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, pain and discomfort are much more serious than when other joints are affected. The consequences of the pathology are also severe - if the destruction of small bone joints causes a lot of discomfort, then osteoarthritis of the hip joint without treatment is a direct path to disability. Only proper therapy, and sometimes surgery, will help a person not to lose the ability to walk.
What is hip osteoarthritis?
Coxarthrosis, osteoarthritis, osteoarthritis 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 osteoarthritis: it was previously believed that inflammation is not characteristic of degenerative processes, but more precise studies have shown the opposite. Affected articular cartilage tissues release inflammatory elements (interleukins), so osteoarthritis is another correct term.
The disease is characterized by the following signs:
- It is constantly advancing, passing from one phase to another,
- Leads to 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 the elderly, but often begins after the age of 40,
- Symptoms of pathology are present in 70% of people older than 75 years,
- Women are more likely to suffer from this disease.
The wrist is a mechanism in which there are parts that rub. Due to the reduction in the quality or quantity of lubrication (interarticular fluid), the contact surfaces wear out. Small cracks appear on the cartilage, they are later destroyed, and instead of healthy tissue, callus is formed. Such growths do not allow the leg to move normally, its functions are lost.
Reasons for the development of diseases
Osteoarthritis of the right or left thigh region can be primary or secondary, and the first option is typical for the elderly. The disease of the primary form has been developing for decades, it is associated with aging and wear and tear and destruction of cartilage.
Secondary coxarthrosis has other causes and can start even in a young person. It is associated with inflammation (infectious, autoimmune), which gives rise to pathology. Hip trauma (bruising, sprain, bone fracture) can also be a cause. Other possible causes of the secondary form:
- Operations on this anatomical zone,
- 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 systemic nature, which lead to deterioration of cartilage nutrition,
- Bone tuberculosis, rheumatoid osteoarthritis,
- gout, Perthes' disease,
- Tumors are benign and malignant.
Symptoms of hip osteoarthritis of any shape will appear faster if risk factors affect the body:
- Constant stress, nervous shocks, depression and worries,
- Obesity, even moderate overweight,
- unfavorable heredity,
- Physical inactivity, sedentary work or certain occupations with a large load on the joint,
- Excessive physical (strong) loads, professional sports.
Symptoms of the disease
The development of osteoarthritis of the hip joint and its symptoms cannot be ignored. Even in the early stages, the disease is felt, and above all the pain. The pain in the developing and progressive arthrosis of the hip joint increases as the disease progresses from one phase to another. They appear in the thigh area, on the knee, on the groin, and even on the lower abdomen. Usually after sleep, the pain subsides, but in the advanced stage it can be present all the time. On palpation, pain is not always felt, as joint damage can begin with deeply located parts.
Other possible signs of the disease:
- Creaking when moving, sometimes even with a slight,
- Lameness, gait change,
- Shortening the leg on the side where there is osteoarthritis 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 bone deformation, 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 of the limbs.
In general, pain and other clinical manifestations are largely stage dependent. There are the following stages of coxarthrosis:
- First.The symptoms are mild, but the initial changes are noticeable already during the diagnosis. The synovial fluid becomes thicker, its volume decreases, and the structure of the cartilage changes towards the end of the stage. Small cracks appear that the body tries to heal by creating small "couriers".
- Second.The pain at this stage is quite noticeable, squeaking, limitation of motor function is obvious. The pain syndrome radiates to other parts of the body, spreading down the entire leg. The picture shows: thinning of the cartilage, narrowing of the space between the bones, breaking the structure of the joint surfaces, sometimes - moving the head of the bone out of the cavity. The number of bone growths (osteophytes) has increased.
- Third.The pain becomes unbearable, the person is severely limited in movement, many stop moving completely. The cartilage is almost completely destroyed, the muscles atrophy, the joint is seriously 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 osteoarthritis of the hip joint, the symptoms and treatment are determined incorrectly, out of time, it threatens disability. Pain syndrome, inability to walk, the need for constant care - this is what awaits a person without treatment of this disease.
Disability in the case of damage to the bones of the thigh is determined by the severity of the disease, with a complete lack of ability to work, give the first group. Such patients are shown surgery - this is the only effective method of treatment in such a situation. But even modern methods of surgery can carry the risk of complications:
- contagious infection,
- thrombosis, thrombus embolism,
- Significant blood loss.
The total share of complications is small - 0, 5-2%, but they occur. The most common infection is a prosthesis, which must then be replaced with a new one. That is why it is important to carry out a course of antibiotic treatment after the operation.
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. Initially, if osteoarthritis of the hip is suspected, the doctor conducts physical examinations:
- Feels the upper thigh, reveals sore spots, bone osteophytes,
- Performs passive leg movements - flexion, extension, abduction and adduction to determine the range of possible movements.
Instrumental diagnostics will help in making a more accurate diagnosis and prescribing treatment for osteoarthritis of the hip joint. Usually radiography is done - the cheapest, available research method. It is recommended to make an X-ray on modern devices, or replace it with a CT scan, where the image quality is much higher. CT provides comprehensive information on the condition of bones, cartilage, joint surfaces. If a detailed study of the condition of the soft tissues is needed (for example, when the nerve root is pinched), a specialist will prescribe an MRI.
Other possible diagnostic measures:
- ultrasound of joints,
- 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 osteoarthritis of the hip - drugs and physiotherapy
If the signs of the disease are implicit, and it has not passed into the phase of irreversible changes, conservative treatment will help the patient. Drug therapy will also be needed when osteoarthritis of the hip joint has become severe - as part of the treatment.
How to treat hip osteoarthritis? There is a program of medical correction of the disease:
- Nonsteroidal anti-inflammatory drugs. Pills or injections will help get rid of pain, inflammation. They cannot be used uncontrolled - the ability to regenerate cartilage will be reduced, moreover, the stomach and intestines suffer greatly from NSAIDs.
- Vascular drugs. Treatment with such means helps to strengthen the cartilage diet and contributes to its renewal.
- Muscle relaxants. Indicated for spastic muscle pain caused by damage to the thigh area.
- Chondroprotectors. Osteoarthritis of the hip joint requires mandatory and several months of taking such medications. It is also necessary to apply injection forms in courses, including injection into the joint cavity. An even more effective technique is to inject hyaluronic acid into the joint.
- Corticosteroids. It is 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 location of the joint. But physiotherapy techniques are often used and give serious pain relief. We are doing UHF, laser therapy, magnetotherapy on the thighs, UHF, massage. Also, in osteoarthritis, manual therapy is indicated, in some cases - pulling the joint.
Folk remedies for osteoarthritis
Many people use alternative treatments for this pathology, although osteoarthritis of the hip joint does not respond well to various external methods. Only in the case of a severe pain syndrome, compresses with insulation can be applied to the painful area, although this will interfere more. Treatment of complicated and advanced osteoarthritis of the hip joint is best done with oral medications:
- Pour 100 g of dried kerosene 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, prepare jelly regularly - meals will serve no worse than chondroprotectors.
With the help of such a coating, you can alleviate the pain. It is necessary to mix honey, medical bile, ammonia, glycerin, apply to the wrist, tie with a warm cloth. Leave the dressing on for 3 hours, then rinse.
Other methods and operations
For the complete treatment of osteoarthritis it is very important to adhere to a proper diet, you will have to give up foods that disrupt the blood supply and disrupt cartilage nutrition. These are smoked meat, vinegar, salty foods, fried foods, as well as foods with preservatives, trans fats. But there should be more foods in the diet with magnesium, potassium, iodine, calcium.
What is necessary for the treatment of osteoarthritis of the hip joint are therapeutic exercises. Daily warm-up, special exercises in the supine position should be performed by all patients. For example, you need to slowly raise your leg and hold it above the floor for a few seconds. It is important to exclude sudden movements, avoid long and fast walking - with coxarthrosis, it will only increase the progression of the disease. You can use a cane, crutches to relieve the joint, and an orthopedist can also recommend special orthoses to relieve the load.
Treatment of osteoarthritis of the hip joint third, the last stage is carried out only with the help of surgery, other methods are ineffective. In 95% of cases, the operation was successful, the leg movements were completely restored. But dentures are not eternal, their lifespan is up to 20 years, so surgery is the last resort. During arthroplasty, his own joint is replaced with an artificial one, and arthrosis of the hip joint no longer threatens him.
Prevention of coxarthrosis
In order not to carry out complex treatment of pathology, in order not to suffer from pain syndrome, it is important to start preventive measures from an early age. Prevention of coxarthrosis is especially important for those who are exposed to risk factors.
To prevent blood flow to the cartilage, you should:
- Eat with the inclusion of plant foods in the menu, a sufficient amount of lean meat, cottage cheese, jellies, sour-milk foods,
- Stop smoking, don't abuse alcohol,
- When sitting, warm up regularly, do simple exercises,
- Give up a sedentary lifestyle in favor of skiing, swimming and other low-intensity aerobic activities.
In order not to upset a person with osteoarthritis of the hip joint, it is necessary to control body weight, prevent obesity and the appearance of even 5-10 kilograms of excess - this seriously increases the load on the femoral area. Coxarthrosis can only be prevented with an integrated approach and a healthy lifestyle!