Coxarthrosis or arthrosis of the hip joint is a degenerative-dystrophic disease that causes loss and loss of cartilage tissue elasticity and premature wear of the joint of the same name. Osteoarthritis is an age-related problem confirmed by world statistics: after 40 years, every second person is diagnosed, and in about 70 cases, 80% of cases are pathological. Structural changes in the hip area occur 2. 5 to 5 times more often in women than in men.
Causes of the disease
The hip joint is formed by the acetabulum, which contains the head of the femur. A large trochanter is attached to the articular head, surrounded by a synovial sac with a thick mucus-like mass. It is the synovium that nourishes the cartilage of the hips and allows them to slide easily between each other without noise and pain. Age-related decrease in synovial fluid production and changes in its viscosity are the main causes of osteoarthritis of the hip joint.
Coxarthrosis of the mobile joints in the hip area occurs in the following cases:
- Perthes disease.
- Hip dysplasia.
- Reactive or infectious coccyx.
- Metabolic disorders. Diabetes and gout can cause osteoarthritis.
- Chondromatosis of the joints. The disease is characterized by the formation of free intraarticular bodies that damage the hyaline cartilage.
- mechanical injuries. These include fractures or dislocations of the hip (including congenital), rupture of the joint capsule, and frequent microtrauma of the joints.
The risk group includes people who are overweight and have bad habits. In professional runners or weightlifters, connective tissue wears out quickly, and in addition, athletes are not immune to displacement of joint cartilage and rupture of hip muscles. Spontaneously, osteoarthritis of the hip joint is not inherited, but the structural features of the bone tissue or slow metabolism are genetically determined.
The course of the disease
First, osteoarthritis affects the large joints of the pelvic and knee bones (gonarthrosis), which account for a large load during movement. During the period of exacerbation, acute osteoarthritis occurs, followed by palpation of the joint and hip tissues, accompanied by pain. After an injury, an incomplete or incorrect fusion of the femur results in neoarthritis or a false fusion filled with connective tissue, not callus.
There is arthrosis of the hip joint of 1, 2 and 3 degrees, each stage of the disease has its own characteristics:
- Grade 1 osteoarthritis develops slowly, without disturbing the mobility of articular structures, muscle tone is normal. In the early stages of coxarthrosis, the disease can be detected only by X-rays.
- Secondary femoral arthrosis is accompanied by severe pain in the thigh area, and sometimes a crackling sound is heard in the joint. With osteoarthritis, it is difficult to rotate the hip and move it to the side, the articular space narrows, and the tone of the thigh muscles weakens. The contract is starting to take shape.
- Pain syndrome is pronounced with grade 3 coxarthrosis. The leg is shortened due to atrophy of the muscles of the hip area and enlargement of the neck of the femur. The patient uses support while walking. Due to osteoarthritis, the joint space may disappear completely, in which case they are talking about bone ankylosis.
In clinical practice, physicians routinely encounter involutive coxarthrosis (characteristic of the elderly) and postinfectious osteoarthritis of the hip joint. Patients taking corticosteroids and antidepressants are at risk for dyshormonal coxarthrosis, which also affects a woman's joints during menopause. In osteoarthritis, the inflammatory process is predominant in the hip joint, not degenerative.
When the etiology of the disease is unknown, we are talking about primary or idiopathic coxarthrosis. The disease usually affects the joints of people over 50 years of age. Secondary osteoarthritis develops at a young age, usually diagnosed with osteoarthritis of the left thigh or right thigh (unilateral coxarthrosis).
Symptoms
The symptoms of osteoarthritis of the hip joint do not bother the patient at first, only sometimes reminiscent of the problem of prolonged loads or awkward movement in the affected area.
Coxarthrosis of the hip joint manifests itself:
- Pain in the hip area. The intensity and nature of joint pain depends on the stage of osteoarthritis and weather conditions.
- An increase in body temperature. With osteoarthritis of one or both hips, tremors and swelling of the joints are observed.
- Weakening and subsequent atrophy of the muscles of the hip.
- A different crisis in the joints. A possible sign of coxarthrosis, but not mandatory.
- lameIn osteoarthritis, an indeterminate, "duck" gait occurs due to the destruction of the femur.
People suffering from coxarthrosis often experience pain that spreads to the patella, so an inexperienced doctor can misdiagnose and delay the recovery process for several months after listening to the patient's complaints.
Diagnostics
The diagnosis of osteoarthritis is made by a rheumatologist, traumatologist or orthopedist. After questioning the patient, the doctor conducts an external examination of the hip area, checks the mobility of the foot, assesses the gait of the patient with coxarthrosis.
The most effective methods for diagnosing osteoarthritis include:
- General and biochemical analysis of blood.
- Direct radiography of the hip area.
- Ultrasound and MRI.
If you suspect infectious osteoarthritis of the femoral joint, the volume of synovial fluid is determined and the cell composition is examined. To rule out the presence of autoaggressive antibodies in the body, the patient is sent for RF analysis in blood serum.
How is hip osteoarthritis treated?
Treatment of osteoarthritis of the hip joint is selected taking into account the stage of coxarthrosis, the age of the patient and the accompanying diagnoses. Grade 1 and 2 osteoarthritis can be treated with an integrated approach: physiotherapy, massage and pharmaceuticals in combination with a special diet.
For the treatment of the hip joint, cardio exercises without running and jumping are allowed after the end of the acute period of coxarthrosis.
After the end of the acute period of coxarthrosis, careful gymnastic exercises with a limited range of motion, cardio exercises without running and jumping are selected for the treatment of the hip joint. In the final stage, the treatment of osteoarthritis of the hip joint takes place in a sanatorium-resort environment.
Treatment
Conservative therapy of the disease is aimed at relieving pain in the hip area and maintaining joint functionality. The main goal is complete recovery or stable remission of coxarthrosis.
Treatment of osteoarthritis is not completed without an appointment:
- NSAIDs. Non-steroidal drugs relieve pain and inflammation in the cellular joint, but the tablets are not associated with the restoration of hyaline cartilage structure in coxarthrosis.
- Vasodilators. Preparations ensure the delivery of nutrients to the joints affected by osteoarthritis, eliminate congestion in the hip area.
- Chondroprotectors. They saturate the tissues of the joint with water, improving its lubricating properties. Stop the destruction of articular structures in the hip area. Glucosamine and chondroitin sulfate are part of many chondroprotectors.
- Gels and ointments against osteoarthritis. They have a warming, irritating or distracting effect. Remedies for the successful treatment of osteoarthritis of the hip joints.
- Injections of steroid drugs into the joint cavity are recommended to relieve pain in the acute stage of coxarthrosis.
Compresses with medical bile increase the effectiveness of the listed means for osteoarthritis. Therapeutic dressings should not be applied to the thigh area with damage to the lymphatic system and 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 warming paraffin applications. Acupuncture improves the innervation of cartilage tissue and the functioning of internal organs. In osteoarthritis, hydrocortisone and phonophoresis combine the benefits of ultrasound and the drug effect on the hip area.
Diet and Nutrition
The special diet for coxarthrosis consists of low-fat products and high amounts 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. Prefer boiled and steamed foods.
The daily menu for osteoarthritis should include:
- Dairy products.
- Fresh vegetables and fruits.
- Low-fat fish and meat species.
- Whole grain bread.
- Porridge boiled in water.
Eliminate salty and spicy foods, nightshades, cakes, smoked meats and fizzy drinks from your diet. When treating coxarthrosis, you should not buy ready meals from supermarkets or semi-finished products.
Endoprostheses
Artificial replacement of the affected joint is indicated in the final stage of coxarthrosis. Before the operation, the patient should undergo general blood and urine tests, hip ultrasound, ECG.
The main stages of the procedure:
- The surgeon cuts off the head of the femur and inserts a pin to attach it to the titanium implant of the femur.
- Part of the surface of the pelvis is removed and replaced with a polymer bed attached to a titanium head.
Dentures are best fixed with bone cement. If osteoarthritis affects the joints at a young age, cement-free dressings are sometimes used.
Massage
Massage relieves muscle spasms, strengthens the garden apparatus during coxarthrosis. During the procedure, the patient with osteoarthritis should take a comfortable position and rest. First we rub the back (10 minutes), then we massage the sacro-hip area. With circular movements of the bent fingers, we knead the problematic leg in the direction of lymph flow - from bottom to top. The procedure is performed 3 times a day to slow the development of osteoarthritis.
Exercise and exercise therapy
The level of load on the hip joints with osteoarthritis is selected by the exercise therapy physician. For this purpose, it is recommended to do physiotherapy exercises in a specially equipped room. Swimming or skiing in the pool will accelerate the recovery of joints with coxarthrosis.
The method of combating osteoarthritis, presented by an experienced rheumatologist P. V. Evdokimenko, is gaining popularity. Gymnastics Evdokimenko 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 stretch your right leg, then hold it high for about 30 seconds, then the muscles will begin to contract. With coxarthrosis, the task is performed in 5 approaches for each leg.
Folk remedies
At the heart of folk methods of treatment of coxarthrosis are the basic concepts of the properties of medicinal plants. Before the development of the pharmaceutical industry, eucalyptus oil, cloves and fresh aloe juice were applied to diseased joints for osteoarthritis. Celandine ointments relax the hip muscles and tendons.
Effective alternative medicine prescriptions:
- Chop 200 g of white wild roots and fill with lard (300-400 g). Put on low heat, after 5-7 minutes the remedy for coxarthrosis is ready. Rub the cooled mass on the affected joint overnight for 2 weeks.
- Beat egg whites with 1 tbsp. l. un. The therapeutic mixture should be applied to the hip area for osteoarthritis before bedtime. Remember to wrap the painful joint with parchment paper and a woolen scarf.
Mummy has an intensive restorative effect, improves the mobility of the hip joints. For arthritis and osteoarthritis, 5 g of mummy is dissolved in 10-20 ml of water, 45 g of heated Vaseline is poured into it. The product is gently rubbed into the skin of the thigh.
Prevention
Prevention of osteoarthritis of the hip joint imposes the rejection of bad habits, a sedentary lifestyle, the extra pounds of the hip area exceeding the physiological limit of joint strength. Follow the daily regimen and principles of PP for coxarthrosis, follow your posture. An annual examination of the joints from the age of 30 will allow a patient with osteoarthritis to prevent the development of irreversible changes in the body.
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 a major cause of disability at a young age. Even if you can't protect yourself from coxarthrosis, don't despair - take action!