Arthrosis of the hip joint

Coxarthrosis(arthrosis of the hip joint) is a type of deforming arthrosis of the joints, which is a chronic non-inflammatory disease that affects the hip joints (one or both at the same time). This disease has a degenerative-dystrophic character. This means that the cartilage that forms the hip joint undergoes degenerative changes, and the surface of the bones also changes. Further, bone growths (osteophytes) are formed, the joint is deformed, the volume of movement in the affected joint decreases, and they become extremely painful and uncomfortable.

The hip joint is one of the largest joints in our body. Thanks to it, a very important motor function is performed in the human body, and it is also responsible for our body being able to move. If the hip joint gets sick, it affects the whole body as a whole and makes it impossible for a person to live peacefully, walk, not to mention play sports. Very often we see elderly people who are forced to rely on a cane due to hip joint disease.

Despite the fact that the hip joint is extremely massive and strong, at the same time it is quite vulnerable, especially over time. Pain in the hip joints significantly reduces the quality of human life.

Coxarthrosis (arthrosis of the hip joint)It firmly ranks second among arthrosis of the joints in terms of the frequency of diagnosed cases after gonarthrosis (arthrosis of the knee joint).

Classification of coxarthrosis (arthrosis of the hip joint)

It happenscoxarthrosisboth primary and secondary.

• The cause of primary coxarthrosis is the inevitable wear and tear of the hip joints during life, and it most often affects people after the age of 40.
• The causes of secondary coxarthrosis are most often the following diseases: congenital dislocation of the femur, necrotic mass of the hip bone in the head area, Peter's disease, traumatization of the previous hip joint, inflammatory diseases of the hip joint. Wherearthrosis of the hip jointit can affect one joint in particular or both.

There are several types of coxarthrosis:

• Dysplastic (it is a congenital pathology and is characterized by joint underdevelopment).
• Involutive (typical for people of the older age category and is associated with age-related changes).
• Post-infectious (it was preceded by purulent or purulent-allergic, rheumatoid arthritis).
• Disease due to Peters disease (development of osteochondropathy in the femoral head).
• Coxarthrosisdue to trauma (fractures of the neck and head of the bone (femoral)).
• Coxarthrosis due to metabolic disorders (metabolism).
• Dyshormonal (long-term use of glucocorticosteroids, antidepressants).
• Idiopathic (the cause of which could not be determined).

Symptoms of coxarthrosis (arthrosis of the hip joint)

In order to correctly describe the symptoms of coxarthrosis, the stages of the disease should be considered at the same time, because the symptomatology depends on the stage of the disease.

Stages of coxarthrosis (arthrosis of the hip joint)

In total, there are three stages of coxarthrosis (arthrosis of the hip joint):

• 1st stage of coxarthrosis. This is the initial stage of the disease, in which the symptoms are still mild. The joint does not hurt much at this stage, and pain occurs only after physical exertion, such as lifting heavy objects or jogging, hiking long distances. After the person rests, the pain goes away. The patient may also develop lameness if, for example, he walks more than two kilometers on foot. Increases pain when climbing stairs. The motor volume of the joint is slightly reduced or preserved. X-ray examination can show only small changes in bone structures.
• 2nd stage of coxarthrosis. This stage develops in the absence of treatment of the first stage. A specific crack (crunch) in the joint is added to the above symptoms. The pain becomes more intense and starts radiating to the groin, and can also spread to the thigh and knee. At this stage, not only strong, but also any movements can cause symptoms of pain, even a light load on the hip joint. Even getting out of bed or turning your torso can cause pain. There is tension in the periarticular muscles, which does not disappear even at night, so patients often complain that the thigh hurts at night. A person can start limping even after short walks (up to 500 meters). At this stage, the disease already forces the person to rely on a stick when walking. The limitation of movement in the joint becomes more and more pronounced. According to the results of X-ray diagnostics, the resulting osteophytes are determined.
• 3rd stage of coxarthrosis. The final stage of the disease. At this stage, the pain becomes permanent and torments the patient. Every movement, even the weakest, increases the pain symptoms several times. At this stage, the hip joint is completely immobilized. Muscle mass in the thigh and buttocks is reduced due to muscular dystrophy, which is very noticeable. It is characteristic that the patient cannot stand directly, while the body will be tilted. Every arthrosis leads to the creation of a contracture (flexion position), in this case the contracture is also due to the fact that the muscle fibers are in constant tension, while the leg on the side of the lesion becomes shorter. Due to the immobilization of the hip joint, the whole leg stops performing its motor function, which has a very negative effect and leads to their osteochondrotic lesion. In addition, the spine also suffers, there are feelings of discomfort and pain in the sacral region.

Causes of coxarthrosis (arthrosis of the hip joint)

The main causes of coxarthrosis:

• Age-related changes in the joint. Typical for older people. The hip joint wears out over time, over time it stops performing its functions, "drying out", which leads to a decrease in its cushioning function and the friction of the bones that form the joint against each other.
• Hip joint injury. The most common injury among people of this age group is a fracture of the neck of the femur, which threatens disability in the absence of appropriate treatment. A joint can be injured at any age, but older people suffer more often.
• Disturbed metabolism. This is typical for people with a history of metabolic disorders and diseases associated with impaired metabolism.
• Violation of hormonal status. It is more characteristic of women, especially those who take antidepressants and glucocorticosteroids for a long time.
• Hereditary anomalies in the development of the musculoskeletal system, as well as congenital anomalies. Unfortunately, at this moment, quite a large number of children are born with congenital pathologies of the musculoskeletal and nervous systems. As for anomalies in the development of the hip joint, it can include its dysplasia, in which several joint structures do not develop.
• Systemic arthritis. Damage to several joints can also lead to damage to the hip joint. In this case, one of the main risk factors will be the presence of an inflammatory process.
• Rheumatic conditions and chronic arthritis. All this can lead to pain in the hip joint. Such diseases that cause pain in the studied joint include: rheumatism; rheumatoid arthritis; spondyloarthropathy; juvenile rheumatoid arthritis.
• Defeat of osteochondrosis. Osteochondrosis of the spinal column is a fairly common and serious disease that, in addition to the spine, can "disable" other structures of our body, especially the hip joint.
• Muscles and ligaments of the joint. Damage to these structures can also be the result of degenerative and dystrophic processes in the hip joint.
• Infectious lesions of the joint itself and the femur. Such lesions are very serious, as they lead to serious consequences and are sometimes difficult to treat. Osteomyelitis can occur, which simply "eats" or "dissolves" bone tissue. Tuberculosis lesions can also occur, and more often such localization occurs in children in the pre-pubescent period. An abscess in the pelvic area, which is more often the result of an untreated or poorly treated infectious process, for example in appendicitis, inflammatory processes, especially when it comes to the female genital organs (ovarian disease), the development of an abscess in the region of the ischiorectal deepening, which leads to difficultywalk (appearance of lameness). In most cases, pain and lameness are the result of compression or damage to nearby nerves (sciatic or obturator).
• Neoplasms of a malignant nature. Very rarely, malignant neoplasms affect the hip joint and the bones surrounding it, because more often the cause of the disease is metastases from other malignant areas, for example, breast or lung cancer.
• Narrowing of the lumen of the aorta and iliac arteries (their stenosis and occlusion). At the same time, the joint receives less and less nutrients needed for normal functioning, which leads to its degeneration.

Risk group for coxarthrosis (arthrosis of the hip joint)

The main risk group may include the following categories of people and harmful factors:

• Older people. This disease is typical for older people, elderly people, because the degeneration processes occur that occur precisely in this age period.
• Woman. According to statistics, women are more prone to hip joint problems.
• People who are overweight or obese.
• Previous trauma to one or both hip joints.
• Hereditary predisposition to this type of disease and congenital anomalies in the development of the hip joint.
• The presence in the past of infectious lesions, such as abscesses, aseptic necrosis of the head of the hip bone, osteomyelitis, and so on.
• Hard physical work.
• Summers who have an extremely high risk of developing coxarthrosis.

Prevention of coxarthrosis (arthrosis of the hip joint)

The main measures for the prevention of coxarthrosis are the following:

• Dosed physical activity. It is important to do gymnastics and knead the joint in order to prevent the development of pathological processes in it and its slower aging. This will help not only improve the condition of the hip joint, but also the whole body.
• If there are metabolic disorders, they need to be corrected. To do this, you need to contact an expert.
• Watch your weight. Do not forget that the hip joint already carries a large load, almost the entire body, so you should not interfere with it to perform its functions. In addition, the heavy weight will put so much pressure on the joints that they will gradually collapse. Overweight people are also prone to metabolic disorders.
• Avoid sharp turns of the body, especially if you are not warmed up and you are not prepared, this will prevent you from injuring the head and neck of the femur.
• It is better, of course, to choose a sport in which joint injuries are the least dangerous, such as swimming or yoga, especially if there are hereditary predispositions or developmental anomalies.
• Predisposition to joint diseases implies careful handling of them, as well as regular visits to the doctor in order not to miss the possible development of the disease or any other pathological process in the joint.
• If a child is diagnosed with hip dysplasia, it should be treated, and immediately! It is better to let a child be immobilized for a few weeks at an early age than to suffer all his life.
• Timely treatment of infectious diseases, especially those that threaten to spread to the hip joint.

Diagnosis of coxarthrosis (arthrosis of the hip joint)

When diagnosing coxarthrosis, it is very important to find the cause that caused it. After all, as we have already mentioned, there are many reasons, they are different andtreatment of osteoarthritis of the hip, that is, they will be radically different. Sometimes it is not so easy, and sometimes it is not possible at all. Emphasis is placed on studying the manifestations of the disease and choosing the appropriate treatment.

First of all, the doctor carefully interviews the patient, studies in detail the complaints, the causes of the disease, the hereditary burden, the presence of injuries and so on. It is very important to have the complaints described above and how long they have been observed in the patient.

After the interview, the doctor personally examines the affected area for the presence of inflammatory changes, trophicity, deformity, limb shortening, asymmetry, etc. Children can also have the "click" symptom.

Additional examination methods - computer and magnetic resonance imaging, ultrasound and X-ray examination - are important, as they will help in making a final diagnosis. In the differential diagnosis of coxarthrosis from other diseases of the hip joint, this item is extremely important.