Coxarthrosis or arthrosis of the hip joint is a degenerative dystrophic disease that leads to loss of elasticity and destruction of cartilaginous tissue, premature wear of the joint of the same name.Osteoarthritis is considered an age-related problem, which is confirmed by global statistics: after the age of 40, one in two people is diagnosed and, closer to 70, the pathology is detected in 80% of cases.Structural changes in the hip region occur 2.5 times more frequently 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 sac with a thick mucus-like mass.It is the synovium that nourishes the hip cartilages and ensures their easy sliding between them, 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 movable joints in the hip region occurs when:
- Perthes disease.
- Hip dysplasia.
- Reactive or infectious coxitis.
- Metabolic disorders.Diabetes mellitus and gout can cause osteoarthritis.
- 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 fracture or dislocation of the hip (including congenital), rupture 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, connective tissue wears out quickly, and athletes are not immune to displacement of articular cartilage and tears of hip muscles.Arthrosis of the hip joint itself is not hereditary, but the structural features of bone tissue or slow metabolism are genetically determined.
Course of the disease
Firstly, osteoarthritis affects the large joints of the pelvic bones and knee joints (gonarthrosis);they are the ones who carry a huge load when they move.During the period of exacerbation, acute arthrosis occurs, so palpation of the hip joint and 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, filled not with callus, but with connective tissue.
There are arthrosis of the hip joint of the 1st, 2nd and 3rd degrees, each stage of the disease has its own characteristics:
- First-degree arthrosis develops slowly, without affecting the mobility of the joint structures, muscle tone is normal.In the initial stage of coxarthrosis, the disease can only be detected on x-rays.
- Osteoarthritis of the hip joint of the second degree is accompanied by severe pain in the hip area, sometimes a crunching sound is heard in the joint.With osteoarthritis, 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 3rd degree coxarthrosis, the pain syndrome is pronounced.Due to atrophy of the muscles in the hip region and expansion of the femoral neck, the leg becomes shortened.When walking, the patient uses support.Due to osteoarthritis, the joint space can completely disappear, in which case we speak of bone ankylosis.
In clinical practice, doctors regularly encounter an involutional type of coxarthrosis (typical in the elderly) and post-infectious arthrosis of the hip joint.Patients taking corticosteroids and antidepressants are at risk for dyshormonal coxarthrosis;This type of osteoarthritis also affects the joints of menopausal women.In arthrosis-arthritis, the inflammatory and non-degenerative process predominates in the hip joint.
If the etiology of the disease is not established, we are talking about primary or idiopathic coxarthrosis.The disease usually affects the joints of people who have crossed the 50-year mark.Secondary osteoarthritis 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 occasionally prolonged loads on the affected area or awkward movements remind of the problem.
Coxarthrosis of the hip joint manifests itself:
- Pain in the hip region.The intensity and nature of joint pain depends on the stage of osteoarthritis and weather conditions.
- Increased body temperature.Chills and swelling of the joints are seen in arthrosis-arthritis of one or two hip joints.
- Weakening and subsequent atrophy of the muscles in the hip region.
- A distinct crunching sound in the joints.Possible sign of coxarthrosis, but not mandatory.
- Lameness.Due to the destruction of the hip bone with arthrosis, an uncertain “duck” gait is formed.
Those suffering from Coxarthrosis often feel pain radiating to the kneecap, 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
Osteoarthritis is diagnosed by a rheumatologist, traumatologist or orthopedist.After interviewing the patient, the doctor performs an external examination of the hip region, studies the mobility of the legs and assesses the gait of the patient with coxarthrosis.
The most effective methods for diagnosing osteoarthritis include:
- General and biochemical blood test.
- Plain x-ray of the hip region.
- Ultrasound and MRI examination.
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 autoaggressive antibodies in the body, the patient is sent for analysis of RF in the blood serum.
How is osteoarthritis of the hip joint treated?
Treatment of 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: using pharmaceutical drugs in combination with physiotherapy methods, massage and a special diet.
After the acute period of coxarthrosis ends, cardiovascular 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, cardiovascular 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 setting.
Drug treatment
Conservative treatment of the disease aims to alleviate pain in the hip region and maintain joint functionality.The main objective is complete recovery or stable remission from coxarthrosis.
Osteoarthritis treatment is not complete without the following:
- NSAIDs.Non-steroidal medications relieve pain and inflammation in the movable joint, but tablets have nothing to do with restoring the structure of hyaline cartilage in coxarthrosis.
- Vasodilators.The medications ensure the supply of nutrients to the joints affected by osteoarthritis and eliminate congestion in the hip region.
- Chondroprotectors.Saturate joint tissues with water, improving their lubricating properties.Prevents the destruction of joint structures in the hip region.Glucosamine and chondroitin sulfate are part of many chondroprotectors.
- Gels and ointments against osteoarthritis.They have warming, irritating or distracting effects.Medicines successfully cure arthrosis of the hip joints.
- It is advisable to inject steroid medications into the joint cavity to eliminate pain in the acute phase of coxarthrosis.
Compresses with medicinal 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 a 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 paraffin heating applications.Acupuncture improves the innervation of cartilaginous tissue and the functioning of internal organs.Hydrocortisone phonophoresis for arthrosis combines the advantages of ultrasound and medicinal effects in the hip area.
Diet and nutrition
A special diet for Coxarthrosis consists of foods low in fat and high in 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.
- Wholemeal 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 foods or semi-finished products in supermarkets.
Endoprostheses
Replacement of the affected joint with an artificial one is indicated in 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 steps of the procedure:
- The surgeon cuts the femoral head and inserts a pin inside it 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 fixed, which is connected to the titanium head.
The best way to fix dental prostheses is with bone cement.If osteoarthritis affects the joints at a young age, cementless fixation methods are sometimes used.
Massage
Massage relieves muscle spasms, strengthens the ligamentous apparatus in case of coxarthrosis.During the procedure, the patient with osteoarthritis should remain in a comfortable position and relax.First we rub the back (10 minutes) and then massage the sacrogluteal region.Using circular movements with bent fingers, we massage the problem thigh in the direction of lymph flow - from bottom to top.To slow down the development of arthrosis, the procedure is carried out 3 times a day.
Exercise and exercise therapy
The level of load on the hip joints during arthrosis is determined by the physiotherapist.It is advisable to carry out physiotherapy 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 the 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 leg, 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 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 vera juice were rubbed into painful joints for osteoarthritis.Celandine ointments relax the hip muscles and tendons.
Effective alternative medicine recipes:
- Grind 200 g of white foot roots and fill with pork fat (300–400 g).Put on low heat, after 5-7 minutes the medicine for coxarthrosis is ready.Rub the cooled mass on the affected joint at night for 2 weeks.
- Beat the egg white with 1 tbsp.I.flour.For osteoarthritis, the medicinal mixture should be applied to the hip area before bed.Don't forget to wrap the painful joint with baking 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 petroleum jelly is poured into it.The product is rubbed into the skin of the thigh with gentle movements.
Prevention
Preventing osteoarthritis of the hip joint involves abandoning bad habits, a sedentary lifestyle, extra pounds burdening the hip region, exceeding the physiological limits of joint strength.Follow the daily routine and principles of PN for Coxarthrosis, watch your posture.An annual examination of the joints, starting from the age of 30, will help prevent the development of irreversible changes in the body of a patient with osteoarthritis.
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 you haven't managed to protect yourself from coxarthrosis, don't despair – take action!