Coxarthrosis: treatment, symptoms, diagnosis

In this article, we will consider the symptoms and treatment of coxarthrosis of the hip joint.

The disease is a deforming arthrosis of the hip joints. This pathology is a very common disease. Various facts affect the appearance of the disease, in particular the abnormal development of the pelvic bones, lower limbs and spine. The statistics of coxarthrosis are disappointing today. Among all varieties of osteoarthritis, the share of the development of pathologies of large joints accounts for fifty percent. The incidence of this pathology in this case is twenty-five percent.

The treatment of coxarthrosis is described in detail below.

Disease data

To date, coxarthrosis of unclear etiology occurs in forty percent of cases. The secondary form of the disease is formed in twenty percent of cases. The remaining forty percent is a consequence of various injuries, excessive physical and professional stress. More often this disease affects people of average working age. Recently, coxarthrosis of the hip joint has become significantly younger. Symptoms and treatment are of interest to many.

The mechanism of pathology

In the hip joint, the anonymous and femur are articulated in people. There is an acetabulum in the pelvic cavity, in which the femoral head is located. The acetabulum is covered with cartilage. The bottom and front are thinner, and the top and back are slightly thicker. Directly, the femoral head is covered with cartilage. The slit-like space inside the joint is completely filled with special synovial fluid. It is usually transparent and resembles egg white. Synovial fluid carries out metabolic functions in the joint, it acts as one of the representatives of the immune defense.

Since large loads are placed on the joint, it is equipped with supporting ligaments that form its capsule. Cartilage is devoid of a sensitive nerve field that could signal an excessive load. Therefore, the cartilage tissue can gradually loosen, and, in addition, the chemical properties of the cell matrix change. Each updated cartilage cell is defective. As a result, cartilage loses its biomechanical property.

Synovial fluid affects particles of exfoliated cartilage. These pieces penetrate the joint capsule and synovial membrane. As a result of this, the membrane becomes inflamed, much more liquid is released, but its quality is worse. This whole process increases the destruction of the joint. It begins to swell and become covered with bone growths that create pain during movements. In addition to physiology, the biomechanics of the joint are excessively impaired.

Treatment of the symptoms of coxarthrosis of the hip should be timely.

Causes of coxarthrosis and types of its classification

There are primary and secondary forms of coxarthrosis. In the first case, the disease forms in the joint, the cartilage of which was healthy from birth, and the problems arose due to excessive stress. In the secondary form, the process of degeneration of already changed cartilage occurs. The causes of coxarthrosis include the following factors:

• The presence of a congenital subluxation of the femoral head, which is about twenty percent of all arthrosis of the hip joints, and is mainly found among women.
• Obtaining acetabular or pelvic fractures.
• Getting hip fractures.
• The presence of fractures and necrosis of the femoral head.
• The presence of benign or malignant bone tumors.
• The appearance of arthrosis caused by Paget's disease.
• The presence of ankylosing spondylitis and rheumatoid arthritis.

Symptoms and treatment of coxarthrosis are interrelated.

Symptoms of the development of pathology

A symptom of coxarthrosis is the appearance of pain in the joints, especially in the legs. The next day, such pain can last a whole day. And later, a person simply cannot fall asleep.

In such patients, the muscles of the buttocks and hips begin to atrophy. Walking can be very problematic. The limbs can subsequently be shortened, and the person begins to limp. Next comes the defeat of the joint, which leads to its change, and it completely ceases to fulfill its functions. At an early stage, the joint is only limited in its movement, and later it can completely immobilize a person. A significant limitation of mobility appears in the second or third degree of coxarthrosis of the hip joint. Treatment is selected depending on this.

Initial degree and its symptoms

The first degree of this disease is characterized, as a rule, by the appearance of aching pain, localized in the joint area after heavy loads. Against this background, the biomechanics of movements are not disturbed, and the pain, in turn, quickly passes. On x-rays, you can notice a slight narrowing of the joint spaces.

Treatment of coxarthrosis of the 2nd degree is carried out much more often.

Second degree and its symptoms

Against the background of the second degree, the following symptoms are observed in patients:

• The pain intensifies, and articular mobility is impaired.
• The extension process is not brought to a twenty-degree angle. The amplitude of the lead is less than forty-five degrees. In particular, a violation with restriction of rotational movements is strongly felt.
• Pain in the groin and popliteal ligament is given. Often these pains are associated with diseases of the spine or knee joints.
• The appearance of aching pains at rest, which are caused by developing inflammation.
• Violation of biomechanics, and at the same time, functional abilities are reduced.
• The appearance of characteristic sounds in the joints during movement.
• The appearance of gluteal dystrophy along with a slight specific limp. The limb can be visually shortened due to a distortion of the pelvis.
• X-ray images show osteophyte overgrowth and deformation of the femoral head and its contours. The joint gap narrows by one third of the standard physiological state. The head of the hip moves up.

The treatment of coxarthrosis of the 2nd degree of the hip joint is presented in detail below.

The third degree of the disease and its symptoms

Against the background of the third degree, the following symptoms are observed in patients:

• Muscles are very atrophied.
• The pain becomes permanent and disturbs at night.
• The biomechanics of the functioning of the joint is significantly impaired.
• The appearance of a sharp starting pain greatly complicates any movement.
• Pelvic distortion is greatly enhanced, and the limb, in turn, is shortened.
• The gait in a person becomes specific.
• An x-ray shows deformation of the head of the bone along with a large number of osteophytes. The joint gap is absent altogether, and the neck of the thigh is significantly thickened.

With the development of the third degree of coxarthrosis, doctors are already talking about patient disability. Often, such patients are not able to move without a cane.

Surgery in the treatment of coxarthrosis of the hip is used, but not always.

Pathology Prediction

Depending on the position of the affected joint, a prognosis of the course of the disease is made. In the event that the lesion was in the central part, then we can hope for a longer and more calm course of the disease. Against this background, pain will have a medium severity. The joint gap will narrow in the central region of the acetabulum. In this situation, it is possible to support the patient for a long time through conservative treatment of coxarthrosis of the hip joint, without resorting to surgery.

In the case of localization of the lesion in the lower region, the pain will not show up much. In this case, the internal rotation will be violated more than the external one. Sclerosis of the end plates will be observed. This type of coxarthrosis may not be particularly aggressive for many years. The prognosis for conservative treatment is usually positive.

Coxarthrosis with damage to the upper region is considered the most difficult. This situation is more common with congenital anomalies of the joints. At the same time, painful sensations are very strong and are already evident in adolescence. In the advanced stages, subluxations of the joints occur. The outer rotation is seriously impaired. In addition, a part of the acetabulum and the bone head is deadening. The prognosis of the disease is uncomfortable. In relation to such patients, surgery is performed.

Before talking about the treatment of coxarthrosis, consider diagnostic methods.

Diagnosis of the disease

In diagnosing an ailment, the qualification of a doctor plays an important role. In the event that the orthopedic surgeon treats the spine, forgetting to prescribe a radiography of the hip joint, then time will be greatly missed. Unfortunately, this is often what often happens. The following methods are recognized as the most truthful and informative techniques for establishing coxarthrosis:

• Radiography. In this case, it will be possible to determine the size of the joint space in the images, the presence or absence of osteophytes along with the condition of the femoral head.
• Performing an ultrasound scan. It makes it possible to determine the degree of the disease. Thanks to him, localization is clarified along with the number of growths and the state of the acetabulum. Changes in the ligamentous apparatus are also determined.
• Conducting computed tomography. In essence, this technique is not much different from x-rays, but it makes it possible to obtain more detailed and voluminous images.
• Using magnetic resonance imaging. This technique is considered the most complete and truthful. It allows you to study joints in layers, fixing the most minor changes in the structures of bones and cartilage.

Additional laboratory tests, as a rule, help to identify the level of inflammation in the joint. In this case, an orthopedic examination is an integral part of the diagnosis. Only by summing up all the data in the complex, you can confidently make a diagnosis by indicating the degree of development of the disease.

How is coxarthrosis treated?

Treatment of this disease is divided into several directions. First of all, we are talking about drug therapy, physiotherapy and non-traditional methods. Drug treatment of coxarthrosis, as a rule, includes:

• Correction of disorders within the joints.
• Relief of pain.
• Effect on improving blood supply.
• Stimulation of metabolic processes.
• Decrease or complete removal of the inflammatory process.
• Conducting chondroprotective treatment.

The following methods are referred to physiotherapy:

• Conducting electrical procedures.
• The implementation of mud therapy.
• Performing massages and manual therapy.
• Conducting plasmolifting. This procedure is a new technique based on an injection of platelet autoplasma.

Treatment of coxarthrosis of the 2nd degree with unconventional techniques involves acupuncture along with reflexology and apitherapy. In addition, for the treatment of this disease, it is possible to turn to traditional medical gymnastics, original methods and surgical intervention. Next, we dwell in more detail on the treatment of coxarthrosis without surgery using drugs.

Medical treatment

For the treatment of this disease, various groups of drugs are used. Among them, the use of anti-inflammatory drugs is primarily relevant. After all, the first step that you need to take is to remove the inflammation along with the pain syndrome. The following tools are used for this:

• The use of acetylsalicylic acid. It does not have sufficient effect, but for patients at risk of thrombosis, such an acid in low doses is necessary. For example, Curantil is often used for this.
• Drugs in the form of "Olfen", "Naklofen" and "Indomethacin" can very quickly relieve pain, but they are not suitable for prolonged use, as they have many side effects. These drugs are emergency medications for exacerbation.
• "Meloxicam", "Nabumeton" and "Nimesil" cause fewer side effects. The most optimal option for long-term use is considered "Meloxicam" it is better to use it in the form of candles.

The use of antispasmodics can improve blood circulation in the treatment of coxarthrosis of the hip joint of the 2nd degree. Against the background of the disease, the thigh muscles are in a state of spasm. This has an extremely negative effect on the general circulation. To solve this problem, muscle relaxants are used with agents that reduce vascular permeability. Muscle relaxants include “No-shpa” along with “Midokalm”, “Sirdalud” and “Riabal”. The drugs in the form of Ascorutin, Upsavit, Trental and Cavinton are well reduced permeability and improve peripheral blood circulation.

Physiotherapy and massages

Physiotherapy is aimed at relieving pain, and, in addition, at improving the penetration of medications to the joints. The most effective and common of these include the following procedures:

• Conducting electrophoresis with novocaine.
• Conducting radiation therapy.
• Performing an ultrasound scan.
• Conducting magnetotherapy.

It is also advisable to carry out massages in relation to such patients, as they significantly improve blood circulation, enhance tissue trophism, strengthen the ligamentous apparatus and relieve the tone of spasmodic muscles. Especially useful for coxarthrosis are vibrational massages that work best on deeply located joints.

What other treatment for the symptoms of coxarthrosis of the hip is performed?

Mud therapy and manual therapy

This method of treatment is a very effective technique for combating coxarthrosis. Healing mud of various compositions, whether peat or silt, can enhance regeneration along with trophic tissue. Mud therapy saturates the joints of a person with useful minerals, stimulating the restoration of cartilage and well removing various inflammations.

In the treatment of coxarthrosis of the joints, an application technique is used. Mud is applied from the lower back to the middle of the thighs. For therapeutic purposes, mud treatment should be done twice a year. Manual treatment includes:

• Carrying out various manipulations, for example, the implementation of sharp movements that are aimed at relieving spasms and returning the amplitude of motion.
• Mobilization performance. This extends the limbs, thereby increasing the distance between the femoral head and the acetabulum.

A very common and effective method for the treatment of coxarthrosis of the hip joint of the 2nd degree is the complex of the manual therapist Gitt. Unconventional methods like acupuncture and apitherapy are very effective additions.

What else does treatment for coxarthrosis of the hip suggest?

Operation

With advanced pathogenesis, surgery on the hip is a necessary measure. Only surgical intervention in the last stages of the disease can restore lost motor capabilities, eliminate pain.

Depending on the characteristics of the pathology, the patient may be offered:

• Arthrodesis - correction only support function. The articular bones are firmly fixed with metal plates to completely immobilize the anatomical structure.
• Endoprosthetics is the best method of surgical intervention, thanks to which it is possible to solve the problem with coxarthrosis dramatically (almost 100% success).
• Osteotomy - provides a temporary delay in the replacement of the joint. The bone is aligned along the axis with an artificial fracture, and then the osteotomy sites are fused in a favorable position for the joint. This slightly relieves the affected area, reduces pain and improves gait.

Coxarthrosis has always been attributed to age-related diseases, in this regard, preventive diagnosis should be carried out by patients after the age of thirty-five. This will make it possible to timely identify this pathology and successfully conduct treatment. In accordance with medical indications, patients are referred for all kinds of tests and diagnostics in cases of complaints of characteristic pain in the hip area during movement. It should be understood that against the background of advanced forms of pathology, surgical intervention may be necessary, therefore, it is best to determine the disease in advance.

We examined the symptoms and treatment of coxarthrosis of the hip joint.