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 of the same name. Arthrosis is considered to be an age-related problem, which is confirmed by world statistics: after 40 years, every second person is faced with a diagnosis, 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.
Causes of the disease
The hip joint is formed by the acetabulum, which includes the head of the femur. A large trochanter is attached to the articular head, surrounded by a synovial bag with a thick mucus-like mass. It is synovia that nourishes the hip cartilages and ensures their easy sliding between each other, without noise and pain. 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 mobile joints in the hip region occurs when:
- Perthes disease.
- Hip dysplasia.
- Reactive or infectious coxitis.
- Metabolic disorders. Diabetes and gout can cause arthrosis.
- Chondromatosis of the joints. The disease is characterized by the formation of free intra-articular bodies that damage hyaline cartilage.
- mechanical injuries. This includes a fracture or dislocation of the hip (including congenital), tearing of the joint capsule, frequent microtrauma of the joints.
At risk are people who are overweight and have bad habits. In professional runners or weightlifters, the connective tissue wears out quickly, and besides, athletes are not immune from displacement of the articular cartilage and ruptures of the hip muscles. By itself, arthrosis of the hip joint is not inherited, however, the structural features of the bone tissue or slow metabolism are genetically determined.
The course of the disease
First of all, arthrosis affects the large joints of the bones of the pelvis and knee joints (gonarthrosis), it is on their share that a huge load falls during movement. During the period of exacerbation, acute arthrosis occurs, then palpation of the joint and hip tissues is accompanied by pain. With incomplete or incorrect fusion of the femur after an injury, neoarthrosis or a false joint is formed, filled not with callus, but with connective tissue.
There are arthrosis of the hip joint of 1, 2 and 3 degrees, each stage of the disease has its own characteristics:
- Arthrosis of the 1st degree develops slowly, without disturbing the mobility of the articular structures, muscle tone is normal. At an early stage of coxarthrosis, the disease can only be detected on x-rays.
- Arthrosis of the hip joint of the second degree is accompanied by intense pain in the hip region, sometimes a crunch is heard in the joint. With arthrosis, it is difficult to make rotational movements of the hip and take it to the side, the articular space narrows, the tone of the hip muscles weakens. Contracture begins to form.
- With coxarthrosis of the 3rd degree, the pain syndrome is pronounced. Due to atrophy of the muscles of the hip region and the expansion of the neck of the femur, the leg is shortened. When walking, the patient uses a support. Due to arthrosis, the joint space can completely disappear, in which case they speak of bone ankylosis.
In clinical practice, doctors regularly encounter an involutive type of coxarthrosis (typical for the elderly) and postinfectious 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 in menopause. In arthrosis-arthritis, the inflammatory rather than degenerative process predominates in the hip joint.
If the etiology of the disease is not established, we are talking about primary or idiopathic coxarthrosis. Usually the disease affects the joints of people who have crossed the 50-year milestone. Secondary arthrosis develops at a young age, as a rule, arthrosis of the left hip joint or the right one (unilateral coxarthrosis) is diagnosed.
Symptoms of arthrosis of the hip joint do not bother the patient at first, only occasionally prolonged loads on the affected area or awkward movement 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 arthrosis and weather conditions.
- An increase in body temperature. Chills and swelling of the joints are observed with arthrosis-arthritis of one or two hip joints.
- Weakening and subsequent atrophy of the muscles of the hip region.
- A distinct crunch in the joints. A possible sign of coxarthrosis, but not mandatory.
- lame. Due to the destruction of the femoral bone in arthrosis, an uncertain, "duck" gait is formed.
Those suffering from coxarthrosis often experience pain radiating to the patella, so an inexperienced doctor, after listening to the patient's complaints, can make an erroneous diagnosis and delay the recovery process for many months.
Arthrosis is diagnosed by a rheumatologist, traumatologist or orthopedist. After questioning the patient, the doctor conducts an external examination of the hip region, examines the mobility of the leg, evaluates the gait of the patient with coxarthrosis.
The most effective methods for diagnosing arthrosis include:
- General and biochemical analysis of blood.
- Plain radiography of the hip region.
- Ultrasound and MRI.
If infectious arthrosis of the femoral joint is suspected, the volume of synovial fluid is determined and its cellular composition is examined. To rule out the presence of autoaggressive antibodies in the body, the patient is sent for RF analysis in the blood serum.
How is osteoarthritis of the hip treated?
Treatment of arthrosis of the hip joint is selected taking into account the stage of coxarthrosis, the age of the patient and concomitant diagnoses. It is possible to cure arthrosis of degrees 1 and 2 using an integrated approach: taking pharmaceutical preparations in combination with physiotherapy methods, massage and a special diet.
After the end of the acute period of coxarthrosis for the treatment of the hip joint, cardio training is allowed without running and jumping.
After the end of the acute period of coxarthrosis, sparing gymnastic exercises with a limited range of motion, cardio training without running and jumping are selected 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 environment.
Conservative therapy of the disease is aimed at relieving pain in the hip area and maintaining the functionality of the joints. The main goal is complete recovery or stable remission of coxarthrosis.
Treatment of arthrosis is not complete without the appointment:
- NSAIDs. Non-steroidal drugs relieve pain and inflammation in the mobile joint, but the tablets are not related to the restoration of the hyaline cartilage structure in coxarthrosis.
- Vasodilators. The preparations provide the delivery of nutrients to the joints affected by arthrosis, eliminate congestion in the hip region.
- Chondroprotectors. They saturate the tissues of the joint with water, improving its lubricating properties. Stop the destruction of articular structures in the hip region. Glucosamine and chondroitin sulfate are part of many chondroprotectors.
- Gels and ointments against arthrosis. They have a warming, irritating or distracting effect. Means successfully cure arthrosis of the hip joints.
- Injections of steroid drugs into the joint cavity, it is advisable to inject to eliminate pain in the acute phase of coxarthrosis.
Compresses with medical bile increase the effectiveness of the listed remedies for arthrosis. Therapeutic dressings should not be applied to the hip area with damage to the lymphatic system and fever (infectious coxarthrosis).
Despite the deep location of the hip joints, physiotherapy methods bring relief from coxarthrosis. Popular physiotherapeutic procedures include electrophoresis, laser therapy, warming paraffin applications. Acupuncture improves the innervation of cartilage tissue and the functioning of internal organs. Phonophoresis with hydrocortisone in arthrosis combines the advantages of ultrasound and medicinal 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 desirable 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.
- Whole grain bread.
- Kasha boiled in water.
Exclude salty and spicy foods, nightshade plants, muffins, smoked meats, carbonated drinks from the diet. When treating coxarthrosis, you should not buy ready-made food from supermarkets or semi-finished products.
Replacement of the affected joint with an artificial one is indicated at the last stage of coxarthrosis. Before the operation, the patient must pass general blood and urine tests, ultrasound of the hip region, ECG.
The main stages of the procedure:
- The surgeon cuts off the femoral head and inserts a pin to connect it to the titanium femoral head implant.
- Part of the surface of the pelvic bone is removed, a polymer bed is attached in its place, which is connected to the titanium head.
Dentures are best fixed with bone cement. If arthrosis affects the joints at a young age, cementless attachment methods are sometimes used.
Massage relieves muscle spasms, strengthens the ligamentous apparatus in case of coxarthrosis. During the procedure, the patient with arthrosis should take a comfortable position and relax. First, we rub the back (10 minutes), then massage the sacro-buttock region. With circular movements of bent fingers, we knead the problematic thigh in the direction of the lymph flow - from the bottom up. 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 joints with arthrosis is selected by the exercise therapy doctor. It is advisable to engage in physiotherapy exercises 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, which was presented by the practicing rheumatologist P. V. Evdokimenko, is growing. Gymnastics Evdokimenko consists of static exercises to strengthen the hip muscles, stretch marks with minimal pressure on the affected area. For example, if you lie on your left side, bend your left leg at the knee and stretch your right leg, then hold it in an elevated position for about 30 seconds, then the muscles will begin to contract. With coxarthrosis, the task is performed in 5 approaches for each leg.
At the heart of folk methods of treating coxarthrosis are the basic concepts of the properties of medicinal herbs. Before the development of the pharmaceutical industry, eucalyptus oils, cloves and fresh aloe juice were rubbed into diseased joints for arthrosis. Celandine ointments relax the hip muscles and tendons.
Effective alternative medicine recipes:
- Grind 200 g of white steppe roots and fill it with pork fat (300–400 g). Put on low heat, after 5-7 minutes the remedy for coxarthrosis is ready. Rub the cooled mass overnight into the affected joint for 2 weeks.
- Whisk the egg white with 1 tbsp. l. flour. The therapeutic mixture should be applied for arthrosis to the hip area at bedtime. Do not forget to wrap the sore joint with parchment paper and a woolen scarf.
Mumiyo has an intense restorative effect, improves the mobility of the hip joints. For arthritis and arthrosis, 5 g of mummy is dissolved in 10-20 ml of water, 45 g of heated vaseline is poured into it. The product is gently rubbed into the skin of the thigh.
Prevention of arthrosis of the hip joint involves the rejection of bad habits, a sedentary lifestyle, extra pounds load the hip region, exceeding the physiological limits of the strength of the joints. Follow the daily routine and principles of PP for coxarthrosis, watch your posture. To prevent the development of irreversible changes in the body of a patient with arthrosis, an annual examination of the joints, starting from the age of 30, will allow.
Among the pathologies of the musculoskeletal system, arthrosis of the hip joint occupies a leading position. The disease reduces the quality of life of the patient and is the main cause of disability at a young age. Even if it was not possible to protect yourself from coxarthrosis, do not despair - act!