Coxarthrosis or arthrosis of the hip joint is a degenerative-dystrophic disease leading to loss of elasticity and destruction of cartilaginous tissue, 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, one in two people is diagnosed, and closer 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 joint head, surrounded by a synovial bursa with a thick mucus-like mass.It is the synovium that nourishes the cartilages of the hip and ensures their easy sliding together, without noise or 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 mobile 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 the hyaline cartilage.
- Mechanical injuries.This includes a fracture or dislocation of the hip (including congenital), rupture of the joint capsule and frequent microtraumas of the joints.
People who are overweight and have bad habits are at risk.In professional runners or weight lifters, 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 hereditary, but the structural characteristics of the bone tissue or slow metabolism are determined genetically.
Course of the disease
First of all, arthrosis affects the large joints of the pelvic bones and knee joints (gonarthrosis);it is they who bear a huge load when moving.During the period of exacerbation, acute arthrosis occurs, so palpation of the joint tissue and hip is accompanied by pain.In case of incomplete or incorrect fusion of the femur after an injury, a neoarthrosis or a false joint is formed, filled not with callus, but with connective tissue.
There are arthrosis of the hip joint of the 1st, 2nd and 3rd degree, each stage of the disease has its own characteristics:
- 1st degree arthrosis develops slowly, without compromising the mobility of the joint structures, muscle tone is normal.In the initial stage of coxarthrosis, the disease can be detected only by x-rays.
- Second degree arthrosis of the hip joint is accompanied by intense pain in the hip area, sometimes a creaking sound is heard in the joint.With osteoarthritis, it is difficult to rotate the hip and move it laterally, 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 atrophy of the muscles of the hip region and expansion of the femoral neck, the leg shortens.When walking, the patient uses support.Due to arthrosis the joint space can disappear completely, in which case we speak of bone ankylosis.
In clinical practice, doctors regularly encounter involutional coxarthrosis (typical of the elderly) and post-infectious arthrosis of the hip joint.Patients taking corticosteroids and antidepressants are at risk for dyshormonal coxarthrosis;this type of osteoarthritis also affects the joints of menopausal women.In arthrosis-arthritis in the hip joint, the inflammatory process predominates rather than the degenerative one.
If the etiology of the disease is not established, it is called primary or idiopathic coxarthrosis.The disease usually affects the joints of people who are over the age of 50.Secondary arthrosis develops at a young age;arthrosis of the left or right hip joint (unilateral coxarthrosis) is usually diagnosed.
Symptoms
Symptoms of arthrosis of the hip joint at first do not bother the patient, only occasionally prolonged loads on the affected area or awkward movements 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 osteoarthritis 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 region.
- A distinct cracking sound in the joints.A possible sign of coxarthrosis, but not mandatory.
- Lameness.Due to the destruction of the hip bone with arthrosis, an uncertain, "duck" gait is formed.
Those who suffer from coxarthrosis often feel pain radiating to the kneecap, which is why an inexperienced doctor, after listening to the patient's complaints, can make an incorrect diagnosis and delay the healing process for many months.
Diagnostics
Osteoarthritis is diagnosed by a rheumatologist, traumatologist or orthopedist.After interviewing the patient, the doctor carries out an external examination of the hip area, studies the mobility of the legs and evaluates the gait of the patient suffering from coxarthrosis.
The most effective methods for diagnosing osteoarthritis include:
- General and biochemical blood test.
- Plain x-ray of the hip area.
- Ultrasound examination and magnetic resonance imaging.
If infectious arthrosis of the hip joint is suspected, the volume of 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 for arthrosis of the hip joint is selected taking into account the stage of coxarthrosis, the age of the patient and concomitant diagnoses.Grade 1 and 2 arthrosis can be treated using an integrated approach: taking medications in combination with physiotherapeutic methods, massage and a special diet.
After the end of the acute period of coxarthrosis, cardiovascular training without running and jumping is allowed for the treatment of the hip joint.
After the end of the acute period of coxarthrosis, gentle gymnastic exercises with a limited range of motion, cardio training without running and jumping are selected for the treatment of the hip joint.At the final stage, treatment of arthrosis of the hip joint takes place in a sanatorium resort.
Pharmacological 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.Non-steroidal drugs relieve pain and inflammation of the mobile joint, but tablets have nothing to do with restoring the structure of hyaline cartilage in coxarthrosis.
- Vasodilators.The drugs ensure the supply of nutrients to the joints affected by arthrosis and eliminate congestion in the hip area.
- Chondroprotectors.Saturate joint tissues with water, improving their lubricating properties.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 warming, irritating or distracting effects.The drugs 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 remedies for arthrosis.It is not possible to apply therapeutic bandages to the hip area if the lymphatic system is affected and you have fever (infectious coxarthrosis).
Physiotherapy
Despite the deep location of the hip joints, physiotherapeutic methods bring relief from coxarthrosis.Popular physiotherapeutic procedures include electrophoresis, laser therapy, and heating paraffin applications.Acupuncture improves the innervation of cartilaginous tissue and the functioning of internal organs.Phonophoresis with hydrocortisone for osteoarthritis combines the advantages of ultrasound and medicinal effects on the hip area.
Diet and nutrition
A special diet for coxarthrosis consists of foods low in fat and a high content of vitamins B, C, E, as well as calcium, potassium and magnesium.It is desirable that each new day begins 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 fruit and vegetables.
- Low-fat varieties of fish and meat.
- Wholemeal bread.
- Porridge cooked in water.
From your diet, exclude salty and spicy foods, nightshades, baked goods, smoked foods and carbonated drinks.When treating coxarthrosis, you should not buy ready-made food from supermarkets or semi-finished products.
Endoprosthesis
Replacement of the affected joint with an artificial one is indicated in the last stage of coxarthrosis.Before surgery, the patient must undergo general blood and urine tests, hip ultrasound and ECG.
Main steps of the procedure:
- The surgeon cuts the femoral head and inserts a pin inside to connect to the titanium femoral head implant.
- Part of the surface of the pelvic bone is removed and in its place a polymer bed connected to the titanium head is fixed.
The best way to fix the prosthesis is with bone cement.If osteoarthritis affects the joints at a young age, cementless fixation methods are sometimes used.
Massage
The massage relieves muscle spasms and strengthens the ligament system 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 problem thigh in the direction of lymphatic flow, from bottom to top.To slow the development of arthrosis, the procedure is performed 3 times a day.
Exercises and physical therapy
The level of load on the hip joints during osteoarthritis is determined by the physiotherapist.It is recommended 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 affected by coxarthrosis.
The popularity of the method of combating arthrosis, presented by the practicing rheumatologist P. V. Evdokimenko, is growing.Evdokimenko gymnastics consists of static exercises to strengthen the hip muscles, stretching them 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, your 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 herbs.Before the development of the pharmaceutical industry, oils of eucalyptus, cloves and fresh aloe juice were rubbed into joints painful from osteoarthritis.Celandine ointments relax the hip muscles and tendons.
Effective recipes of alternative medicine:
- Grind 200 g of white foot roots and fill them with pork fat (300–400 g).Place on low heat, after 5-7 minutes the remedy for coxarthrosis is ready.Rub the cooled mass into the affected joint overnight for 2 weeks.
- Beat the egg white with 1 tbsp.the.Flour.For osteoarthritis, the medicinal mixture should be applied to the hip area before bedtime.Don't forget to wrap the sore joint with baking 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 heated petroleum jelly is poured into it.The product is massaged into the skin of the thigh with gentle movements.
Prevention
Prevention of arthrosis of the hip joint involves abandoning bad habits, a sedentary lifestyle, extra pounds load the hip area, exceeding the physiological limits of joint strength.Follow the daily routine and principles of PN for coxarthrosis, observe 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 osteoarthritis.
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 can't protect yourself from coxarthrosis, don't despair: act!