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 to be an age-related problem, which is confirmed by world statistics: after 40 years, every second person is diagnosed, and closer to 70, 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 the disease
The hip joint is formed by 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 their easy sliding between each other, without noise or pain.An age-related decrease in the production of synovial fluid and a change in its viscosity are the main causes of arthrosis of the hip joint.
Coxarthrosis of mobile joints in the hip area occurs when:
- Perthes disease.
- Hip dysplasia.
- Reactive or infectious coxitis.
- Metabolic disorders.Diabetes mellitus and gout can provoke arthrosis.
- Chondromatosis of the joints.The disease is characterized by the formation of loose intra-articular bodies that damage hyaline cartilage.
- Mechanical injuries.This includes a 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, the connective tissue wears out quickly, and athletes are not immune to displacement of the articular cartilage and tears of the hip muscles.Arthrosis of the hip joint itself is not inherited, 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 bear a huge load when moving.During the period of exacerbation, acute arthrosis occurs, 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, neoarthrosis or false joint is formed, filled not with callus, but with connective tissue.
There are arthrosis of the hip joint of 1st, 2nd and 3rd degrees, 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.At the early stage of coxarthrosis, the disease can only be detected on x-rays.
- Osteoarthritis of the hip joint of the second degree is accompanied by intense pain in the hip area, sometimes a crunching 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 atrophy of the muscles of the hip region and expansion of the neck of the femur, the leg is shortened.When walking, the patient uses support.Due to arthrosis, the joint space may completely disappear, in which case they speak of bone ankylosis.
In clinical practice, doctors regularly encounter an involuting type of coxarthrosis (typical of older people) 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.With arthrosis-arthritis, the inflammatory rather than degenerative process predominates 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 is diagnosed (unilateral coxarthrosis).
Symptoms
Symptoms of arthrosis of the hip joint do not bother the patient at first, only occasionally prolonged loads on the affected area or awkward movement remind of the problem.
Coxarthrosis of the hip joint manifests itself:
- Pain in the hip area.The intensity and nature of joint pain depend on the stage of arthrosis and weather conditions.
- Increased body temperature.Chills and swelling of the joints are observed with arthrosis-arthritis of one or two hip joints.
- Weakening and subsequent atrophy of the muscles of the hip region.
- A distinct crunching sound in the joints.A possible sign of coxarthrosis, but not obligatory.
- Lameness.Due to the destruction of the hip bone with arthrosis, an uncertain, “duck” gait is formed.
Those suffering from coxarthrosis often experience pain radiating to the kneecap, so an inexperienced doctor, after listening to the patient’s complaints, can make an erroneous diagnosis and delay the recovery process for many months.
Diagnostics
Arthrosis is diagnosed by a rheumatologist, traumatologist or orthopedist.After interviewing the patient, the doctor conducts an external examination of the hip area, studies leg mobility, and evaluates the gait of the patient with coxarthrosis.
The most effective methods for diagnosing arthrosis include:
- General and biochemical blood test.
- Plain radiography 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 examined.To exclude the presence of auto-aggressive antibodies in the body, the patient is sent for analysis of RF in the blood serum.
How is arthrosis of the hip joint treated?
Treatment for arthrosis of the hip joint is selected taking into account the stage of coxarthrosis, the patient’s age and concomitant diagnoses.Arthrosis of degrees 1 and 2 can be cured using 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.At the final stage, treatment of arthrosis of the hip joint takes place in a sanatorium-resort setting.
Drug treatment
Conservative treatment of the disease is aimed at relieving 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.Non-steroidal medications relieve pain and inflammation in the mobile joint, but tablets have nothing to do with restoring the structure of hyaline cartilage in coxarthrosis.
- Vasodilators.The drugs ensure the delivery of nutrients to joints affected by arthrosis and eliminate congestion in the hip area.
- Chondroprotectors.Saturate joint tissues with water, improving 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 warming, irritating or distracting effects.The drugs successfully cure arthrosis of the hip joints.
- It is advisable 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 listed remedies for arthrosis.Therapeutic bandages cannot be applied to the hip area if the lymphatic system is affected and there is 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 medicinal effects on the hip area.
Diet and nutrition
A special diet for coxarthrosis consists of low-fat foods and a high content of vitamins B, C, E, as well as calcium, potassium and magnesium.It is advisable 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 varieties of fish and meat.
- Whole grain bread.
- Porridge cooked in water.
From your diet, exclude salty and spicy foods, nightshades, baked goods, smoked foods, and carbonated drinks.When treating coxarthrosis, you should not buy ready-made food from supermarkets or semi-finished products.
Endoprosthetics
Replacement of the affected joint with an artificial one is indicated at the last stage of coxarthrosis.Before the operation, the patient must undergo general blood and urine tests, ultrasound of the hip area, and ECG.
Main stages of the procedure:
- The surgeon cuts off the head of the femur and inserts a pin inside to connect to the titanium femoral head implant.
- Part of the surface of the pelvic bone is removed, and in its place a polymer bed is attached, which is connected to the titanium head.
The best way to fix dentures is with bone cement.If arthrosis affects the joints at a young age, cementless methods of fastening are sometimes used.
Massage
Massage relieves muscle spasms, strengthens the ligamentous 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 massage the sacro-gluteal area.Using circular movements of bent fingers, we knead the problem thigh in the direction of lymph flow - from bottom to top.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 physical therapy doctor.It is advisable to engage in physical therapy 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, which was presented by practicing rheumatologist P. V. Evdokimenko, is growing.Evdokimenko’s gymnastics consists of static exercises to strengthen 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, then hold it in an elevated 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 herbs.Before the development of the pharmaceutical industry, eucalyptus oils, cloves and fresh aloe juice were rubbed into sore joints for arthrosis.Celandine ointments relax the hip muscles and tendons.
Effective alternative medicine recipes:
- Grind 200 g of the roots of the white foot and fill it with pork fat (300–400 g).Place on low heat, after 5-7 minutes the remedy for coxarthrosis is ready.Rub the cooled mass into the affected joint at night for 2 weeks.
- Beat egg white with 1 tbsp.l.flour.For arthrosis, the medicinal mixture should be applied to the hip area before bedtime.Don't forget to wrap the sore joint with parchment paper and a woolen scarf.
Shilajit has an intense restorative effect and improves the mobility of the hip joints.For arthritis and arthrosis, 5 g of mumiyo 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 thigh with gentle movements.
Prevention
Prevention of arthrosis of the hip joint involves giving up bad habits, a sedentary lifestyle, extra pounds load the hip area, exceeding the physiological limits of the strength of the joints.Follow the daily routine and principles of PN for coxarthrosis, watch 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 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 you couldn’t protect yourself from coxarthrosis, don’t despair – act!