Coxarthrosis or arthrosis of the hip joint is a degenerative-dystrophic disease that causes 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: after 40 years, every second person is diagnosed, and before 70, the pathology appears 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 covers 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 cartilage of the hip and ensures that they slide easily together without noise or pain.Age-related decrease in production of synovial fluid and changes in its viscosity are the main causes of arthrosis of the hip joint.
Coxarthrosis of the movable joints in the hip occurs when:
- Perthes disease.
- Hip dysplasia.
- Reactive or infectious coxitis.
- Metabolic disorders.Diabetes and gout can provoke 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 hip fracture or dislocation (including congenital), joint capsule rupture, 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 down quickly, and athletes are not immune to articular cartilage displacement and hip muscle tears.Arthrosis of the hip joint itself is not hereditary, but structural features of bone tissue or slow metabolism are genetically determined.
course of the disease
First of all, arthrosis affects the large joints of the bones of the pelvis and knee joints (gonarthrosis);It is they who carry a huge load when moving.During the exacerbation period, acute arthrosis develops, then palpation of the joint and hip tissue is accompanied by pain.In case of incomplete or incorrect fusion of the femur after an injury, a neoarthrosis or false joint is formed, which is filled not with callus, but with connective tissue.
There are 1st, 2nd and 3rd degree arthrosis of the hip joint, each stage of the disease has its own characteristics:
- Arthrosis 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 be detected only by X-ray.
- Osteoarthritis of the second degree of the hip joint is accompanied by severe pain in the thigh area, sometimes a crackling sound is heard in the joint.During arthrosis, it is difficult to turn the hip and move it to the side, the joint space narrows, the tone of the thigh muscles weakens.A contracture begins to form.
- Pain syndrome is expressed with coxarthrosis of the 3rd degree.Due to atrophy of the muscles of the thigh region and enlargement of the femoral neck, the leg is missing.The patient uses support while walking.Due to arthrosis, the joint space may disappear completely, in this case we are talking about bone ankylosis.
In clinical practice, doctors regularly encounter the involutional type of coxarthrosis (characteristic of elderly people) and post-infectious arthrosis of the hip joint.Patients receiving corticosteroids and antidepressants are at risk of dyshormonal coxarthrosis;This type of arthrosis affects the joints of women during menopause as well.In the case of arthrosis-arthritis, the inflammatory and non-degenerative process prevails in the hip joint.
If the etiology of the disease is not established, 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 sometimes a prolonged load on the affected area or awkward movement reminds of the problem.
Coxarthrosis of the hip joint is manifested by:
- Pain in the thigh.The intensity and nature of joint pain depends on the stage of arthrosis and weather conditions.
- increase in body temperature.Coldness and swelling of the joints is indicated by arthrosis-arthritis of one or two hip joints.
- Weakening of the muscles of the thigh region and subsequent atrophy.
- Clear crackling sound in the joints.A possible sign of coxarthrosis, but not mandatory.
- lameness.Due to the destruction of the femur with arthrosis, an uncertain, "duck" gait occurs.
Patients with coxarthrosis often have pain radiating 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 many months.
diagnosis
Arthrosis is diagnosed by a rheumatologist, traumatologist or orthopedist.After interviewing the patient, the doctor conducts an external examination of the thigh area, studies the mobility of the leg and evaluates the gait of the patient with coxarthrosis.
The most effective methods of diagnosing arthrosis 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 studied.In order to exclude the presence of auto-aggressive antibodies in the body, the patient is sent for RF analysis of blood serum.
How is arthrosis of the hip joint treated?
The 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 using an integrated approach: taking pharmaceutical drugs together with physiotherapy methods, massage and a special diet.
After the acute period of coxarthrosis is over, 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 without running and jumping are selected for the treatment of the hip joint.At the last stage, hip joint arthrosis is treated in sanatorium-resort conditions.
drug treatment
Conservative treatment of the disease is aimed at alleviating the pain in the thigh area and maintaining joint function.The main goal is complete recovery or stable remission of coxarthrosis.
Treatment of arthrosis is not complete without the following:
- Nonsteroidal anti-inflammatory drugs.Nonsteroidal drugs relieve pain and inflammation in the moving joint, but tablets have nothing to do with restoring the structure of hyaline cartilage in coxarthrosis.
- Vasodilators.Medicines ensure the supply of nutrients to the joints affected by arthrosis and eliminate swelling in the hip area.
- Chondroprotectors.Saturation of joint tissues with water improves 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 arthrosis.They have a warming, irritating or distracting effect.Medications successfully treat arthrosis of the hip joints.
- In the acute phase of coxarthrosis, it is advisable to inject steroid drugs into the joint cavity to eliminate pain.
Compresses together with medical bile increase the effectiveness of the listed remedies for arthrosis.The therapeutic bandage cannot be applied to the thigh area if the lymphatic system is damaged and there is fever (infectious coxarthrosis).
Physiotherapy
Despite the deep location of the hip joints, physiotherapy methods relieve coxarthrosis.Popular physical therapy procedures include electrophoresis, laser therapy, and the use of warming paraffin.Acupuncture improves the innervation of cartilage tissue and the work of internal organs.Phonophoresis with hydrocortisone in arthrosis combines the advantages of ultrasound and healing effect in the hip area.
Diet and nutrition
A special diet for coxarthrosis consists of low-fat foods and high content of vitamins B, C, E, as well as calcium, potassium and magnesium.It is recommended that every new day begins with a glass of freshly squeezed juice.Give preference to boiled 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 in water.
Exclude salty and spicy foods, overnight stays, baked, smoked foods and carbonated drinks from the diet.When treating coxarthrosis, you should not buy ready-made food from supermarkets or semi-finished products.
Endoprosthesis
Replacement of the damaged joint with an artificial one is indicated in the last stage of coxarthrosis.Before the operation, the patient should undergo general blood and urine tests, ultrasound of the thigh and ECG.
The main stages of the procedure:
- The surgeon makes an incision in the femoral head and inserts a pin into the titanium femoral head implant.
- A portion of the pelvic bone surface is removed and a polymer bed is attached in its place, which is connected to a titanium head.
The best means of prosthetics is bone cement.If arthrosis affects the joints at a young age, cementless fixation methods are sometimes used.
Massage
Massage relieves muscle spasm, strengthens the ligament apparatus in coxarthrosis.During the procedure, the patient with arthrosis should take a comfortable position and rest.First we rub the back (10 minutes), then we massage the sacro-gluteal area.With circular movements of bent fingers, we stroke the problematic thigh in the direction of the lymph flow - from bottom to top.To slow down the development of arthrosis, the procedure is carried out 3 times a day.
Exercises and exercise therapy
Physiotherapy doctor determines the level of load on hip joints during arthrosis.It is advisable to engage in physical therapy in a room specially designed 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, which was presented by the practicing rheumatologist P.V.Evdokimenko.Yevdokimenko's gymnastics consists of static exercises to strengthen the hip muscles, stretching with minimal pressure on the affected side.For example, if you lie on your left side, bend your left leg at the knee and extend your right leg, then hold the raised position for about 30 seconds, the muscles will begin to contract.In case of coxarthrosis, the task is performed with 5 approaches on each leg.
Folk remedies
Traditional methods of treating coxarthrosis are based on the basic concepts of the properties of medicinal herbs.Before the development of the pharmaceutical industry, eucalyptus oils, cloves and fresh aloe juice were poured into painful joints in arthrosis.Celandine ointments soothe the thigh muscles and tendons.
Effective recipes of alternative medicine:
- Grind 200 g of white leg roots and fill with pork fat (300-400 g).Put it on low heat, after 5-7 minutes the coxarthrosis remedy is ready.Massage the cooled mass into the affected joint at night for 2 weeks.
- Beat the egg whites with 1 tbsp.L.flour.In case of arthrosis, the medicinal mixture should be applied to the hip area before going to bed.Do not forget to wrap the painful joint with parchment paper and a woolen scarf.
Shilajit has an intense restorative effect and improves the mobility of the hip joints.In case of arthritis and arthrosis, 5 g of mummy is dissolved in 10-20 ml of water and 45 g of heated vaseline is poured.The product is rubbed into the thigh skin with gentle movements.
Prevention
Prevention of arthrosis of the hip joint involves abandoning bad habits, a sedentary lifestyle, loading extra kilograms in the hip area, exceeding the physiological limits of joint strength.Follow the daily routine and principles of PN in coxarthrosis, watch your posture.An annual examination of the joints, starting from the age of 30, will help prevent irreversible changes in the body of a patient with arthrosis.
Arthrosis of the hip joint occupies the leading position among the pathologies of the musculoskeletal system.The disease reduces the patient's quality of life and is the main cause of disability at a young age.Even if you cannot protect yourself from coxarthrosis, do not despair - act!