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 closer to 70 years, 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 mucous mass.It is the synovium that nourishes the hip cartilages and ensures their easy sliding into each other, 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 arthrosis of the hip joint.
Coxarthrosis of the movable joints in the area of the hip joint occurs in:
- Perthes disease.
- Hip dysplasia.
- Reactive or infectious coxitis.
- Metabolic disorders.Diabetes mellitus and gout can provoke arthrosis.
- Chondromatosis of the joints.The disease is characterized by the formation of loose intra-articular bodies that damage the hyaline cartilage.
- Mechanical injuries.This includes fracture or dislocation of the hip joint (including congenital), rupture of the joint capsule and frequent microtrauma of the joints.
People with excess weight and bad habits are at risk.In professional runners or weightlifters, the connective tissue wears down quickly, and athletes are not immune to displacement of articular cartilage and tearing of the thigh muscles.Hip arthrosis itself is not inherited, but structural characteristics of bone tissue or slow metabolism are genetically determined.
Course of the disease
First of all, arthrosis affects the large joints of the bones of the pelvis and knee joints (gonarthrosis);it is they who carry a huge load when moving.During the period of exacerbation, acute arthrosis occurs, after which palpation of the joint and hip tissue is accompanied by pain.In case of incomplete or incorrect fusion of the femur after an injury, a neoarthrosis or false joint is formed, filled not with callus, but with connective tissue.
There is arthrosis of the hip joint of the 1st, 2nd and 3rd degree, each stage of the disease has its own characteristics:
- Arthrosis of the 1st degree 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 on X-rays.
- Osteoarthritis of the hip joint of the second degree is accompanied by severe pain in the area of the hip joint, sometimes a crunch 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 muscles of the hip joint weakens.A contracture begins to form.
- In coxarthrosis of the 3rd degree, the pain syndrome is pronounced.Due to atrophy of the muscles of the hip area and expansion of the neck of the femur, the leg is shortened.When walking, the patient uses support.Due to arthrosis, the joint can completely disappear, in this case it is called bone ankylosis.
In clinical practice, doctors regularly encounter involutive type coxarthrosis (characteristic of elderly people) 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.In arthrosis-arthritis in the hip joint, the inflammatory rather than the degenerative process prevails.
If the etiology of the disease is not established, we speak 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
The symptoms of arthrosis of the hip joint do not initially bother the patient, only sometimes prolonged loading of the affected area or uncomfortable movement remind of the problem.
Coxarthrosis of the hip joint manifests itself:
- 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 in arthrosis-arthritis of one or two hip joints.
- Weakening and subsequent atrophy of the muscles of the hip area.
- A distinct crunch in the joints.Possible sign of coxarthrosis, but not necessarily.
- Lameness.Due to the destruction of the hip bone with arthrosis, an insecure, "duck" gait is formed.
Sufferers of coxarthrosis often experience pain radiating to the kneecap, so an inexperienced doctor, after listening to the patient's complaints, can make a wrong diagnosis and delay the recovery process for many months.
Diagnosis
Arthrosis is diagnosed by a rheumatologist, traumatologist or orthopedist.After an interview with the patient, the doctor conducts an external examination of the hip area, studies the mobility of the legs and assesses 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.
If infectious arthrosis of the hip joint is suspected, the volume of the synovial fluid is determined and its cell 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 osteoarthritis of the hip treated?
Treatment of arthrosis of the hip joint is selected, taking into account the stage of coxarthrosis, the age of the patient and concomitant diagnoses.Arthrosis of the 1st and 2nd degree can be cured by an integrated approach: taking pharmaceutical drugs in combination with physiotherapeutic methods, massage and a special diet.
After the end of the acute period of coxarthrosis, cardio training without running and jumping is allowed for the treatment of the hip joint.
After the end of the acute period of coxarthrosis, light gymnastic exercises with a limited range of motion, cardio training without running and jumping are chosen for the treatment of the hip joint.In the last stage, the treatment of arthrosis of the hip joint is carried out in a sanatorium-resort environment.
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.
The treatment of arthrosis is not complete without the following:
- NSAIDs.Nonsteroidal drugs 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 provide nutrients to the arthritic joints and remove congestion in the hip joint area.
- Chondroprotectors.Saturate joint tissues with water, improving its lubricating properties.It stops the destruction of joint structures in the hip area.Glucosamine and chondroitin sulfate are part of many chondroprotectors.
- Gels and ointments against arthrosis.They have a warming, irritating or distracting effect.Medicines successfully treat 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.
Compresses with medical bile increase the effectiveness of the listed means for the treatment of arthrosis.Therapeutic bandages cannot be applied to the hip joint area if the lymphatic system is affected and there is a high temperature (infectious coxarthrosis).
Physiotherapy
Despite the deep location of the hip joints, physiotherapeutic methods relieve coxarthrosis.Popular physical therapy treatments include electrophoresis, laser therapy, and warming paraffin applications.Acupuncture improves the innervation of cartilage tissue and the functioning of internal organs.Phonophoresis with hydrocortisone in arthrosis combines the advantages of ultrasound and the healing effect on the hip area.
Diet and nutrition
A special diet for coxarthrosis consists of foods with a low fat content and a high content of vitamins B, C, E, as well as calcium, potassium and magnesium.It is desirable 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.
- Whole wheat bread.
- Oatmeal 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 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 head of the femur and inserts a pin inside to connect to the titanium implant of the femoral head.
- A part of the surface of the pelvic bone is removed, and in its place a polymer bed is attached, which connects 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 ligament apparatus 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 sacro-gluteal area.With 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 performed 3 times a day.
Exercise and training therapy
The level of load on the hip joints during arthrosis is determined by the physiotherapist.It is recommended to do physiotherapy 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 combating arthrosis, presented by practicing rheumatologist P. V. Evdokimenko, is growing.Evdokymenko's gymnastics consists of static exercises to strengthen the hip 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 leg, then hold it in the raised position for about 30 seconds, the muscles will begin to contract.With coxarthrosis, the task is performed in 5 approaches on each leg.
People's funds
Traditional methods of treating coxarthrosis are based on the basic concepts of the properties of medicinal herbs.Before the development of the pharmaceutical industry, eucalyptus oil, cloves and fresh aloe juice were rubbed into diseased joints in arthrosis.Calendula ointments relax the muscles and tendons of the thighs.
Effective recipes for alternative medicine:
- Grind 200 g of white leg roots and pour lard (300–400 g) over them.Put on low heat, after 5-7 minutes the medicine for coxarthrosis is ready.Rub the cooled mass into the affected joint at night for 2 weeks.
- Beat the egg white with 1 tbsp.l flour.In case of arthrosis, the medicinal mixture should be applied to the area of the hip joint before going to bed.Be sure to wrap the affected 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 mumio 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
The prevention of arthrosis of the hip joint includes giving up bad habits, a sedentary lifestyle, extra pounds burden the area of the hip joint, exceed the physiological limits of joint strength.Follow the daily regime and principles of PN for coxarthrosis, monitor 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!