Coxarthrosis or osteoarthritis 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 an age-related problem, which is confirmed by global statistics: after 40, one in two people is faced with a diagnosis, and closer to 70, a pathology is detected in 80% ofcase. Structural changes in the hip area occur 2. 5 times more often in women than in men.
Causes of disease
The hip joint is formed by the acetabulum, which includes the head of the femur. A greater trochanter is attached to the articular head, surrounded by a synovial sac with a thick mucus-like mass. It is the synovia that nourishes the cartilages of the hip and ensures their easy sliding between them, without noise or pain. The 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 region occurs when:
- Perthes disease.
- Hip dysplasia.
- Reactive or infectious coxitis.
- Metabolic disorders. Diabetes and gout can lead to osteoarthritis.
- Chondromatosis of the joints. The disease is characterized by the formation of free intra-articular bodies that damage the hyaline cartilage.
- mechanical injuries. This includes a fracture or dislocation of the hip (including congenital), a tear in the joint capsule, frequent microtrauma to the joints.
People at risk are overweight and have bad habits. In professional runners or weightlifters, the connective tissue wears out quickly and, moreover, athletes are not immune to joint cartilage displacement and hip muscle ruptures. By itself, arthrosis of the hip joint is not hereditary, however, the structural features of bone tissue or the slowing down of metabolism are genetically determined.
The course of the disease
First of all, arthrosis affects the large joints of the pelvic bones and knee joints (gonarthrosis), it is on their part that a huge load falls during movement. During the period of exacerbation, acute arthrosis occurs, then palpation of the joint and hip tissues is accompanied by pain. With incomplete or incorrect fusion of the femur after injury, neoarthrosis or a false joint is formed, filled not with callus, but with connective tissue.
There is arthrosis of the hip joint of 1, 2 and 3 degrees, each stage of the disease has its own characteristics:
- Arthrosis of the 1st degree develops slowly, without disturbing the mobility of articular structures, muscle tone is normal. At an early stage of coxarthrosis, the disease can only be detected on X-rays.
- Arthrosis of the hip joint of the second degree is accompanied by severe pain in the hip area, sometimes a cracking sound is heard in the joint. With arthrosis, it is difficult to rotate the hip and take it to the side, the joint space narrows, the tone of the hip muscles weakens. Contracture begins to form.
- With coxarthrosis of the 3rd degree, the pain syndrome is pronounced. Due to the atrophy of the muscles in the hip region and the expansion of the neck of the femur, the leg is shortened. When walking, the patient uses support. Due to osteoarthritis, the joint line can completely disappear, in which case we speak of bone ankylosis.
In clinical practice, doctors regularly encounter involutive coxarthrosis (typical of the elderly) and post-infectious arthrosis of the hip joint. Patients taking corticosteroids and antidepressants are at risk of dyshormonal coxarthrosis, this type of osteoarthritis also affects the joints of women in menopause. In arthrosis-arthritis, the inflammatory rather than degenerative process predominates in the hip joint.
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 milestone of 50 years. Secondary arthrosis develops at a young age, as a rule, arthrosis of the left or right hip joint (unilateral coxarthrosis) is diagnosed.
Symptoms
Symptoms of arthrosis of the hip joint do not bother the patient at first, only occasional prolonged loads on the affected area or awkward movements remind of the problem.
Coxarthrosis of the hip joint is manifested:
- 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. Chills and swelling of the joints are observed with arthrosis-arthritis of one or two hip joints.
- Weakening and subsequent atrophy of the muscles in the hip region.
- A distinct crack in the joints. A possible sign of coxarthrosis, but not mandatory.
- lame. Due to the destruction of the femoral bone in arthrosis, an uncertain "duck" gait is formed.
People with coxarthrosis often feel pain radiating to the patella, so an inexperienced doctor, having listened to the patient's complaints, can make an erroneous diagnosis and delay the recovery process for several months.
Diagnostic
Osteoarthritis is diagnosed by a rheumatologist, traumatologist or orthopedist. After interviewing the patient, the doctor conducts an external examination of the hip area, examines the mobility of the leg, assesses the gait of the patient with coxarthrosis.
The most effective methods for diagnosing osteoarthritis include:
- General and biochemical analysis of blood.
- Simple x-ray of the hip region.
- Ultrasound and MRI.
If infectious arthrosis of the femoral 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 RF analysis in blood serum.
How is osteoarthritis of the hip treated?
The treatment of arthrosis of the hip joint is selected taking into account the stage of coxarthrosis, the patient's age and concomitant diagnoses. It is possible to cure arthrosis of degrees 1 and 2 using an integrated approach: taking pharmaceutical preparations in combination with physiotherapy methods, massage and a special diet.
After the end of the acute period of coxarthrosis for the treatment of the hip joint, cardio training is allowed without running and jumping.
After the end of the acute period of coxarthrosis, sparing gymnastic exercises with a limited range of motion, cardio training without running and jumping are selected for the treatment of the hip joint. In the final stage, the treatment of arthrosis of the hip joint takes place in a sanatorium environment.
Medical treatment
Conservative therapy 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.
Osteoarthritis treatment is not complete without an appointment:
- NSAIDs. Nonsteroidal drugs relieve pain and inflammation of the mobile joint, but tablets are not related to the restoration of the structure of hyaline cartilage in coxarthrosis.
- Vasodilators. Preparations provide the delivery of nutrients to the joints affected by arthrosis, eliminate congestion in the hip area.
- Chondroprotectors. They saturate the tissues of the joint with water, improving its lubricating properties. Stop the destruction of joint structures in the hip area. Glucosamine and chondroitin sulfate are among many chondroprotectors.
- Gels and ointments against osteoarthritis. They have a warming, irritating or distracting effect. Means successfully curing osteoarthritis of the hip joints.
- Injections of steroid drugs into the joint cavity, it is advisable to inject to eliminate pain in the acute phase of coxarthrosis.
Compresses with medical bile increase the effectiveness of the listed remedies for arthrosis. Therapeutic dressings should not be applied to the hip area with damage to the lymphatic system and fever (infectious coxarthrosis).
Physiotherapy
Despite the deep localization of the hip joints, physiotherapy methods relieve coxarthrosis. Popular physiotherapeutic procedures include electrophoresis, laser therapy, paraffin warming applications. Acupuncture improves the innervation of cartilage tissue and the functioning of internal organs. Phonophoresis with hydrocortisone in osteoarthritis combines the benefits of ultrasound and drug effects on the hip region.
Diet and nutrition
A special diet for coxarthrosis consists of low-fat products with a high content of vitamins B, C, E, as well as calcium, potassium and magnesium. It is desirable that each new day begin with a glass of freshly squeezed juice. Give preference to boiled and steamed dishes.
The daily menu for arthrosis should include:
- Dairy products.
- Fresh vegetables and fruits.
- Varieties of fish and meat low in fat.
- Whole grain bread.
- Kasha boiled in water.
Exclude salty and spicy foods, nightshades, muffins, smoked meats, carbonated drinks from the diet. When treating coxarthrosis, you should not buy ready-made food in supermarkets or semi-finished products.
Stents
Replacement of the affected joint with an artificial joint is indicated at the last stage of coxarthrosis. Before the operation, the patient must pass general blood and urine tests, ultrasound of the hip area, ECG.
The main stages of the procedure:
- The surgeon cuts the femoral head and inserts a pin to connect it to the titanium femoral head implant.
- Part of the surface of the pelvic bone is removed, a polymer bed is fixed in its place, which is connected to the titanium head.
Dentures are best fixed 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 should take a comfortable position and relax. We first rub the back (10 minutes), then massage the sacro-gluteal region. With circular movements of bent fingers, we knead the problematic thigh in the direction of lymphatic flow - from bottom to top. To slow down the development of arthrosis, the procedure is carried out 3 times a day.
Exercise and exercise therapy
The level of load on the hip joints with arthrosis is selected by the exercise therapy doctor. It is advisable to engage in physiotherapy exercises 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 practicing rheumatologist P. V. Evdokimenko, is constantly growing. Evdokimenko gymnastics consists of static exercises to strengthen the muscles of the hip, stretch marks 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 in an elevated position 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 traditional methods of treating coxarthrosis are the basic concepts of the properties of medicinal herbs. Before the development of the pharmaceutical industry, eucalyptus oils, cloves and fresh aloe juice were rubbed into diseased joints for osteoarthritis. Celandine ointments relax the muscles and tendons of the hip.
Effective Alternative Medicine Recipes:
- Grind 200 g of white steppe roots and fill them with pork fat (300–400 g). Put on low heat, after 5-7 minutes the remedy for coxarthrosis is ready. Rub the cooled mass overnight into the affected joint for 2 weeks.
- Whisk the egg white with 1 tbsp. I. flour. The therapeutic mixture should be applied for osteoarthritis in the hip area before going to bed. Do not forget to wrap the painful joint with parchment paper and a woolen scarf.
Mumiyo has an intense restorative effect, improves the mobility of the hip joints. For arthritis and arthrosis, 5 g of mummy is dissolved in 10-20 ml of water, 45 g of heated petroleum jelly is poured into it. The product is gently rubbed into the skin of the thigh.
Prevention
Prevention of arthrosis of the hip joint involves the rejection of bad habits, a sedentary lifestyle, extra pounds load the hip area, exceeding the physiological limits of joint strength. Follow the daily routine and the principles of PP for coxarthrosis, monitor your posture. To prevent the development of irreversible changes in the body of a patient with arthrosis, an annual examination of the joints, starting from the age of 30, will allow.
Among the pathologies of the musculoskeletal system, arthrosis of the hip joint occupies a prominent place. The disease reduces the patient's quality of life and is the main cause of disability at a young age. Even if it was not possible to protect yourself from coxarthrosis, do not despair - take action!