What is deforming arthrosis of the hip joint and why it occurs
Arthrosis of the hip joint (also known as coxarthrosis and deforming osteoarthrosis of the hip joint) is one of the most frequently diagnosed pathologies of the bone muscular system.In Russia, this ailment is a leading cause of disability in people with joint diseases.
For reference
Coksartrosis is a chronic inflammation of the hip joint, which is characterized by premature destruction of the cartilage, narrowing of the joint gap and a decrease in the mobility of the leg from the lesion.
Figuratively the problem of a person suffering from arthrosis of the hip joint can be compared with a door whose loops are not lubricated.Due to the lack of “lubrication” inside the joint, the bones begin to come into contact, which provokes pain and constraint (like a creak and tight course of the door).Later, if the disease is ignored, outgrowths (“rust”) occur on bone surfaces, which more and more limit movements in the joint, and with adverse outcome, it ceases to fulfill its function.
It is usually believed that arthrosis of the hip joint is an age problem.Statistics confirm this point of view: after 40 years, such a diagnosis has been made one of ten, after 60 years - one of three patients, and in those who are 70 in 80% of cases for 70.But often the pain in the thigh lead to the office of orthopedic and youth.
So, among the causes of osteoarthrosis of the hip joint, the following most significant are distinguished:
- Inborn impaired development (dysplasia) of the joint, which may not show itself until adulthood;
- premature wear of the joints that occurs due to intensive loads in athletes or in obesity;
- injuries and infections affecting the musculoskeletal system;
- other diseases of the musculoskeletal system, which lead to pathological redistribution of the load on the joints;
- Violation of the blood supply to the joint (for example, due to vessels atherosclerosis).
Doctors believe that a combination of factors leads to arthrosis of the hip joint, therefore, in people with a predisposition to this disease, the pathological process occurs earlier, as in patients with obesity, diabetes mellitus or ischemic damage to the heart.
Symptoms of coxarthrosis
The first sign of arthrosis is pain after physical activity.Unpleasant sensations arise both in the inguinal region, so in the thigh and knee.
This is important
Often, with coxarthrosis, the pain is initially concentrated in the knee joint, and a person addresses the doctor with such a complaint.An inexperienced doctor can prescribe an X -ray of this area and, if there are minor changes, make an erroneous diagnosis - gonartrosis of the 1st degree.As a result, time will be missed.Therefore, with pain in the leg, it is worth devoting time to the search for a competent orthopedic physician and a good orthopedic clinic.
If coksartrosis is not started to treat in the early stages, the following symptoms join the pain: stiffness and crunch in the joint, a change in the gait (often to avoid unpleasant sensations, patients unfold the leg outward and transmit when walking from side to side - a “duck” gait is formed), lipping.Over time, the pathological process leads to atrophy of the hip muscles and visual shortening of the diseased limb.In the later stages, osteoarthrosis of the hip joint develops into ankylosis - the complete fraining of the femur with a pelvis, which is why the leg is fixed in one position and performs only the support function.
Degree of disease
For the convenience of diagnostics, doctors distinguish three degrees of coxarthrosis:
- 1 degree of osteoarthrosisThe hip joint is set with moderate pain manifestations and the absence of constraint in movements.With radiography, a small narrowing of the joint gap and single bone outgrowths, osteophytes are noticeably a small narrowing.Subject to adequate treatment, coxarthrosis of the 1st degree can be stopped by eliminating the symptoms of the disease.
- 2 degree of coxarthrosisIt is accompanied by aching pain even at rest of the leg.The movements in the joint are difficult: a person cannot lift and take the leg to the side.The pain is especially noticeable when trying to unfold the foot of the straightened leg to the right and left.The patient is lame, sometimes a crunch is heard in the joint.In X -ray pictures - deformation of the femoral head, numerous osteophytes and narrowing of the joint gap per third.Therapeutic measures allow to suspend the course of the disease for many years.
- At3 degrees of coxarthrosisThe pain in the joint does not subside around the clock, atrophy of the muscles of the thigh and buttocks develops - the whole body of a person seems skewed towards the lesion.X -ray indicates a deep deformation of the joint and narrowing of the gap of the gap until the full connection of the bone surfaces.The therapeutic approach, as a rule, does not give a tangible effect - a joint replacement for a prosthesis is required.
For the diagnosis of deforming osteoarthritis, it is used as an external examination, in which the doctor studies the mobility of the leg, evaluates the gait and appearance of the patient, as well as radiography.In doubt in the correctness of the diagnosis, the specialist additionally prescribes a direction for magnetic resonance tomography (MRI) of the hip joint.
How to treat arthrosis of the hip joint
The fight against cokesartrosis requires the involvement of various methods: from drugs and physiotherapy exercises to the joints of the joint and surgery, which is usually prescribed for unsuccessful attempts to turn back the development of the disease.
Conservative treatment
Non -surgical treatment requires time and financial costs, but it can improve the quality of the patient’s life in the long run - to cancel the need for surgical surgery.The first thing that an orthopedist prescribes coksartrosis is drugs that relieve pain and inflammation (non -steroidal and steroidal anti -inflammatory drugs, muscle relaxants).To activate blood supply in the field of arthrosis and restoration of cartilage tissue, vasodilating drugs and chondroprotectors are prescribed.In addition, the patient can offer a modern methodology for stimulating regenerative processes - plasmolifting, that is, the injection of the patient’s blood components into the pathological focus.These measures are most effective for osteoarthritis of the hip joint of the 1st and 2nd severity.
Non -surgical treatment methods
In addition to tablets, ointments and injections, treatment of coxarthrosis requires the use of physiotherapy and kinesitherapy, as well as diet correction.A help strategy developed by an experienced orthopedic allows people with 1 and 2 degree of arthrosis of the hip joint to avoid endoprosthetics and limit the need for drugs.
Physiotherapy
- Shock-wave therapy (UVT)It is used in cardiology, neurology, orthopedics and sports medicine.The basis of the effect on the body is sound waves that provide blood flow to the desired area of the body, which stimulates regeneration processes and accelerates the metabolism.This relatively new method already shows significant results in the treatment of diseases of the musculoskeletal system and becomes one of the most popular.
- MyostimulationIn case of coxarthrosis, it is aimed at restoring muscle functioning, weakened due to a forced restriction of movements in the joint.
- PhonophoresisIt combines the advantages of ultrasound and drug effects on the body: under the influence of the device, a pharmaceutical drug in the form of an ointment or cream penetrates more effectively through the skin to the hip joint.
- OzonotherapyReduces unpleasant sensations and activates the growth of cartilage due to the properties of the ozos-acid mixture.
Kinesitherapy
- Exercise therapyIt is considered the basis for the successful treatment of arthrosis of any localization: the regular implementation of a special exercise system strengthens the ligaments and muscles around the sore joint, which reduces discomfort with the usual daily loads.
- Massage(including lymphatic drainage) and manual therapy are aimed at passive work with muscles, ligaments and joints.Approaches used to help people with coxarthrosis reduce the need for tablets and injections, which reduces the pharmacological load on the body.
- MechanotherapyIt implies work with simulators that help to exercise the joint without significant physical efforts, which is especially in demand in patients of advanced age.
- Joint trafficWith the help of a special traction apparatus or hands of a manual therapist, it increases the space inside the joint, which “casts” the pathological process several steps back, facilitating the symptoms and giving the body time to restore the function of the hip joint.
Diet therapy
All patients with coksartrosis are required, but most important for obesity patients.Losing weight reduces the load on the inflamed joint and improves metabolism.In combination with other conservative methods, a balanced diet allows you to forget about pain and other manifestations of arthrosis of the hip joint.
Surgical treatment
This group includes procedures carried out by a surgeon in the operating room.All of them, except for the puncture of the hip joint, require hospitalization and a multi -month recovery period.With coxarthrosis of the 3rd degree, when conservative treatment does not bring relief, only prosthetics helps to save the patient from discomfort and pain, returning him the joy of movement.
- Puncture (minimally invasive intervention)It implies pumping out of the joint of the excess fluid, which relieves pain and improves the mobility of the leg.It can be carried out repeatedly, especially when prescribing steroid drugs.
- Arthroscopic debateIt implies the purification of the inner surface of the joint from fragments of the altered cartilage tissue and washing its cavity with a therapeutic solution to relieve inflammation.This operation is carried out through several punctures, without opening the joint cavity.
- Hemive osteotomy- an artificial fracture of the femur, followed by its fraining from a different angle, which allows to reduce the load on the joint.Such an intervention cannot be called a panacea - after 2–5 years, the pain returns, but in some conditions when endoprosthetics is impossible, the periosurge osteotomy of the hip joint is the best solution to the problem of coxarthrosis.
- Endoprostheticsmeans a complete replacement of the joint for a prosthesis, which can serve up to 20 years.Despite the complexity of the intervention, it is well tolerated by patients of different ages who are ready for active rehabilitation after surgery.Surgeons note that an important condition for success is preliminary treatment of obesity and the use of kinesitherapy methods in order to restore muscle strength surrounding the joint.
Prevention of osteoarthritis of the hip joint is important to people after 40 years, athletes and relatives of people with already diagnosed coksartrosis or a fracture of the femoral neck.Doctors recommend that the risk group monitor the figure, beware of injuries (for example, wear in winter shoes on non -slip soles) and regularly engage in fitness.At the first symptoms of arthrosis of the hip joint, immediately turn to the orthopedic.Treatment of the disease must be held with a specialist doctor, experienced and attentive to any changes in the health of the patient.