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 with the same name.Arthrosis is considered 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.
Cause of disease
The hip joint is formed by the acetabulum, which covers 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 cartilage of the hips and ensures that they slide easily over each other, without noise or pain.An age-related decrease in the production of synovial fluid and changes in its viscosity are the main causes of hip joint arthrosis.
Coxarthrosis of the mobile joint in the hip area occurs when:
- Perthes disease.
- Hip dysplasia.
- Reactive or infectious coccitis.
- Metabolic disorders.Diabetes mellitus and gout can trigger arthrosis.
- Joint chondromatosis.This disease is characterized by the formation of loose intra-articular bodies that damage the hyaline cartilage.
- Mechanical injury.These include fractures or dislocations of the hip (including congenital), torn joint capsule, and frequent joint microtrauma.
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 articular cartilage displacement and hip muscle tears.Arthrosis of the hip joint itself is not inherited, but the characteristics of bone tissue structure or slow metabolism are genetically determined.
Course of disease
First of all, arthrosis affects the large joints of the pelvic bones and knee joints (gonarthrosis);they are the ones who carry a large load when moving.During the exacerbation period, acute arthrosis occurs, then palpation of the joint and hip tissue is accompanied by pain.In the case of incomplete or incorrect fusion of the femur after injury, a neoarthrosis or false joint is formed, not filled with callus, but with connective tissue.
There are degrees 1, 2 and 3 hip joint arthrosis, each stage of the disease has its own characteristics:
- Stage 1 arthrosis develops slowly, without affecting the mobility of joint structures, muscle tone is normal.In the early stages 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 crackling 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.Contractures begin to form.
- With coxarthrosis of the 3rd degree, the pain syndrome is pronounced.Due to the atrophy of the muscles of the hip area and the expansion of the neck of the femur, the legs are shortened.When walking, the patient uses support.Due to arthrosis, the joint space may disappear completely, in this case they talk about bone ankylosis.
In clinical practice, doctors often encounter types of coxarthrosis (common in the elderly) 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 the degenerative process dominates the hip joint.
If the etiology of the disease is not established, we talk about primary or idiopathic coxarthrosis.Usually this disease affects the joints of people who have passed 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 sometimes a prolonged load on the affected area or awkward movements remind of the problem.
Coxarthrosis of the hip joint manifests itself:
- Pain in the hip area.The intensity and nature of joint pain depends on the stage of arthrosis and weather conditions.
- Increased body temperature.Shivering and joint swelling are observed with arthrosis-arthritis of one or two hip joints.
- Weakness and atrophy of the muscles of the hip area that follows.
- A clear buzzing sound in the joint.Signs of coxarthrosis are possible, but not mandatory.
- Defects.Due to the destruction of the hip bones with arthrosis, an uncertain "duck" gait is formed.
Those who suffer from coxarthrosis often experience pain that radiates to the kneecap, so an inexperienced doctor, after listening to the patient's complaint, can make an incorrect diagnosis and delay the recovery process for several months.
Diagnostics
Arthritis is diagnosed by a rheumatologist, traumatologist or orthopedic specialist.After interviewing the patient, the doctor conducts an external examination of the hip area, examines the mobility of the legs, and evaluates the gait of the patient with coxarthrosis.
The most effective methods for diagnosing arthrosis include:
- General blood and biochemical tests.
- Plain radiograph of the hip area.
- Ultrasound and MRI examinations.
If infectious arthrosis of the hip joint is suspected, the amount of synovial fluid is determined and its cellular composition is checked.To exclude the presence of auto-aggressive antibodies in the body, patients are sent for RF analysis in 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 age of the patient and concomitant diagnoses.Arthrosis 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 acute period of coxarthrosis, cardio exercises without running and jumping are allowed for the treatment of the hip joint.
After the acute period of coxarthrosis, soft gymnastic exercises with a limited range of motion, cardio exercises without running and jumping are chosen for the treatment of the hip joint.At the final stage, the treatment of arthrosis of the hip joint takes place in a sanatorium-resort setting.
Drug treatment
Conservative treatment of this disease aims to relieve pain in the hip area and maintain joint function.The main goal is complete recovery or stable remission of coxarthrosis.
Treatment of arthrosis is incomplete without the following:
- NSAIDs.Non-steroidal drugs relieve pain and inflammation in mobile joints, but tablets have nothing to do with restoring the structure of hyaline cartilage in coxarthrosis.
- Vasodilators.Medicines ensure the delivery of nutrients to joints affected by arthrosis and relieve congestion in the hip area.
- Chondroprotectors.Saturate the joint tissue with water, increasing its lubricating properties.Stops the destruction of articular structures in the hip area.Glucosamine and chondroitin sulfate are part of many chondroprotectors.
- Gel and ointment against arthrosis.They have a warming, irritating or disturbing effect.Medicines successfully cure arthrosis of the hip joint.
- It is advisable to inject steroid drugs into the joint cavity to relieve pain in the acute phase of coxarthrosis.
Compressing with medical bile increases the effectiveness of the drugs listed for arthrosis.Therapeutic bandages should not be used on the hip area if the lymphatic system is affected and there is fever (infectious coxarthrosis).
Physiotherapy
Despite the deep location of the hip joint, physiotherapy methods bring relief from coxarthrosis.Popular physiotherapeutic procedures include electrophoresis, laser therapy, and the application of heating paraffin.Acupuncture improves the preservation of cartilage tissue and the function of internal organs.Phonophoresis with hydrocortisone for arthrosis combines the advantages of ultrasound and medical 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 advised that every day starts 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 types of fish and meat.
- Whole grain bread.
- Porridge cooked in water.
From your diet, exclude salty and spicy foods, nightshades, baked foods, smoked foods and carbonated drinks.When treating coxarthrosis, you can not buy ready-made food from the supermarket or semi-finished products.
Endoprosthetics
Replacement of the affected joint with an artificial one is indicated in the last stage of coxarthrosis.Before the operation, the patient must undergo a general blood and urine test, an ultrasound of the hip area, and an ECG.
The main stages of the procedure:
- The surgeon cuts 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 instead 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 joint at a young age, cementless bonding methods are sometimes used.
massage
Massage relieves muscle spasms, strengthens ligaments in case of coxarthrosis.During the procedure, patients with arthrosis should take a comfortable position and rest.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.
Exercise and exercise therapy
The level of load on the hip joint during arthrosis is determined by a physical therapist.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 methods of combating arthrosis, presented by 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 in the elevated position for about 30 seconds, the muscles will begin to contract.For coxarthrosis, the task is performed in 5 approaches on each leg.
People's recovery
The traditional method of treating coxarthrosis is based on the basic concept of the properties of medicinal herbs.Before the development of the pharmaceutical industry, eucalyptus oil, cloves and fresh aloe juice were applied to painful joints for arthrosis.Celandine ointment relaxes hip muscles and tendons.
Effective alternative medicine recipes:
- Grind 200 g of white leg 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 into the affected joints at night for 2 weeks.
- Beat the egg whites with 1 tbsp.l.flour.For arthrosis, the drug mixture should be applied to the hip area before going to bed.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 joint.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 thighs with gentle movements.
Prevention
Prevention of hip joint arthrosis involves giving up bad habits, inactive lifestyle, extra pounds loading the hip area, exceeding the physiological limit of joint strength.Follow the daily routine and principles of PN for coxarthrosis, pay attention to your posture.Annual examination of the joints, starting at the age of 30, will help prevent the development of irreversible changes in the body of patients with arthrosis.
Among the pathologies of the musculoskeletal system, arthrosis of the hip joint occupies a leading position.This disease reduces the patient's quality of life and is the main cause of disability at a young age.Even if you cannot protect yourself from coxarthrosis, do not despair - act!