Arthrosis of the hip joint

Coxarthrosis(arthrosis of the hip joint) is a type of deforming joint arthrosis, which is a chronic non-inflammatory disease that affects the hip joint (one or both at the same time). This disease has a degenerative-dystrophic character. This means that the cartilage that makes up the hip joint undergoes degenerative changes, while also changing the surface of the bone. Further, bone growths (osteophytes) are formed, the joints change shape, the amount of movement in the affected joints decreases, and they become very painful and uncomfortable.

The hip joint is one of the largest joints in our body. It is thanks to him that very important motor functions are performed in the human body, and he is also responsible for ensuring that our bodies can move. If the hip joint becomes painful, then this affects the whole body as a whole and prevents a person from living peacefully, walking, not to mention playing sports. Often we see elderly people who have to rely on crutches because of hip joint disease.

Despite the fact that the hip joint is very large and strong, at the same time it is quite vulnerable, especially over time. Hip joint pain significantly reduces the quality of human life.

Coxarthrosis (arthrosis of the hip joint)ranks second among joint arthrosis in terms of the frequency of diagnosed cases after gonarthrosis (arthrosis of the knee joint).

Classification of coxarthrosis (arthrosis of the hip joint)

It happencoxarthrosisboth primary and secondary schools.

• The main cause of coxarthrosis is mainly the wear and tear of the hip joint that cannot be avoided in the course of life, and usually affects people after the age of 40.
• The causes of secondary coxarthrosis are usually the following diseases: congenital femoral dislocation, necrotic mass of the hip bone in the head area, Peter's disease, trauma to the hip joint earlier, inflammatory disease of the hip joint. Wherearthrosis of the hip jointcan affect either one joint separately, or both.

There are several types of coxarthrosis:

• Dysplastic (is a congenital pathology and is characterized by underdevelopment of the joints).
• Involutive (common for people in the older age category and associated with age-related changes).
• Post-infectious (it is preceded by purulent or purulent-allergy, rheumatoid arthritis).
• Disease due to Peters disease (development of osteochondropathy in the head of the femur).
• Coxarthrosisdue to trauma (broken neck and head of bone (femoral)).
• Coxarthrosis due to metabolic disorders (metabolism).
• Dyhormonal (taking glucocorticosteroids, antidepressants for a long time).
• Idiopathic (undetermined cause).

Symptoms of coxarthrosis (arthrosis of the hip joint)

To correctly describe the symptoms of coxarthrosis, one should simultaneously consider the stage of the disease, because the symptomatology depends on the stage of the disease.

Stages of coxarthrosis (arthrosis of the hip joint)

Overall, there are three stages of coxarthrosis (arthrosis of the hip joint):

• The first stage of coxarthrosis. This is the early stage of the disease, where the symptoms are still mild. The joints at this stage are not too painful and the pain only occurs after doing physical exercise, such as lifting heavy objects or jogging, climbing for long distances. After the person rests, the pain goes away. The patient may also experience lameness if, for example, he walks more than two kilometers on foot. Increased pain when climbing stairs. Joint motor volume is slightly reduced or preserved. An X-ray examination can only show minor changes in bone structure.
• 2nd stage of coxarthrosis. This stage develops in the absence of first-stage treatment. To the above symptoms, certain cracks (crunch) in the joints are added. The pain becomes more intense and begins to radiate to the groin area, and can also spread to the thighs and knees. At this stage, not only strong, but also any movement can cause pain symptoms, even a slight load on the hip joint. Even getting out of bed or turning the body 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 can start to drown even after a short walk (up to 500 meters). At this stage, the disease already forces a person to rely on a cane when walking. Limitation of movement in the joints becomes more pronounced. According to the X-ray diagnostic results, the appearing osteophytes are determined.
• 3rd stage of coxarthrosis. Final stage of the disease. At this stage, the pain becomes permanent and torments the patient. Any movement, even the weakest, several times increases the symptoms of pain. At this stage, the hip joint is completely immobile. Muscle mass in the thighs and buttocks is reduced due to muscular dystrophy, which is very noticeable. Characteristic is the inability of the patient to stand up straight, while the body will tilt. Any arthrosis leads to the formation of a contracture (flexion position), in this case, a contracture is also formed due to the fact that the muscle fibers are in constant tension, while the leg on the side of the lesion becomes shorter. As a result of the fact that the hip joint does not move, the whole leg stops performing its motor function, which has a very negative effect, and leads to their osteochondrotic lesions. In addition, the spine also suffers, there is a sensation of discomfort and pain in the sacral area.

Causes of coxarthrosis (arthrosis of the hip joint)

The main causes of coxarthrosis:

• Age-related changes in the joints. Common for older people. The hip joint wears out over time, stops performing its function over time, "dry", which leads to a decrease in the function of absorbing shock and friction of the bones that make up the joint against each other.
• Injury to the hip joint. The most common injury among people in this age group is a femoral neck fracture, which threatens disability if not properly treated. Joints can be injured at any age, but older people are more likely to suffer.
• Metabolism is disrupted. This is typical for people with a history of metabolic disorders and diseases related to impaired metabolism.
• Violation of hormonal status. It is more characteristic of women, especially those who have taken antidepressants and glucocorticosteroids for a long time.
• Hereditary anomalies in the development of the musculoskeletal system, as well as congenital anomalies. Unfortunately, at this time, 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, where some joint structures do not develop.
• Systemic arthritis. Damage to several joints can also cause damage to the hip joint. In this case, one of the main risk factors is the presence of an inflammatory process.
• Rheumatic conditions and chronic arthritis. All this can also cause the appearance of pain in the hip joint. Such diseases that cause pain in the studied joints include: rheumatism; rheumatoid arthritis; spondyloarthropathy; juvenile rheumatoid arthritis.
• Defeat of osteochondrosis. Osteochondrosis of the spine is a fairly common and serious disease that, in addition to the spine, can "cripple" other structures of our body, in particular, the hip joint.
• Muscles and joint ligaments. Damage to this structure can also be caused by degenerative and dystrophic processes in the hip joint.
• Infectious wounds of both the joint itself and the femur. Such lesions are very serious, because they lead to serious consequences and are sometimes difficult to treat. Osteomyelitis may occur, which simply "eats" or "dissolves" bone tissue. Tuberculous lesions may also occur, and more often such localization occurs in children in the pre-pubescent period. Abscesses in the pelvic region, which are more often caused by untreated or poorly treated infectious processes, for example, with appendicitis, inflammatory processes, especially when it is related to the female genital organs (ovarian disease), the development of abscesses in the ischiorectal deepening area, whichleading to walking disorders (appearance of lameness). In most cases, pain and lameness are the result of compression or damage to a nearby nerve (sciatic or obturator).
• Neoplasms are malignant. Quite rarely, malignant neoplasms affect the hip joint and surrounding bones, 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 artery (stenosis and their occlusion). At the same time, the joints receive less and less nutrients needed for normal functioning, which leads to their degeneration.

Risk group for coxarthrosis (arthrosis of the hip joint)

The main risk groups can include the following categories of people and dangerous factors:

• Older people. This disease is typical for older people, the elderly, because the degeneration process occurs that occurs precisely in this age period.
• female. According to statistics, women are more prone to problems with the hip joint.
• People who are overweight or obese.
• Previous trauma to one or both hip joints.
• Hereditary predisposition to this type of disease and congenital anomalies in the development of the hip joint.
• The presence in the past of infectious lesions, such as abscess, aseptic necrosis of the head of the hip bone, osteomyelitis, etc.
• Hard physical work.
• Summer residents have a very high risk of getting 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 joints to prevent the development of pathological processes in them and slower aging. This will help not only improve the condition of the hip joint, but also the whole body.
• If there is a metabolic disorder, it should be corrected. To do this, you need to contact an expert.
• Watch your weight. Do not forget that the hip joint already bears a large load, almost the entire body, so you should not disturb it to perform its function. In addition, a lot of body weight will put so much pressure on the joints that they will gradually collapse. People who are overweight are also prone to metabolic disorders.
• Avoid sharp turns of the body, especially if you are not warmed up and unprepared, this will prevent you from injuring the head and neck of the femur.
• It is better, of course, to choose sports where joint injuries are most dangerous, such as swimming or yoga, especially if there is a hereditary predisposition or developmental anomaly.
• The tendency to joint diseases implies a careful handling of them, as well as regular visits to the doctor in order not to miss the possibility of the development of the disease or any other pathological process in the joints.
• If a child is diagnosed with hip dysplasia, it needs to be treated, and immediately! It is better to keep the child immobile for a few weeks at an early age than to suffer for the rest of his life.
• 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 have discussed above, there are many reasons, they are diverse, andhip osteoarthritis treatment, respectively, will be radically different. Sometimes it is not so easy, and sometimes it is not possible at all. Emphasis is placed on the study of disease manifestations and the selection of appropriate treatment.

First of all, the patient is carefully interviewed by the doctor, studying in detail the complaints, the cause of the disease, the hereditary burden, the presence of injuries, etc. It is very important to have the complaint described above and how long it has been observed in the patient.

After the interview, the doctor personally examines the affected area for the presence of inflammatory, trophic changes, deformities, limb shortening, asymmetry, etc. And children may have "click" symptoms.

The important thing is additional examination methods - magnetic resonance imaging calculations, ultrasound and X-ray examination, because they will help to make a final diagnosis. In the differential diagnosis of coxarthrosis from other diseases of the hip joint, this item is very important.