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.Arthrosis is considered an age-related problem, which is confirmed by world statistics: every second person is diagnosed after the age of 40, 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 disease
The hip joint forms the acetabulum, which includes the head of the femur.The greater trochanter is attached to the articular 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 into each other, without noise or pain.A decrease in the production of synovial fluid due to aging and changes in its viscosity are the main causes of arthrosis of the hip joint.
Coxarthrosis of the movable joints in the hip area occurs when:
- Perthes disease.
- Hip dysplasia.
- Reactive or infectious coxitis.
- Metabolic disorders.Diabetes mellitus and gout can cause arthrosis.
- Chondromatosis of the joints.The disease is characterized by the formation of loose intra-articular bodies that damage the hyaline cartilage.
- Mechanical injuries.These include fracture or dislocation of the hip (including congenital), tearing of the joint capsule and frequent microtrauma of the joints.
People who are overweight and have bad habits are at risk.In professional runners or weightlifters, connective tissue wears out quickly, and athletes are not immune to displacement of articular cartilage and tearing of hip muscles.Osteoarthritis of the hip joint itself is not hereditary, but the structural characteristics of bone tissue or a slow metabolism are genetically conditioned.
The course of the disease
First of all, arthrosis affects the large joints of the pelvis and knee joints (gonarthrosis);they are the ones who bear the huge load when moving.During the period of exacerbation, acute arthrosis appears, then palpation of the joint and hip tissue is accompanied by pain.In the case of incomplete or improper fusion of the femur after an injury, a neoarthrosis or 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:
- Stage 1 arthrosis 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 an X-ray.
- Osteoarthritis of the hip joint of the second degree is accompanied by intense pain in the hip area, sometimes a creaking sound is heard in the joint.With arthrosis, it is difficult to rotate 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 the atrophy of the muscles of the hip region and the expansion of the neck of the femur, the leg is shortened.When walking, the patient uses support.Due to arthrosis, the joint space can completely disappear, in which case they speak of bone ankylosis.
In clinical practice, doctors regularly encounter the involutive type of coxarthrosis (typical for the elderly) and post-infectious arthrosis of the hip joint.Patients taking corticosteroids and antidepressants are at risk of dyshormonal coxarthrosis;this type of arthrosis also affects the joints of women during menopause.In arthrosis-arthritis, the inflammatory rather than the degenerative process prevails in the hip joint.
If the etiology of the disease has not been determined, we are talking about primary or idiopathic coxarthrosis.Usually, the disease affects the joints of people who have crossed the 50-year mark.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 occasionally long-term loads on the affected area or uncomfortable movement remind of the problem.
Coxarthrosis of the hip joint is manifested by:
- Pain in the hip area.The intensity and nature of pain in the joints depend on the stage of arthrosis and weather conditions.
- Increased body temperature.Trembling and swelling of joints is observed in arthrosis-arthritis of one or two hip joints.
- Weakening and subsequent atrophy of the muscles of the hip region.
- A distinct creaking sound in the joints.Possible sign of coxarthrosis, but not mandatory.
- Lameness.Due to the destruction of the hip bone by arthrosis, an insecure, "duck" gait is formed.
People suffering from coxarthrosis often have pain that radiates to the knee, so an inexperienced doctor, after listening to the patient's complaints, can make a wrong diagnosis and delay the recovery process for several months.
Diagnostics
Arthrosis is diagnosed by a rheumatologist, traumatologist or orthopedist.After talking with the patient, the doctor conducts an external examination of the hip area, studies the mobility of the legs and assesses the gait of the patient with coxarthrosis.
The most effective methods for diagnosing arthrosis include:
- General and biochemical blood test.
- Plain radiograph of the hip area.
- Ultrasound examination and MR.
If infectious arthrosis of the hip joint is suspected, the volume of synovial fluid is determined and its cellular composition is examined.In order to rule out the presence of autoaggressive antibodies in the body, the patient is sent for RF analysis in the blood serum.
How is arthrosis of the hip joint treated?
Treatment of arthrosis of the hip joint is selected taking into account the stage of coxarthrosis, the age of the patient and accompanying diagnoses.Arthrosis of the 1st and 2nd degree can be cured with 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 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-resort.
Drug treatment
Conservative treatment of the disease is aimed at alleviating 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 arthrosis is not complete without the following:
- NSAIDs.Nonsteroidal drugs relieve pain and inflammation in the joint, but the pills have nothing to do with restoring the structure of the hyaline cartilage in coxarthrosis.
- Vasodilators.Medicines ensure the delivery of nutrients to joints affected by arthrosis and eliminate congestion in the hip area.
- Chondroprotectors.Saturates joint tissue with water, improving its lubricating properties.It 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 heating, irritating or distracting effects.Medicines 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 mentioned drugs for 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 physiotherapeutic procedures include electrophoresis, laser therapy, and warming paraffin applications.Acupuncture improves the innervation of cartilage tissue and the functioning of internal organs.Phonophoresis with hydrocortisone for arthrosis combines the advantages of ultrasound and a healing effect on the hip area.
Diet and nutrition
A special diet for coxarthrosis consists of foods with a low fat content and a high content of vitamins B, C, E, as well as calcium, potassium and magnesium.It is advisable to start each new day with a glass of freshly squeezed juice.Give preference to cooked and steamed dishes.
The daily menu for arthrosis should consist of:
- Dairy products.
- Fresh vegetables and fruits.
- Low-fat varieties of fish and meat.
- Whole grain bread.
- Porridge cooked on water.
Exclude salty and spicy foods, nightshades, baked goods, smoked foods and carbonated drinks from your diet.When treating coxarthrosis, you should not buy ready-made food from the supermarket or semi-finished products.
Endoprosthetics
In the last stage of coxarthrosis, replacement of the affected joint with an artificial one is indicated.Before the operation, the patient must undergo general blood and urine tests, hip ultrasound and EKG.
Main stages of the procedure:
- The surgeon cuts the head of the femur and inserts a needle inside to connect to the titanium femoral head implant.
- A part of the surface of the pelvic bone is removed, and a polymer bearing connected to a titanium head is attached in its place.
The best way to fix prostheses is bone cement.If arthrosis 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 arthrosis should take a comfortable position and relax.First we rub the back (10 minutes), then we massage the sacro-gluteal area.With circular movements of bent fingers, we knead the problematic thigh in the direction of lymph flow - from bottom to top.In order to slow down the development of arthrosis, the procedure is performed 3 times a day.
Exercises and exercise therapy
The level of load on the hip joints during arthrosis is determined by the doctor of physical therapy.It is recommended to practice physical therapy in a room specially equipped for this purpose.Swimming in the pool or skiing will speed up the recovery of joints in coxarthrosis.
The popularity of the method of fighting arthrosis, presented by rheumatologist P. V. Evdokimenko, is growing.Evdokimenka's gymnastics consists of static exercises for strengthening 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 leg, then hold it in the raised 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 plants.Before the development of the pharmaceutical industry, eucalyptus oil, cloves and fresh aloe juice were rubbed into painful joints against arthrosis.Celandine ointment relaxes hip muscles and tendons.
Effective recipes of alternative medicine:
- Grind 200 g of the root of the white leg and fill with lard (300-400 g).Put on low heat, after 5-7 minutes the coxarthrosis remedy is ready.Rub the cooled mass into the affected joint at night for 2 weeks.
- Beat the egg white with 1 tsp.l.flour.In case of arthrosis, the medicinal mixture should be applied to the hip area before going to bed.Don't forget to wrap the painful joint with parchment paper and a woolen scarf.
Shilajit has an intense regenerative effect and improves the mobility of the hip joints.For arthritis and arthrosis, 5 g of mummy is dissolved in 10-20 ml of water, and 45 g of heated vaseline is poured into it.The product is rubbed into the skin of the thighs with gentle movements.
Prevention
Prevention of arthrosis of the hip joint includes giving up bad habits, a sedentary lifestyle, excess weight burdens the hip area, exceeding the physiological limits of joint strength.Follow the daily routine and principles of PN for coxarthrosis, take care of 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 arthrosis.
Among the pathologies of the musculoskeletal system, the leading position is occupied by arthrosis of the hip joint.The disease reduces the quality of life of patients and is the main cause of disability at a young age.Even if you failed to protect yourself from coxarthrosis, do not despair - act!