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.Osteoarthritis is considered to be an age-related problem, which is confirmed by world statistics: after 40 years, every second person is diagnosed, and closer to 70, 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 hip cartilages and ensures that they slide easily between each other, 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 osteoarthritis of the hip joint.
Coxarthrosis of mobile joints in the hip area occurs when:
- Perthe's disease.
- Hip dysplasia.
- Reactive or infectious coxitis.
- Metabolic disorders.Diabetes mellitus and arthritis can cause osteoarthritis.
- Chondromatosis of the joints.The disease is characterized by the formation of loose intra-articular bodies that damage hyaline cartilage.
- Mechanical damage.This includes fracture or dislocation of the hip (including congenital), tearing of the joint capsule, and frequent microtrauma to the joints.
People who are overweight and have bad habits are at risk.In professional runners or weightlifters, the connective tissue wears out quickly, and athletes are not immune to displacement of the articular cartilage and tears in the hip muscles.Osteoarthritis of the hip joint itself is not inherited, 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 bones of the pelvis and knee joints (gonarthrosis);they are the ones who carry a huge burden when they move.During the period of exacerbation, acute arthrosis occurs, 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 is arthrosis of the hip joint of the 1st, 2nd and 3rd degrees, each stage of the disease has its own characteristics:
- Osteoarthritis 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 intense pain in the hip area, sometimes a crunching sound is heard in the joint.With osteoarthritis, it is difficult to turn 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 atrophy of the muscles in the hip region and enlargement of the femoral neck, the leg is shortened.When the patient walks, the patient uses support.Due to osteoarthritis, the joint space can completely disappear, in which case they speak of bony ankylosis.
In clinical practice, doctors regularly encounter an involving type of coxarthrosis (typical of older people) 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 osteoarthritis, the inflammatory rather than the degenerative process in the hip joint predominates.
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 passed the 50-year mark.Secondary osteoarthritis develops at a young age;as a rule, arthrosis is diagnosed in the left or right hip joint (unilateral coxarthrosis).
Symptoms
Symptoms of arthrosis of the hip joint do not bother the patient at first, only occasionally prolonged loads on the affected area or awkward 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 osteoarthritis and weather conditions.
- Increased body temperature.Chills and swelling of the joints are observed with osteoarthritis in one or two hip joints.
- Weakening and subsequent atrophy of the muscles in the hip region.
- A distinct crunching sound in the joints.A possible sign of coxarthrosis, but not mandatory.
- Lameness.Due to the destruction of the hip bone with osteoarthritis, an unsafe "duck" gait is formed.
Those who suffer from coxarthrosis often experience pain that radiates to the kneecap, so an inexperienced doctor, after listening to the patient's complaints, can make an incorrect diagnosis and delay the recovery process for many months.
Diagnostics
Osteoarthritis is diagnosed by a rheumatologist, traumatologist or orthopedist.After interviewing the patient, the doctor conducts an external examination of the hip area, studies leg mobility and evaluates the gait of the patient with coxarthrosis.
The most effective methods for diagnosing osteoarthritis include:
- General and biochemical blood test.
- Plain x-ray of the hip area.
- Ultrasound examination and MRI.
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 the blood serum.
How is arthrosis in 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 concurrent diagnoses.Osteoarthritis of degrees 1 and 2 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 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 chosen for the treatment of the hip joint.In the final phase, treatment of arthrosis in the hip joint takes place at a sanatorium resort.
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.
Treatment of osteoarthritis is not complete without the following:
- NSAIDs.Non-steroid 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.The drugs ensure the delivery of nutrients to joints affected by osteoarthritis and eliminate overload in the hip area.
- Chondroprotectors.Saturate joint tissue with water and improve its lubricating properties.Stops 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 warming, irritating or distracting effects.The drugs successfully cure osteoarthritis of the hip joints.
- It is advisable 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 against 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 physiotherapy procedures include electrophoresis, laser therapy and warming paraffin applications.Acupuncture improves the innervation of cartilage tissue and the function of internal organs.Phonophoresis with hydrocortisone for osteoarthritis combines the benefits of ultrasound and medical effects on 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 advisable that every new day begins with a glass of freshly squeezed juice.Give preference to boiled and steamed dishes.
The daily menu for osteoarthritis should consist of:
- Dairy products.
- Fresh vegetables and fruits.
- Low-fat varieties of fish and meat.
- Whole grain bread.
- Porridge cooked in water.
From your diet, you must exclude salty and spicy food, nightshades, baked goods, smoked food and carbonated drinks.When treating coxarthrosis, you should not buy ready-made food 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 off the head of the femur 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 is attached, which is connected to the titanium head.
The best way to fix prostheses is with bone cement.If osteoarthritis affects the joints at a young age, cementless fixation methods are sometimes used.
Massage
Massage relieves muscle spasms, strengthens the ligament apparatus in case of coxarthrosis.During the procedure, the patient with osteoarthritis must take a comfortable position and relax.First we rub the back (10 minutes), then massage the sacro-gluteal area.Using circular movements of bent fingers, we knead the problem thigh in the direction of lymph flow - from bottom to top.To slow down the development of osteoarthritis, the procedure is carried out 3 times a day.
Exercises and exercise therapy
The load level on the hip joints during osteoarthritis is determined by the physiotherapist's doctor.It is advisable to take part in 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, which was presented by the practicing rheumatologist P. V. Evdokimenko, is growing.Evdokimenko'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, 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 herbs.Before the development of the pharmaceutical industry, eucalyptus oils, cloves and fresh aloe juice were rubbed into sore joints for osteoarthritis.Celandine ointment relaxes hip muscles and tendons.
Effective alternative medicine recipes:
- Grind 200 g of the roots of the white foot and fill it with lard (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 at night for 2 weeks.
- Beat egg whites with 1 tbsp.l. flour.For osteoarthritis, the medicinal mixture should be applied to the hip area before going to bed.Don't forget to wrap the sore joint with parchment paper and a woolen scarf.
Shilajit has an intense restorative effect and improves the mobility of the hip joints.For gout and arthrosis, dissolve 5 g of mumiyo in 10-20 ml of water, and pour 45 g of heated vaseline into it.The product is rubbed into the skin of the thigh with gentle movements.
Prevention
Prevention of arthrosis in the hip joint involves giving up bad habits, a sedentary lifestyle, extra kilos strain the hip area and exceed the physiological limits of joint strength.Follow the daily routine and principles of PN for coxarthrosis, watch your posture.An annual examination of the joints, starting at the age of 30, will help prevent the development of irreversible changes in the body of a patient with osteoarthritis.
Among 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 could not protect yourself from coxarthrosis, do not despair - act!