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 an age-related problem, which is confirmed by world statistics: every second person is diagnosed after 40 years, 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.The greater trochanter attaches to the articular head, which is surrounded by a synovial bursa with a thick mucus-like mass.It is the synovium that nourishes the hip cartilages and ensures that they slide easily between each other, without noise or pain.The age-related decrease in the production of synovial fluid and the change in its viscosity are the main causes of arthrosis of the hip joint.
Coxarthrosis of the mobile joints of the hip joint occurs when:
- Perthes disease.
- Hip dysplasia.
- Reactive or infectious coxitis.
- Metabolic disorders.Diabetes and gout can provoke arthrosis.
- Chondromatosis of the joints.The disease is characterized by the formation of loose intra-articular bodies that damage the hyaline cartilage.
- Mechanical damage.This includes fracture or dislocation of the hip (including congenital), rupture of the joint capsule, and frequent microtrauma of the joints.
People who are overweight and have bad habits are at risk.In professional runners or weightlifters, the connective tissue wears out quickly, and athletes are not exempt from displacement of articular cartilage and tearing of hip muscles.Arthrosis of the hip joint itself is not inherited, but the structural characteristics of the bone tissue or slow metabolism are genetically determined.
The course of the disease
First, arthrosis affects the large joints of the bones of the pelvis and knee joints (gonarthrosis);they are the ones who carry a huge load during movement.During the period of exacerbation, acute arthrosis occurs, and then pain accompanies the palpation of joint and hip tissue.In the case of incomplete or incorrect fusion of the femur after an injury, a neoarthrosis or false joint is formed, which is not filled with callus, but with connective tissue.
There are degrees 1, 2 and 3 arthrosis of the hip joint, each stage of the disease has its own characteristics:
- Grade 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 by X-ray.
- Second-degree osteoarthritis of the hip joint is accompanied by intense pain in the hip area, sometimes a creaking sound can be heard in the joint.In the case of arthrosis, it is difficult to rotate and move the hip to the side, the joint space narrows, and the tone of the hip muscles weakens.Contracture begins to develop.
- In the case of grade 3 coxarthrosis, 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 leg is shortened.The patient uses support while walking.Due to arthrosis, the joint gap can disappear completely, in which case it is called bone ankylosis.
In clinical practice, doctors regularly encounter an involutive type of coxarthrosis of the hip joint (typical of the elderly) and post-infection arthrosis.Patients taking corticosteroids and antidepressants are at risk of dyshormonal coxarthrosis;this type of arthrosis also affects the joints of women during menopause.In the case of arthrosis-arthritis, the inflammatory rather than the degenerative process dominates in the hip joint.
If the etiology of the disease is not established, then we speak of primary or idiopathic coxarthrosis.Usually, the disease affects the joints of people who have crossed the 50-year mark.Secondary arthrosis develops at a young age;arthrosis of the left or right hip joint is usually diagnosed (unilateral coxarthrosis).
Symptoms
The symptoms of arthrosis of the hip joint do not bother the patient at first, only occasionally long-term loading or awkward movement of the affected area reminds of the problem.
Coxarthrosis of the hip joint is manifested by:
- Pain in the hip area.The intensity and nature of joint pain depends on the stage of arthrosis and weather conditions.
- Increased body temperature.Chills and joint swelling are observed in arthrosis-arthritis of one or two hip joints.
- Weakening and subsequent atrophy of the muscles of the hip region.
- A distinct crunching sound in the joints.A possible sign of coxarthrosis, but not mandatory.
- Lameness.Due to the arthrosis of the hip bone, an unsteady, "duck" gait develops.
People suffering from coxarthrosis often experience pain radiating to the kneecap, so an inexperienced doctor can make a wrong diagnosis after listening to the patient's complaints and delay the healing process for months.
Diagnostics
Arthritis is diagnosed by a rheumatologist, traumatologist or orthopedist.After interviewing the patient, the doctor performs an external examination of the hip area, examines the movement of the leg, and evaluates the gait of the patient with coxarthrosis.
The most effective methods of diagnosing arthrosis are:
- General and biochemical blood test.
- Plain radiograph of the hip area.
- Ultrasound examination and MRI.
In case of suspicion of infectious arthrosis of the hip joint, the volume of synovial fluid is determined and its cell composition is examined.In order to rule out the presence of autoaggressive antibodies in the body, the patient is sent for RF analysis of the blood serum.
How is arthrosis of the hip joint treated?
The treatment of arthrosis of the hip joint is selected taking into account the stage of coxarthrosis, the age of the patient and the concomitant diagnoses.Grade 1 and 2 arthrosis can be cured with an integrated approach: taking pharmaceutical drugs in combination with physiotherapy methods, massage and a special diet.
After the end of the acute period of coxarthrosis, cardio training without running and jumping is allowed for the treatment of the hip joint.
After the end of the acute period of coxarthrosis, gentle gymnastic exercises with limited range of motion, cardio training without running and jumping are chosen for the treatment of the hip joint.In the final stage, hip joint arthrosis is treated at a sanatorium resort.
Drug treatment
Conservative treatment of the disease is aimed at alleviating hip pain and preserving the functionality of the joints.The main goal is complete healing or stable remission of coxarthrosis.
The treatment of arthrosis is incomplete without the following:
- NSAIDs.Non-steroidal drugs relieve pain and inflammation in the moving joint, but tablets have nothing to do with restoring the structure of hyaline cartilage in coxarthrosis.
- vasodilators.Medicines ensure the delivery of nutrients to the joints affected by arthrosis and eliminate congestion in the hip area.
- Chondroprotectors.It saturated the joint tissues with water, improving its lubricating properties.It stops the destruction of joint structures in the hip area.Glucosamine and chondroitin sulfate are part of many chondroprotectors.
- Gels and ointments against arthrosis.They have a warming, irritating or distracting effect.Medicines successfully cure arthrosis of the hip joints.
- It is advisable to inject steroid drugs into the joint cavity to eliminate pain in the acute phase of coxarthrosis.
Compresses with medical bile increase the effectiveness of the listed remedies for arthrosis.A therapeutic bandage cannot be applied to the hip if the lymphatic system is affected and there is a fever (infectious coxarthrosis).
Physiotherapy
Despite the deep location of the hip joints, physiotherapy methods relieve coxarthrosis.Popular physiotherapy procedures include electrophoresis, laser therapy and the use of warming paraffin.Acupuncture improves the innervation of cartilage tissue and the functioning of internal organs.Phonophoresis with hydrocortisone in the case of arthrosis combines the advantages of ultrasound and the healing effect on the hip.
Diet and nutrition
A special diet for coxarthrosis consists of low-fat foods and high in vitamins B, C, E, as well as calcium, potassium and magnesium.It is advisable to start each new day with a glass of freshly squeezed fruit juice.Give preference to boiled and steamed foods.
The daily menu for arthrosis should consist of:
- Dairy products.
- Fresh vegetables and fruits.
- Low-fat types of fish and meat.
- Whole wheat bread.
- Porridge cooked in water.
She excludes salty and spicy foods, nightshades, baked goods, smoked foods and carbonated drinks from her diet.When treating coxarthrosis, do not buy ready-made food from supermarkets or semi-prepared products.
Endoprosthesis
In the last stage of coxarthrosis, replacement of the affected joint with an artificial one is recommended.Before the operation, the patient must have a general blood and urine test, an ultrasound of the hip area and an EKG.
The main stages of the procedure:
- The surgeon cuts the head of the femur and inserts a pin to connect to the titanium femoral head implant.
- A portion of the surface of the pelvic bone is removed and replaced with a polymer bed that is attached to the titanium head.
The best way to fix dentures is with bone cement.If arthrosis affects the joints at a young age, cementless fixation methods are sometimes used.
Massage
The massage relieves muscle spasms and strengthens the ligament apparatus in case of coxarthrosis.During the procedure, the patient with arthrosis must be in a comfortable position and rest.First, the back is rubbed (10 minutes), then the sacro-gluteal area is massaged.With circular movements of bent fingers, the problematic thigh is kneaded in the direction of the lymph flow - from bottom to top.In order to slow down the development of arthrosis, the procedure is performed three times a day.
Exercises and exercise therapy
The load level of the hip joints during arthrosis is determined by the physiotherapist.It is advisable to perform physical therapy in a room specially designed for this purpose.Swimming in the pool or skiing accelerates the healing of coxarthrosis joints.
The popularity of the method of combating arthrosis, which was presented by practicing rheumatologist P. V. Evdokimenko, is becoming more and more popular.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, extend your right leg, and then hold it in the raised position for about 30 seconds, the muscles will begin to contract.In the case of coxarthrosis, the task is performed in 5 approaches on each leg.
Folk remedies
Traditional methods of treating coxarthrosis are based on the basic concepts of the properties of medicinal plants.Before the development of the pharmaceutical industry, eucalyptus oil, cloves and fresh aloe juice were rubbed into painful joints due to arthrosis.Celandine ointments relax hip muscles and tendons.
Effective alternative medicinal recipes:
- Grind 200 g of the root of the white leg and fill it with pork fat (300-400 g).Put it on low heat, after 5-7 minutes the remedy for coxarthrosis is ready.Rub the cooled mass into the affected joint at night for 2 weeks.
- Beat the egg whites with 1 tbsp.l.flour.In case of arthrosis, the drug mixture should be applied to the hip before going to bed.Don't forget to wrap the sore joint with parchment paper and cotton wool.
Shilajit has an intense restorative effect and improves the mobility of the hip joints.In case of arthritis and arthrosis, dissolve 5 g of mummy in 10-20 ml of water and pour 45 g of warmed petroleum jelly into it.Rub the product into the skin of the thigh with gentle movements.
Prevention
Prevention of arthrosis of the hip joint involves giving up bad habits, a sedentary lifestyle, extra pounds burdening the hips, exceeding the physiological limits of the joints' strength.Follow the daily routine and principles of coxarthrosis PN, watch your posture.An annual examination of the joints starting at the age of 30 helps to prevent the development of irreversible changes in the body of patients suffering from arthrosis.
Among the pathologies of the musculoskeletal system, arthrosis of the hip joint takes a leading place.The disease reduces the patient's quality of life and is the main cause of disability at a young age.Even if you could not protect yourself from coxarthrosis, do not despair - act!