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 and tear of the joint of the same name. Osteoarthritis is considered an age-related problem, which is confirmed by world statistics: after 40 years, every second person is faced with a diagnosis, and closer to 70, pathology is detected in 80% of cases. Structural changes in the hip area occur in women 2. 5 times more often than in men.
causes of the disease
The hip joint is formed by the hip socket, which encompasses the femoral head. A large trochanter is attached to the condyle, surrounded by a synovial sac containing a thick mucous-like mass. It is the synovium that nourishes the hip cartilages and allows them to slide between one another easily and without noise and 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 the movable joints in the hip area 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 hyaline cartilage.
- mechanical injuries. These include a fracture or dislocation of the hip (including congenital), a rupture of the joint capsule, frequent microtraumas of the joints.
At risk are people with obesity and bad habits. In professional runners or weightlifters, the connective tissue wears out quickly, and athletes are not immune to displacement of the articular cartilage and tears in the hip muscles. Osteoarthritis of the hip joint itself is not inherited, but the structural features of the bone tissue or the slow metabolism are genetic.
The course of the disease
Osteoarthritis primarily affects the large joints of the pelvic and knee joints (gonarthrosis), a large load falls on their part 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 an injury, neoarthrosis develops, or a false joint 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 joint 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 region, sometimes a crunch is heard in the joint. With arthrosis, it is difficult to rotate and move the hip 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 femoral neck, the leg is shortened. When walking, the patient uses a brace. Arthrosis can cause the joint gap to disappear completely, which is referred to as bone stiffening.
In clinical practice, doctors regularly encounter an involutive form of coxarthrosis (typical of the elderly) and post-infectious arthrosis of the hip joint. Patients taking corticosteroids and antidepressants are at risk of developing dyshormonal coxarthrosis, this type of arthrosis also affects the joints of menopausal women. In osteoarthritis, the inflammatory rather than the degenerative process predominates in the hip joint.
If the etiology of the disease has not been clarified, then we speak of primary or idiopathic coxarthrosis. Usually, the disease affects the joints of people who have passed the 50-year milestone. Secondary arthrosis develops at a young age, usually arthrosis of the left hip joint or the right hip joint (unilateral coxarthrosis) is diagnosed.
Symptoms of arthrosis of the hip joint do not bother the patient at first, only occasionally prolonged stress on the affected area or clumsy movements remind of the problem.
Coxarthrosis of the hip joint is manifested:
- pain in the hip region. The intensity and type 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 osteoarthritis of one or two hip joints.
- Weakening and subsequent atrophy of the muscles of the hip region.
- A distinct crunching in the joints. A possible sign of coxarthrosis, but not mandatory.
- lame. An unsteady "duck" gait develops as a result of the destruction of the femur in arthrosis.
Those suffering from coxarthrosis often have pain radiating to the patella, so an inexperienced doctor, having listened to the patient's complaints, can make an incorrect diagnosis and delay the recovery process for many months.
Osteoarthritis is diagnosed by a rheumatologist, traumatologist or orthopedist. After questioning the patient, the doctor conducts an external examination of the hip area, examines the mobility of the leg and evaluates the gait of the patient with coxarthrosis.
The most effective methods for diagnosing arthrosis are:
- General and biochemical analysis of blood.
- X-ray of the hip region.
- Ultrasound and MRI.
If an infectious arthrosis of the thigh joint is suspected, the volume of the synovial fluid is determined and its cellular composition is examined. In order 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?
Treatment of arthrosis of the hip joint is selected taking into account the stage of coxarthrosis, the patient's age and the accompanying diagnoses. Healing of arthrosis grade 1 and 2 is possible with an integrated approach: taking pharmaceutical preparations in combination with physiotherapeutic methods, massage and a special diet.
After the end of the acute phase of coxarthrosis for the treatment of the hip joint, cardio training is allowed without running and jumping.
After the end of the acute phase of coxarthrosis, gentle gymnastic exercises with a limited range of motion, cardio training without running and jumping are chosen for the treatment of the hip joint. At the final stage, the treatment of osteoarthritis of the hip joint takes place in a sanatorium-resort setting.
Conservative treatment of the disease aims to relieve pain in the hip area and maintain the functionality of the joints. The main goal is complete recovery or stable remission of coxarthrosis.
The treatment of arthrosis is not complete without the appointment:
- NSAIDs. Nonsteroidal drugs relieve pain and inflammation in the movable joint, but the tablets are not related to the restoration of hyaline cartilage structure in coxarthrosis.
- vasodilators. The preparations ensure the supply of nutrients to the joints affected by arthrosis and eliminate congestion in the hip area.
- chondroprotectors. They saturate the tissues of the joint with water and improve its lubricating properties. Stop 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 a warming, irritating or distracting effect. Means of 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 medicinal bile increase the effectiveness of the listed remedies for osteoarthritis. In the case of damage to the lymphatic system and fever (infectious coxarthrosis), no therapeutic bandages should be applied to the hip area.
Despite the deep location of the hip joints, physiotherapeutic methods bring relief from coxarthrosis. Electrophoresis, laser therapy, warming paraffin applications are popular physiotherapeutic procedures. Acupuncture improves the innervation of the cartilage tissue and the function of the internal organs. Phonophoresis with hydrocortisone in arthrosis combines the advantages of ultrasound and medicinal effects in the hip area.
Diet and Nutrition
A special coxarthrosis diet consists of low-fat products and a high proportion of vitamins B, C, E, as well as calcium, potassium and magnesium. It is desirable that each 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 fish and meat varieties.
- Whole grain bread.
- Kasha boiled in water.
Exclude salty and spicy foods, nightshade plants, muffins, smoked meats and carbonated drinks from your diet. When treating coxarthrosis, you should not buy ready-made meals from supermarkets or semi-finished products.
In the last stage of coxarthrosis, replacement of the affected joint with an artificial one is indicated. Before the operation, the patient must pass general blood and urine tests, ultrasound of the hip region, ECG.
The main stages of the procedure:
- The surgeon cuts the femoral head and inserts a pin to connect it to the femoral head's titanium implant.
- A part of the surface of the pelvic bone is removed, in its place a polymer bed is attached, which is connected to the titanium head.
Dentures are best fixed with bone cement. If arthrosis affects the joints at a young age, cement-free fastening methods are sometimes used.
Massage relieves muscle spasms, strengthens the ligament apparatus in coxarthrosis. During the procedure, the patient with osteoarthritis should take a comfortable position and relax. First we rub the back (10 minutes), then we massage the sacro-potback region. With circular movements of bent fingers, we knead 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 three times a day.
exercise and exercise therapy
The load on the hip joints in osteoarthritis is selected by the movement therapist. It is advisable to carry out 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, presented by practicing rheumatologist P. V. Evdokimenko, is growing. Gymnastics Evdokimenko consists of static exercises to strengthen the muscles of the hips, 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 straighten your right leg, and then hold it in an elevated position for about 30 seconds, the muscles will begin to contract. With coxarthrosis, the task is performed in 5 approaches for each leg.
At the heart of folk methods of treating coxarthrosis are the basic concepts of the properties of medicinal herbs. Before the development of the pharmaceutical industry, osteoarthritis involved rubbing eucalyptus oils, cloves, and fresh aloe juice into diseased joints. Celandine ointments relax the hip muscles and tendons.
Effective Alternative Medicine Recipes:
- Grind 200 g of white steppe roots and fill with pork fat (300–400 g). Put on low heat, after 5-7 minutes the remedy for coxarthrosis is ready. Massage the cooled mass into the affected joint overnight for 2 weeks.
- Beat the egg whites with 1 tbsp. l. Flour. The therapeutic mixture should be applied before bedtime for arthrosis in the hip area. Don't forget to wrap the sore joint with parchment paper and a wool scarf.
Mumiyo has an intense restorative effect, improves hip joint mobility. With arthritis and arthrosis, 5 g of mummy is dissolved in 10-20 ml of water, 45 g of heated petroleum jelly are poured into it. The product is gently rubbed into the skin of the thigh.
Prevention of arthrosis of the hip joint involves the rejection of bad habits, a sedentary lifestyle, extra pounds put a strain on the hip region, exceeding the physiological limits of the strength of the joints. Follow the daily routine and principles of PP for coxarthrosis, pay attention to your posture. In order to prevent the development of irreversible changes in the body of a patient with arthrosis, an annual examination of the joints from the age of 30 is possible.
Among the pathologies of the musculoskeletal system, arthrosis of the hip joint occupies a leading position. 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 - act!