Coxarthrosis(arthrosis of the hip joint) is a type of deforming arthrosis of the joints, which is a chronic non-inflammatory disease that affects the hip joints (one or both at the same time). This disease has a degenerative-dystrophic nature. This means that the cartilage that forms the hip joint undergoes degenerative changes while also changing the surfaces of the bones. Further, bone growths (osteophytes) are formed, the joint is deformed, the range of motion in the affected joint decreases and they become extremely painful and uncomfortable.
The hip joint is one of the largest joints in our body. Thanks to it, a very important motor function is performed in the human body, and it is also responsible for the fact that our body can move. If the hip joint gets sick, it affects the whole body as a whole and does not allow a person to live peacefully, to walk, not to mention sports. Very often we see elderly people who are forced to rely on a cane due to hip disease.
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)firmly ranks second among arthrosis of the joints in terms of the frequency of diagnosed cases after gonarthrosis (arthrosis of the knee joint).
Classification of coxarthrosis (arthrosis of the hip joint)
Happenscoxarthrosisboth primary and secondary.
- The cause of primary coxarthrosis is mainly the inevitable wear and tear of the hip joints in the course of life and usually affects people after 40 years.
- The causes of secondary coxarthrosis are usually the following diseases: congenital luxation of the femur, necrotic formations of the hip bone in the area of the head, Peter's disease, traumatization of the early hip joint, inflammatory diseases of the hip joint. At whicharthrosis of the hip jointit can affect either one joint individually 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 the older age category and is associated with age-related changes).
- Post-infectious (preceded by purulent or purulent-allergic, rheumatoid arthritis).
- Disease due to Peters disease (development of osteochondropathy in the femoral head).
Coxarthrosis due to trauma (fractures of the neck and head of the bone (femur)).- Coxarthrosis due to metabolic disorders (metabolism).
- Dyshormonal (long-term use of glucocorticosteroids, antidepressants).
- Idiopathic (the cause of which cannot be determined).
Symptoms of coxarthrosis (arthrosis of the hip joint)
In order to correctly describe the symptoms of coxarthrosis, the stages of the disease must be taken into account at the same time, since the symptomatology depends on the stage of the disease.
Stages of coxarthrosis (arthrosis of the hip joint)
In total, there are three stages of coxarthrosis (arthrosis of the hip joint):
- 1 stage of coxarthrosis. This is the initial stage of the disease, where the symptoms are still mild. The joint at this stage does not hurt much, and the pain appears only after physical exertion, such as lifting heavy objects or jogging, hiking long distances. After a person rests, the pain disappears. The patient may also develop lameness if, for example, he walks more than two kilometers. Increases pain when climbing stairs. The motor volume of the joint slightly decreases or is preserved. X-ray examination can show only small changes in bone structures.
- 2nd stage of coxarthrosis. This stage develops in the absence of treatment at the first stage. A specific crack (crunch) in the joint is added to the above symptoms. The pain becomes more intense and begins to radiate to the groin area and may also spread to the thigh and knee. At this stage, not only strong, but also any movements can cause symptoms of pain, even a slight load on the hip joint. Even getting out of bed or turning your torso can cause pain. There is tension in the periarticular muscles that does not disappear even at night, so patients often complain that the hip hurts at night. A person can begin to limp even after minor walks (up to 500 meters). At this stage, the disease already forces a person to rely on a cane when walking. The limitation of movements in the joint becomes more pronounced. On the basis of the results of X-ray diagnostics, emerging osteophytes are determined.
- 3rd stage of coxarthrosis. The last stage of the disease. At this stage, the pain becomes constant and torments the patient. Any movement, even the weakest, increases the pain symptoms several times. 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 directly straightening the patient, while the body will be distorted, is characteristic. Any arthrosis leads to the formation of a contracture (flexion position), in this case the contracture is also formed due to the fact that the muscle fibers are in constant tension, while the leg on the side of the lesion becomes shorter. As a result of the fact that the hip joint is immobilized, the entire leg ceases to perform its motor function, which has a very negative effect and leads to their osteochondrosis lesion. In addition, the spine also suffers, there is a feeling of discomfort and pain in the sacral region.
Causes of coxarthrosis (arthrosis of the hip joint)
The main causes of coxarthrosis:
- Age-related changes in the joint. Characteristic of elderly people. The hip joint wears out over time, ceases to perform its functions over time, "dry out", which leads to a decrease in its shock-absorbing function and friction of the bones that form the joint against each other.
- Hip injury. The most common injury among people in this age group is a fracture of the neck of the femur, which threatens with disability in the absence of appropriate treatment. The joint can be injured at any age, but older people suffer more often.
- Disturbed metabolism. This is characteristic 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 take antidepressants and glucocorticosteroids for a long time.
- Hereditary anomalies in the development of the musculoskeletal system, as well as congenital anomalies. Unfortunately, at present, quite a large number of children are born with congenital pathologies of the musculoskeletal system and the nervous system. As for abnormalities in the development of the hip joint, this can include hip dysplasia, in which several structures of the joint do not develop.
- Systemic arthritis. Damage to several joints can also lead to damage to the hip joint. In this case, one of the main risk factors will be the presence of an inflammatory process.
- Rheumatic conditions and chronic arthritis. All this can also lead to the appearance of pain in the hip joint. 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, which, in addition to the spine, can "break down" 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 because they lead to serious consequences and are sometimes difficult to treat. Osteomyelitis can occur, which simply "eats" or "dissolves" the bone tissue. Tuberculous lesions can also appear, and more often such localization occurs in children in the pre-pubescent period. Abscessing in the pelvic area, which is more often the result of an untreated or poorly treated infectious process, for example, in appendicitis, inflammatory processes, especially when it comes to the genitals of women (ovarian disease), the development of an abscess in the area of the ischiorectal deepening, which leads to impaired gait (appearance of lameness). In most cases, pain and lameness are the result of compression or damage to nearby nerves (sciatic or obturator).
- Neoplasms of a malignant nature. Quite rarely, malignant neoplasms affect the hip joint and the bones around it, since more often the cause of the disease is metastases from other malignant areas, for example, in breast or lung cancer.
- 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 may include the following categories of people and harmful factors:
- Older people. This disease is typical for older people, the elderly, as degeneration processes occur that occur precisely at this age period.
- Female. According to statistics, women are more prone to hip problems.
- People who are overweight or obese.
- Previous trauma to one or both hip joints.
- Hereditary predisposition to this type of disease and congenital abnormalities in the development of the hip joint.
- The presence in the past of infectious lesions, such as abscesses, aseptic necrosis of the femoral head, osteomyelitis, etc.
- Heavy 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 the following:
- Dosed physical activity. It is important to do gymnastics and knead the joint to prevent the development of pathological processes in it and its slower aging. This will help not only improve the condition of the hip joint, but also the whole body.
- If there are metabolic disorders, they must be corrected. To do this, you need to contact a specialist.
- Watch your weight. Remember that the hip joint already carries a large load, almost the entire body, so you should not prevent it from performing its functions. Also, the heavy weight will put so much pressure on the joints that they will gradually collapse. Overweight people are also prone to metabolic disorders.
- Avoid sharp turns 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.
- It is better, of course, to choose the sport in which the least dangerous joint injuries, such as swimming or yoga, especially if there are hereditary predispositions or developmental abnormalities.
- The predisposition to joint diseases implies a careful attitude towards them, as well as regular visits to a doctor, so as not to miss the possible development of a disease or other pathological process in the joint.
- If a child is diagnosed with hip dysplasia, it must be treated, and immediately! It is better for a child to be immobilized for a few weeks at an early age than to suffer for a lifetime.
- 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. After all, as we have already discussed above, there are many reasons, they are diverse andtreatment of osteoarthritis of the hip joint, will accordingly differ radically. Sometimes it's not that easy, and sometimes it's not possible at all. Emphasis is placed on the study of the manifestations of the disease and the selection of appropriate treatment.
First of all, the patient is carefully questioned by the doctor, studying in detail the complaints, the causes of the disease, 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 interview, the doctor personally examines the affected area for the presence of inflammatory changes, trophic changes, deformations, limb shortening, asymmetries, etc. And children can have a "clicking" symptom.
An important point is the additional research methods - computer and nuclear magnetic resonance, ultrasound and X-ray examination, because they will help to make a final diagnosis. In the differential diagnosis of coxarthrosis from other diseases of the hip joint, this element is extremely important.