alternative medicine:
- Grind 200 g of white leg roots and stuff with pork fat (300–400 g).Put it on low heat, after 5-7 minutes the medicine for coxarthrosis is ready.Rub the cooled mass on the affected joint at night for 2 weeks.
- Beat the egg white with 1 tbsp.l.flour.For arthrosis, the medicinal mixture should be applied to the hip area before going to bed.Don't forget to wrap the injured joint with parchment paper and a woolen scarf.
Shilajit has an intense restorative effect and improves the 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 hot petroleum jelly is poured into it.The product is rubbed into the skin of the thigh with gentle movements.
Preventing
Prevention of arthrosis of the hip joint involves giving up bad habits, a sedentary lifestyle, extra pounds load the hip area, exceeding the physiological limits of joint strength.Follow the daily routine and PN principles for coxarthrosis, watch your posture.An annual joint examination, starting at the age of 30, will help 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 reduces the patient's quality of life and is the main cause of disability at a young age.Even if you cannot protect yourself from coxarthrosis, do not despair - act!