Coxarthrosis of the hip joint is one of the leading places among all diseases of the musculoskeletal system in the elderly. It does not become a cause of a critical condition, however, if the pathology develops over a long time, it significantly worsens the quality of life of the patient and even leads to disability.
It is very important to determine the presence of the disease at the initial stage and conduct a comprehensive treatment, as this guarantees a faster and more successful recovery.
Features of the disease
What is coxarthrosis of the hip joint is familiar to many elderly people who suffer from this disease. This is a disease in which the cartilage tissue that forms the articular surfaces is affected. Degenerative changes in its structure lead to bone destruction, limitation of joint functioning and the appearance of very unpleasant symptoms.
The complexity of diagnosis and treatment lies in the fact that coxarthrosis develops rather slowly and is very rarely detected in the initial stages. Initially, the symptoms appear in a mild form, and the patient rarely visits a doctor. Despite the fact that such a pathology is much less common than arthritis or arthrosis, it still affects many people over 40 years old.
Untimely treatment leads to deformation of the hip joint. In everyday life, this translates into pain and difficulty walking.
Degree of defeat
By the nature of the joint damage, doctors distinguish 4 degrees of the course of the disease. With coxarthrosis of the hip joint of the 1st degree, discomfort is almost imperceptible, and during the diagnosis it is difficult to make an accurate diagnosis. Pain may appear after exercise. With bilateral damage, soreness occurs immediately in two legs.
Grade 2 coxarthrosis of the hip joint is characterized by the fact that the changes are minor, but they are already clearly visible on x-ray. The gap between the acetabulum and the hip is narrowed. Osteophyte outgrowths may also appear. With coxarthrosis of the hip joint of the 2nd degree, the symptoms become more pronounced, the pain is felt more strongly and can give off to adjacent areas. Often soreness does not go away even at rest. Lameness and stiffness of movements are possible.
With coxarthrosis of the hip joint of the 3rd degree, many osteophytes are formed. Symptoms become more pronounced, and the joint gap narrowes greatly. Often the pains become simply unbearable and force the person to take painkillers. Pathology is accompanied by swelling in the hip joint, and adjacent tissues begin to atrophy. Treatment of coxarthrosis of the hip joint of the 3rd degree is carried out only by surgery.
At 4 degrees of coxarthrosis, an x-ray shows characteristic changes in the joint. In this case, only the operation will be effective, since the bones are fused, which leads to complete immobilization of the limb. In order to timely detect the course of the disease, you need to know exactly what coxarthrosis of the hip joint is and how it manifests itself. The sooner the treatment is carried out, the more likely it is to stop the deforming process.
Causes of occurrence
Many people wonder what coxarthrosis of the hip joint is, for what reasons it occurs and what symptoms are typical for it. There are a number of provoking factors that lead to pathological changes. These include:
- heredity;
- age;
- injuries
- physical exercise;
- illnesses.
One of the most important factors in the development of coxarthrosis is considered age. This disease is diagnosed mainly in people over 40 years old. Also important is the weight of a person. All extra pounds have a significant load on the lower limbs and joints. Cartilage tissue cannot withstand mechanical stress for a long time and begins to deform.
Another important factor is the violation of metabolic processes. Many pathological conditions and diseases accompanied by a violation of metabolic processes adversely affect the blood circulation and the supply of nutrients to the cartilage tissue. Often, disorders occur against the background of diabetes, gout, as well as many other diseases.
Cartilage malnutrition occurs with insufficient production of female sex hormones - estrogen. A similar disorder develops during menopause. Of no small importance is the long or uncontrolled intake of medications containing hormones or corticosteroids, which leads to metabolic disorders.
Main symptoms
As already mentioned, coxarthrosis has several degrees by which the severity of the pathological process and the intensity of the symptoms are evaluated. Depending on this, a treatment regimen is selected. Among the general signs of the course of the disease, it is necessary to highlight such as:
- intense pain;
- restriction or complete blocking of motor activity;
- change in leg length;
- amyotrophy;
- crunch in the joints.
Coxarthrosis of the hip joint of the 1st degree is characterized by the fact that gradually the inter-articular fluid begins to lose its properties, its viscosity increases, which greatly complicates the movement in the joint. Microcracks form in the cartilage, and it becomes thinner.
The main signs of coxarthrosis are the appearance of periodic dull and aching pains in the pelvic region and hips, especially after intense physical exertion. After a short rest, the discomfort goes away. Sometimes a person only complains of discomfort in the groin area. The movements are still free, there are no signs of arthrosis on the radiograph, or a slight narrowing of the interarticular gap is observed. The treatment of the disease is quick and can be eliminated using conservative methods. In addition, there are no complications and relapses.
With coxarthrosis of the hip joint of the 2nd degree, severe pain occurs, which gives to the knee part of the limb and thigh. The pain appears even with a small load and passes only after taking analgesics. If the disease is caused by a severe defect in the articular elements, then discomfort manifests itself even at rest and often worsens at night. Long walks provoke a change in gait.
It becomes difficult for a person to bend a leg in a joint, take it aside, and also put on shoes and socks. Pain is also characteristic after a long stay in one position without movement.
Already at this stage, shortening of the affected limb is observed, as well as atrophy of the muscles of the thigh and buttocks. Muscles work very weakly and lose their volume. At this stage, still conservative treatment is acceptable. Through the use of medicines, it is possible to slow the progression of pathology and the subsequent destruction of articular cartilage.
With coxarthrosis of the hip joint of grade 3, prolonged and very severe pains that are independent of the load are observed. In addition, muscle atrophy, restriction of movements. Due to constant pain in a person, general health deteriorates, irritability occurs, sleep disturbance and depression increase. The affected leg is shortened, although it may be lengthened. It all depends on the characteristics of the destruction of the hip joint. A person has severe lameness, and also reduced motor amplitude. This degree is treated only by surgery.
Diagnostics
Before you determine how to treat coxarthrosis of the hip joint, you must definitely make a diagnosis. If a disease is suspected, conduct a biochemical blood test. Additionally, an x-ray is prescribed, on which you can identify:
- bone growths on the border of the cartilage;
- ossification;
- narrowing the distance between the joints;
- bone compaction.
If it is impossible to consider pathological changes using x-rays, computed tomography is prescribed. It allows you to examine in more detail layer by layer the joint cavity and all components.
In some cases, MRI is prescribed, which makes it possible to examine not only bone and cartilage, but also the soft tissues of the joint. This is the most gentle examination technique, since the human body does not experience any radiation load, so the only contraindication is the presence of metal implants, fragments and other objects.
From laboratory studies, a general blood test is of great diagnostic value. It allows you to identify signs of infectious diseases that could lead to the development of coxarthrosis.
Treatment features
It is very important to timely determine the presence of an ailment and conduct treatment. Initially, it is necessary to establish the degree of the course of the disease, since a specific therapy is prescribed for each of them. When symptoms of coxarthrosis of the hip joint appear, treatment should begin immediately and be comprehensive.
The doctor prescribes medications, physiotherapy exercises, manual therapy, massage. All procedures must be performed under the supervision of an orthopedist. Additionally, you can use traditional medicine.
With advanced stages, treatment is carried out only with the help of an operation, after which a rehabilitation period is required.
Drug treatment
The treatment of coxarthrosis of the hip joint of the 1st degree is carried out with the help of medications. For this, the following groups of drugs are used:
- non-hormonal;
- muscle relaxants;
- vasodilator;
- chondroprotectors;
- hormonal.
Non-hormonal anti-inflammatory drugs are used at all stages of the course of the disease. They help reduce inflammation, pain and swelling. Such drugs include Indomethacin, Diclofenac, Meloxicam. The disadvantage is the presence of many side effects, as well as a negative effect on the stomach. In addition, they can not be taken for a long time, despite the fact that the inflammation in the joint is permanent.
Vasodilators eliminate spasm of blood vessels, normalize blood circulation and tissue nutrition. Such medicines include Trental, Theonikol, Nikoshpan. They do not provoke complications and significant side effects. Perhaps only the appearance of allergies.
Muscle relaxants help relieve muscle cramps, as well as reduce pain. They require the strict dosage prescribed by the doctor. These include Milokalm and Sirdalud. These drugs can provoke side effects, which include dizziness, lethargy, and nausea.
Chondroprotectors contain substances that are the structure of cartilage. With the thinning or destruction of cartilage, they help reduce destructive processes, protect against the progression of the disease, and also contribute to the restoration of the damaged area. The result is noticeable only after prolonged use. People who are at risk of developing coxarthrosis are recommended to use such drugs as a prophylaxis. Most often prescribed Teraflex, Structum, Chondroitin sulfate. It is strictly forbidden to use for acute inflammation in the joints, pregnancy and in case of allergies.
Hormonal drugs are used to eliminate inflammation and swelling. They are prescribed if hormonal drugs do not bring the desired result. Among these drugs, it is necessary to highlight "Methylpred", "Kenagol", "Hydrocortisone." They are prescribed in a short course, and they should be used under the supervision of a doctor.
Locally, you can also use ointments, creams that help eliminate pain and inflammation, and also give a warming effect. Medication is carried out for treatment of coxarthrosis of the hip joint of the 2nd degree, but in addition, physiotherapeutic techniques, massage and exercise therapy should be additionally applied.
Physiotherapy
Symptoms and treatment of coxarthrosis of the hip joint can be different, it all depends on the degree of the course of the disease. However, in any case, physiotherapeutic techniques are prescribed, since they help improve the nutrition of the affected joint and blood supply. Also, such funds accelerate recovery and metabolic processes. Physiotherapeutic treatment includes:
- heat exposure;
- laser therapy;
- electrical stimulation;
- magnetic therapy;
- ultrasound exposure.
Thermal treatment includes ozokerite, mud therapy, paraffin therapy. All the substances used for these procedures help to retain heat well for a long time, which ensures a long and uniform effect on the affected area. Due to this, and also due to the penetration of active components through the skin, there is an improvement in blood microcirculation and metabolic processes in tissues.
When electrical stimulation occurs, the impact of pulsed currents on muscles with different frequencies. This method is considered a kind of gymnastics that normalizes blood circulation in the entire lower limb. However, such a technique cannot compare with a full-fledged exercise therapy or completely replace it. In addition, there are a number of contraindications for the use of electrical stimulation.
The principle of magnetotherapy is to expose the body to a magnetic field, which is created using a special device. The essence of the effect is to heat the joint and adjacent ligaments and muscles. This procedure helps to improve blood circulation in the joint and eliminate swelling, which helps to restore tissue. The procedure itself is painless, safe and takes 5-20 minutes. The course of therapy should be no more than 3-4 weeks.
The principle of laser therapy is to expose the body tissue to an amplified light beam, which consists of infrared, ultraviolet and red radiation spectra. Laser light penetrates the joint through the skin and muscles, causing certain biochemical reactions in the joint tissues.
Ultrasound therapy involves exposure to ultrasonic waves, the range of which is not perceived by the human ear. It can penetrate into the tissues of the body to a depth of 4-6 cm, exerting a therapeutic effect on the joints.
Physiotherapy
A very good result is shown in exercise therapy for coxarthrosis of the hip joint. Applied exercises that return the mobility of the affected area and strengthen the muscles. Physical education is carried out as prescribed by the attending doctor and is selected depending on the course of the disease.
Typically, a set of exercises includes stretching, as well as static and dynamic load. Exercise therapy should be performed correctly and it is advisable to do this regularly and with a qualified instructor. Basically, coxarthrosis of the hip joint is treated without surgery. The operation is assigned only in complex and advanced cases.
Operation
At the latest and most advanced stages, an operation is performed. Without surgery, coxarthrosis of the hip joint is treated only when diagnosing a disease of the 1st and 2nd degree. Previously, a person undergoes a full examination to make sure that there are no contraindications for surgical intervention. Among the main types of operations, it should be noted such as:
- arthroplasty;
- osteomy
- arthroplasty;
- arthrodesis.
Treatment of coxarthrosis of the hip joint of the 3rd degree implies endoprosthetics, i.e., complete or partial replacement of the joint. This operation is considered quite complicated, especially if the lesion is bilateral.
The prosthesis must be selected by the doctor, taking into account the characteristics of the development of the disease. Such treatment may be the only possibility of regaining mobility. After the intervention, a comprehensive recovery is required. With coxarthrosis of the hip joint of the 2nd degree, the operation is performed by modeling the destroyed cartilage. Arthroplasty is considered quite complicated, since it is necessary to take into account the natural anatomical features of the joint.
To restore normal mobility of the affected area, it is important to choose the right treatment for coxarthrosis of the hip joint. The operation can be performed by dissection of the bones of the joint, in which it is possible to eliminate its deformation. Such an intervention helps to restore support and motor function.
Arthrodesis implies that special screws and plates are used to fasten the bones of the hip joint. At the same time, the functionality of the joint is restored, but at the same time a slight stiffness remains.
Unconventional techniques
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In the late stages of the course of coxarthrosis, it is possible to get rid of it only by conducting an operation. With a complete or partial replacement of the joint, the person's well-being normalizes, pain and lameness pass.
Prophylaxis
Specific prophylaxis of coxarthrosis does not exist. Methods of primary prevention are considered earlier identification and timely treatment of dislocation and injury of the thigh. It is also important to constantly monitor people with joint pathologies.
Secondary prevention consists in the timely detection of coxarthrosis and its periodic conservative treatment at least 1-2 times a year.