Coxarthrosis, or degenerative disease of the hip joint, is one of the most serious pathologies of the musculoskeletal system. Due to the large size of the joint structures, the pain and discomfort is much more severe than when other joints are affected. The consequences of the pathology are also serious - if the destruction of small bone joints causes a lot of discomfort, arthrosis of the hip without treatment is a direct path to disability. Only the right therapy, and sometimes surgery, will help a person not lose the ability to walk.
What is osteoarthritis of the hip?
Coxarthrosis, arthrosis, arthrosis of the hip joint are synonymous with the same pathological process that occurs in the thigh area on one or both sides. In modern medicine, the pathology is also called arthrosis: it was previously believed that inflammation is not characteristic of degenerative processes, but more accurate studies have shown the opposite. Affected articular cartilage tissue releases inflammatory elements (interleukins), so osteoarthritis is another correct term.
The disease is characterized by such signs:
- Progresses steadily, moving from one stage to another,
- Causes persistent pain, limited joint mobility,
- Causes deformation of bone surfaces, partial or complete destruction of hyaline cartilage,
- In the advanced stage, it is more characteristic of older people, but often begins after 40 years,
- Symptoms of the pathology are present in 70% of people over 75,
- Women are more likely to suffer from the disease.
A joint is a mechanism in which there are rubbing parts. Due to a decrease in the quality or quantity of lubrication (interarticular fluid), the contact surfaces wear out. Small cracks appear on the cartilage, later they are destroyed and instead of healthy tissue a callus appears. Such growths do not allow the leg to move normally, its functions are lost.
Reasons for the development of the disease
Arthrosis of the right or left thigh region can be primary or secondary, and the first option is typical for older people. The disease of the primary form develops over decades, is associated with age-related wear and cartilage destruction.
Secondary coxarthrosis has other causes and can start even in a young person. It is associated with the resulting inflammation (infectious, autoimmune), which gives impetus to the appearance of pathology. Also, the cause may be trauma to the hip (bruise, dislocation, bone fracture). Other possible causes of the secondary form:
- Operations on this anatomical area,
- Diabetes mellitus and other serious metabolic pathologies,
- hormonal diseases,
- Congenital, acquired forms of curvature and displacement of bones,
- hip dysplasia in a child
- Protrusion of the acetabulum, necrosis of the femoral head,
- Vascular diseases of a systemic nature, leading to deterioration of cartilage nutrition,
- Bone tuberculosis, rheumatoid arthritis,
- Gout, Perthes disease,
- Tumors are benign and malignant.
Symptoms of osteoarthritis of the hip joint, regardless of form, will appear more quickly if risk factors act on the body:
- Constant stress, nervous shocks, depressions and worries,
- Obesity, even moderate overweight,
- unfavorable heredity,
- Physical inactivity, sedentary work or certain jobs with high joint load,
- Excessive physical loads (strength), professional sports.
Disease symptoms
The development of arthrosis of the hip joint and its symptoms cannot be overlooked. Even at an early stage, the disease makes itself felt, and most importantly, pain. Pain in emerging and progressive osteoarthritis of the hip joint increases as the disease progresses from stage to stage. They appear in the thigh area, give to the knee, groin, even the lower abdomen. Usually after sleep the pain subsides, but in advanced stages it can be present all the time. On palpation, pain is not always felt, since joint damage can begin with deeply localized parts.
Other possible signs of the disease:
- The crunch that appears when moving, sometimes even with a slight,
- Limp, change of gait,
- Shortening of the leg on the side where there is arthrosis of the hip joint,
- Stiffness of movement, limited rotation, movement of the leg.
As development progresses, other signs of pathology appear. Thus, palpation gives a feeling of deformation of the bone, the presence of growths. During the examination, the doctor notes muscle atrophy, and the patient, even in ordinary life, is forced to move with a cane, a crutch - due to pain and weakness in the limb.
In general, pain and other clinical manifestations are highly stage dependent. There are such stages of coxarthrosis:
- First.The symptoms are mild, but the initial changes are already noticeable during the diagnosis. The synovial fluid thickens, its volume decreases, the structure of the cartilage changes towards the end of the stage. Small cracks appear, which the body tries to heal with the formation of small "corns".
- Second.The pain at this stage is quite noticeable, the crunch, the restriction of motor function is obvious. The pain syndrome radiates to other parts of the body, spreads along the entire leg. The picture shows: thinning of the cartilage, narrowing of the distance between the bones, violation of the structure of the articular surfaces, sometimes - displacement of the head of the cavity bone. The number of bony growths (osteophytes) is increased.
- The third.The pain becomes unbearable, a person is severely limited in movement, many stop moving altogether. The cartilage is almost completely destroyed, the muscles atrophy, the joint is severely deformed. Bone osteophytes look like spikes and irritate nerve endings.
What are the risks and complications?
It is easy to understand that if with such a pathology as arthrosis of the hip, the symptoms and treatment are determined incorrectly, out of time, it threatens with disability. Excruciating pain syndrome, inability to walk, the need for constant care - this is what awaits a person without treatment for this disease.
Disability in case of damage to the thigh bones is established depending on the severity of the disease, with the complete absence of the possibility of work, they give the first group. Such patients are shown surgical intervention - this is the only effective method of treatment in such a situation. But even modern operating methods can carry the risk of complications:
- infectious infection,
- thrombosis, thrombus embolism,
- Significant blood loss.
The overall proportion of complications is small - 0. 5-2%, but they do occur. Most often, it is an infection of the prosthesis, which must then be replaced by a new one. That is why, after the operation, it is important to undergo antibiotic treatment.
Diagnostic measures for osteoarthritis
It is recommended to seek help from a traumatologist, surgeon, orthopedist at the first signs of damage to the femoral zone. As a first step, if osteoarthritis of the hip is suspected, the doctor performs physical tests:
- Feels the upper thigh, reveals sore spots, bone osteophytes,
- Performs passive leg movements - flexion, extension, abduction and adduction to determine the possible range of motion.
Instrumental diagnostics will help to make a more accurate diagnosis and prescribe treatment for arthrosis of the hip. X-ray is usually performed - the cheapest available research method. It is recommended to take an X-ray on modern devices, or replace it with a scanner, where the quality of the images is much higher. CT scan provides comprehensive information about the condition of bones, cartilage and joint surfaces. If a detailed study of the condition of soft tissues is required (for example, when a nerve root is pinched), the specialist will prescribe an MRI.
Other possible diagnostic measures:
- joint ultrasound,
- arthroscopy,
- Blood test for rheumatoid factor,
- tuberculin tests,
- Biochemical analysis for suspected diabetes mellitus, gout.
It is very important to find the cause of secondary coxarthrosis, because without affecting it it will not be possible to stop the course of the disease.
Treatment of arthrosis of the hip - drugs and physiotherapy
If the signs of the disease are implicit, and it has not passed to the stage of irreversible changes, conservative treatment will help the patient. Drug treatment will also be needed when osteoarthritis of the hip joint has become severe - as part of treatment.
How to treat osteoarthritis of the hip joint? There is a program of drug correction of the disease:
- Nonsteroidal anti-inflammatory drugs. Pills or injections will help get rid of pain, inflammation. They cannot be used uncontrollably - the cartilage's own ability to regenerate will decrease, moreover, the stomach and intestines suffer greatly from NSAIDs.
- Vascular drugs. Treatment with such means helps to strengthen the nutrition of cartilage and contributes to its restoration.
- Muscle relaxants. Indicated for spastic pain in the muscles caused by damage to the thigh area.
- Chondroprotectors. Arthrosis of the hip joint necessarily requires and several months of taking such drugs. It is also necessary to apply ongoing injectable forms, including injection into the joint cavity. An even more effective technique is to introduce hyaluronic acid preparations into the joint.
- Corticosteroids. Used in extreme cases in the form of intra-articular injections. Such treatment is necessary if the symptoms become unbearable.
External agents (ointments, gels) for coxarthrosis are usually ineffective due to the deep localization of the joint. But physiotherapy techniques are often used and seriously relieve pain. UHF, laser therapy, magnetotherapy are performed on the thigh area, UHF, massage are performed. Also, with arthrosis, manual therapy is indicated, in some cases - joint traction.
Folk remedies for arthrosis
Many people use an alternative treatment for this pathology, although osteoarthritis of the hip joint does not respond well to various external methods. Only with an intense pain syndrome can insulating compresses be applied to the sore spot, although this is more distracting. Treatment of complicated and advanced osteoarthritis of the hip joint is best done with oral medications:
- Pour 100 g of dry cinquefoil grass with 500 ml of vodka, insist in the dark for 10 days, take 30 drops three times a day to relieve inflammation,
- Make jelly every day, in the absence of contraindications, regularly prepare jelly - dishes will serve no worse than chondroprotectors.
You can relieve pain with the help of such a compress. It is necessary to mix also honey, medical bile, ammonia, glycerin, apply to the joint, tie with a warm cloth. Leave the compress for 3 hours, then rinse.
Other Methods and Operation
For the full treatment of arthrosis, it is very important to follow the correct diet, you will have to give up foods that disrupt blood supply and impair cartilage nutrition. These are smoked meats, vinegar, salty foods, fried foods, as well as foods with preservatives, trans fats. But there should be more dishes containing magnesium, potassium, iodine and calcium in the diet.
What is needed to treat osteoarthritis of the hip joint are therapeutic exercises. Daily warm-ups, special supine exercises should be performed by all patients. For example, you should slowly raise your leg and hold it above the ground for a few seconds. It is important to exclude sudden movements, avoid long and brisk walking - with coxarthrosis this will only increase the progression of the disease. To unload the joint, you can use a cane, crutches, and an orthopedist may also recommend special braces to ease the load.
Treatment of arthrosis of the hip joint of the third and final stage is carried out only with the help of surgery, other methods are ineffective. In 95% of cases, the operation is successful, leg movements are fully restored. But prostheses are not eternal, their lifespan can be up to 20 years, so the operation is a last resort. During arthroplasty, your own joint is replaced with an artificial joint, and arthrosis of the hip joint no longer threatens it.
Prevention of coxarthrosis
In order not to carry out complex treatment of pathology, not to suffer from the pain syndrome, it is important to start preventive measures from an early age. The prevention of osteoarthritis is particularly important for people exposed to risk factors.
So that the blood supply to the cartilage does not suffer, you must:
- Eat with the inclusion of plant foods in the menu, a sufficient amount of lean meat, cottage cheese, jelly, sour-milk foods,
- Stop smoking, do not abuse alcohol,
- At sedentary work, warm up regularly, do simple exercises,
- Ditch a sedentary lifestyle in favor of skiing, swimming, and other low-intensity aerobic activities.
In order for a person not to be bothered by arthrosis of the hip joint, it is necessary to control body weight, prevent obesity and even the appearance of 5-10 extra pounds - this significantly increases the loadon the femoral area. Coxarthrosis can only be prevented with an integrated approach and a healthy lifestyle!