Coxarthrosis(osteoarthritis of the hip joint) is a type of osteoarthritis deforming joint, which is a chronic non-inflammatory disease that affects the hip joints (one or both of them at the same time). This disease has a degenerative-dystrophic character. This means that the cartilage that forms the hip joint undergoes degenerative changes in addition to altering the surfaces of the bones. In addition, bony growths (osteophytes) are formed, the joint becomes deformed, the volume of movement in the affected joint decreases, and they become extremely painful and uncomfortable.
The hip joint is one of the largest joints in our body. It is thanks to him that a very important motor function is performed in the human body, and he is also responsible for ensuring that our body is able to move. If the hip joint becomes sick, it affects the whole body as a whole and prevents the person from living peacefully, walking, not to mention playing sports. We often see older people who are forced to rely on a cane due to a disease of the hip joint.
Despite the fact that the hip joint is extremely massive and strong, at the same time it is quite vulnerable, especially over time. Hip joint pain significantly reduces human quality of life.
Coxarthrosis (arthrosis of the hip joint)ranks second among arthrosis of the joints in terms of the frequency of cases diagnosed after gonarthrosis (arthrosis of the knee joint).
Classification of coxarthrosis (arthrosis of the hip joint)
It happenscoxarthrosisboth primary and secondary.
- The cause of primary coxarthrosis is mainly the inevitable wear and tear of the hip joints throughout life and it usually affects people after the age of 40.
- The causes of secondary coxarthrosis are usually the following diseases: congenital femoral dislocation, necrotic masses of the hip bone in the head region, Peter's disease, traumatization of the anterior hip joint, inflammatory diseases of the hip joint. On whatosteoarthritis of the hip jointcan affect one joint separately or both.
There are several types of coxarthrosis:
- Dysplastic (is a congenital pathology and is characterized by underdevelopment of the joint).
- Involutive (typical for people in the older age category and associated with age-related changes).
- Post-infectious (was preceded by purulent or purulent-allergic rheumatoid arthritis).
- Illness due to Peters disease (development of osteochondropathy in the head of the femur).
- Coxarthrosisdue to trauma (neck and head bone (femoral) fractures).
- Coxarthrosis due to metabolic disorders (metabolism).
- Deshormonal (taking glucocorticosteroids, antidepressants for a long time).
- Idiopathic (whose cause could not be established).
Symptoms of coxarthrosis (arthrosis of the hip joint)
To correctly describe the symptoms of coxarthrosis, the stages of the disease must be considered simultaneously, as the symptomatology depends on the stage of the disease.
Stages of coxarthrosis (arthrosis of the hip joint)
In total, there are three stages of coxarthrosis (arthrosis of the hip joint):
- 1st stage of coxarthrosis. This is the early stage of the disease, where symptoms are still mild. The joint at this stage does not hurt much and the pain only occurs after physical exertion, such as lifting heavy objects or running, walking for long distances. After the person rests, the pain disappears. The patient may also develop claudication if, for example, he walks more than two kilometers on foot. Increases pain when climbing stairs. Joint motor volume is slightly reduced or preserved. X-ray examination may show only minor changes in bone structures.
- 2nd stage of coxarthrosis. This stage develops in the absence of first stage treatment. To the above symptoms, a specific crack (crunch) in the joint is added. The pain becomes more intense and begins to radiate to the groin area, and may also spread to the thigh and knee. At this stage, not only strong, but also any movement can cause symptoms of pain, even a slight load on the hip joint. Even getting out of bed or twisting your torso can cause pain. There is tension in the periarticular muscles, which does not go away even at night, so patients often complain that the thigh hurts at night. A person may start to limp even after short walks (up to 500 meters). At this stage, the disease already forces the person to rely on a cane when walking. Limitation of movement in the joint becomes more pronounced. According to the X-ray diagnostic results, emerging osteophytes are determined.
- 3rd stage of coxarthrosis. The final stage of the disease. At this stage, the pain becomes permanent and torments the patient. Any movement, even the slightest, increases the pain symptoms several times. At this stage, the hip joint is completely immobilized. Muscle mass in thigh and buttocks is reduced due to muscular dystrophy which is very noticeable. Characteristic is the impossibility of direct position of the patient, while the body will be skewed. Any arthrosis leads to the formation of a contracture (flexion position), in this case, the contracture also forms due to the fact that the muscle fibers are in constant tension, while the leg on the side of the injury becomes shorter. As a result of the immobilization of the hip joint, the entire leg ceases to perform its motor function, which has a very negative effect, and leads to its osteochondrotic injury. In addition, the spine also suffers, there are sensations of discomfort and pain in the sacral region.
Causes of coxarthrosis (arthrosis of the hip joint)
The main causes of coxarthrosis:
- Age-related changes in the joint. Typical for older people. The hip joint wears out over time, ceases to perform its functions over time, "dry", which leads to a decrease in its shock-absorbing and friction function of the bones that form the joint against each other.
- Injury to the hip joint. The most common injury among people in this age group is femoral neck fracture, which threatens disability in the absence of adequate treatment. The joint can be injured at any age, but older people are more likely to suffer.
- Disturbed metabolism. This is typical for people with a history of metabolic disorders and diseases associated with impaired metabolism.
- Violation of the hormonal state. It is more characteristic of women, especially those who have been using antidepressants and glucocorticosteroids for a long time.
- Hereditary anomalies in the development of the musculoskeletal system, as well as congenital anomalies. Unfortunately, at the moment, quite a large number of children are born with congenital pathologies of the musculoskeletal and nervous systems. As for anomalies in the development of the hip joint, this can include its dysplasia, in which various structures of the joint do not develop.
- Systemic arthritis. Damage to multiple joints can also lead to hip joint damage. In this case, one of the main risk factors will be the presence of an inflammatory process.
- Rheumatic conditions and chronic arthritis. All this can also lead to the appearance of pain in the hip joint. Such diseases that cause pain in the studied joint include: rheumatism; rheumatoid arthritis; spondyloarthropathy; juvenile rheumatoid arthritis.
- The defeat of osteochondrosis. Osteochondrosis of the spine is a fairly common and serious disease that, in addition to the spine, can "deactivate" other structures in our body, in particular, the hip joint.
- Joint muscles and ligaments. Damage to these structures can also result from degenerative and dystrophic processes in the hip joint.
- Infectious lesions of both the joint itself and the femur. Such injuries are very serious as they lead to serious consequences and are sometimes difficult to treat. Osteomyelitis can occur, which simply "eats" or "dissolves" bone tissue. Tuberculous lesions can also occur, and most often such a location occurs in prepubertal children. Abscess in the pelvic area, which is most often the result of an untreated or poorly treated infectious process, for example, with appendicitis, inflammatory processes, especially when it comes to the genitals of women (ovarian disease), the development of an abscess in the area of ischiorectal deepening, which leads to an impaired gait (claudication appearance). In most cases, pain and lameness are the result of compression or damage to nearby nerves (sciatic or obturator).
- Malignant neoplasms. Very rarely, malignant neoplasms affect the hip joint and the bones that surround it, because more often the cause of the disease is metastasis from other malignant areas, for example with breast or lung cancer.
- Narrowing of the lumen of the aorta and iliac arteries (their stenosis and occlusion). At the same time, the joint receives less and less nutrients needed for normal functioning, which leads to its degeneration.
Risk group for coxarthrosis (arthrosis of the hip joint)
The main risk group may include the following categories of people and harmful factors:
- Older people. This disease is typical of elderly people, the elderly, as degenerative processes occur precisely in this age period.
- Female. According to statistics, women are more prone to hip joint problems.
- People who are overweight or obese.
- Prior trauma to one or both hip joints.
- Hereditary predisposition to this type of diseases and congenital anomalies in the development of the hip joint.
- The past presence of infectious lesions such as abscesses, aseptic necrosis of the head of the hip bone, osteomyelitis, and so on.
- Heavy physical work.
- Summer residents who have an extremely high risk of developing coxarthrosis.
Prevention of coxarthrosis (arthrosis of the hip joint)
The main measures for the prevention of coxarthrosis are as follows:
- Dosed physical activity. It is important to do gymnastics and knead the joint to prevent the development of pathological processes and its slower aging. This will help not only to improve the condition of the hip joint, but also the whole body.
- If there are metabolic disorders, they must be corrected. To do this, you must contact a specialist.
- Watch your weight. Do not forget that the hip joint already bears a great load, almost the entire body, so you should not interfere with it to perform its functions. Also, too much weight will put so much pressure on the joints that they will gradually collapse. Overweight people are also prone to metabolic disorders.
- Avoid sudden body bends, especially if you are not warmed up and unprepared, this will prevent you from injuring your head and femoral neck.
- It is better, of course, to choose the sport in which joint injuries are less dangerous, such as swimming or yoga, especially if there are hereditary predispositions or developmental anomalies.
- The predisposition to joint diseases implies careful handling of them, as well as regular visits to the doctor so as not to miss the possible development of a disease or any other pathological process in the joint.
- If a child is diagnosed with hip dysplasia, it should be treated, and right away! It is better to leave the child immobilized for a few weeks at an early age than to suffer for a lifetime.
- Timely treatment of infectious diseases, especially those that threaten to spread to the hip joint.
Diagnosis of coxarthrosis (arthrosis of the hip joint)
When diagnosing coxarthrosis, it is very important to find the cause that caused it. After all, as we discussed above, the reasons are many, they are diverse andhip arthrosis treatment, respectively, will be radically different. Sometimes it's not that easy, and sometimes it's not possible. Emphasis is placed on studying the manifestations of the disease and selecting the appropriate treatment.
First of all, the patient is carefully interviewed by the doctor, studying in detail the complaints, the causes of the disease, hereditary burden, the presence of lesions, and so on. It is very important to have the complaints described above and how long they have been observed in the patient.
After the interview, the doctor personally examines the affected area for the presence of inflammatory changes, trophic changes, deformities, shortening of the limbs, asymmetries, and so on. And children may have a "click" symptom.
An important point is the complementary examination methods - MRI and CT, ultrasound and X-ray examination, as they will help to make a final diagnosis. In the differential diagnosis of coxarthrosis with other diseases of the hip joint, this item is extremely important.