Coxarthrosis, or degenerative disease of the hip joint, is one of the most serious diseases of the musculoskeletal system. Due to the large size of the joint structures, the pain and discomfort are much more severe than when other joints are affected. The consequences of the pathology are also serious: if the destruction of small bone joints causes a lot of discomfort, osteoarthritis of the hip joint without treatment is a direct path to disability. Only the right therapy, and sometimes surgery, will help a person not to lose the ability to walk.
What is hip osteoarthritis?
Coxarthrosis, osteoarthritis, osteoarthritis of the hip joint are synonymous with the same pathological process that occurs in the thigh area on one or both sides. In modern medicine, the pathology is also called osteoarthritis: it was previously believed that inflammation is not characteristic of degenerative processes, but more careful studies have shown the opposite. The affected articular cartilage tissues release inflammatory elements (interleukins), so osteoarthritis is another correct term.
The disease is characterized by such signs:
- Constantly advances, passing from one stage to another,
- Leads to persistent pain, limited joint mobility,
- It causes deformation of bone surfaces, partial or complete destruction of hyaline cartilage,
- In the advanced stage it is more characteristic of the elderly, but often begins after the age of 40,
- Symptoms of the disease are present in 70% of people over the age of 75,
- Women are more likely to suffer from the disease.
A joint is a mechanism in which there are rubbing parts. Due to the decrease in the quality or quantity of the lubrication (interarticular fluid), the contact surfaces wear. Small cracks appear on the cartilage, later they are destroyed, and a callus appears in place of healthy tissue. Such growths do not allow the leg to move normally, its functions are lost.
Reasons for the development of the disease
Osteoarthritis of the right or left thigh region can be primary or secondary, and the former is typical for older people. The disease of the primary form develops over decades, is associated with age-related wear and destruction of cartilage.
Secondary coxarthrosis has other causes and can also begin in a young person. It is associated with the resulting inflammation (infectious, autoimmune), which gives impetus to the onset of pathology. Also, the cause could be hip trauma (bruising, dislocation, bone fracture). Other possible causes of the secondary form:
- Operations on this anatomical area,
- Diabetes mellitus and other serious metabolic diseases,
- hormonal diseases,
- Acquired congenital forms of curvature and displacement of bones,
- hip dysplasia in a child
- Protrusion of the acetabulum, necrosis of the femoral head,
- Vascular diseases of a systemic nature, leading to a deterioration in the nutrition of cartilage,
- Bone tuberculosis, rheumatoid arthrosis,
- Gout, Perthes disease,
- Tumors are benign and malignant.
Symptoms of osteoarthritis of the hip joint of any shape will appear faster if the risk factors act on the body:
- Constant stress, nervous shocks, depressions and worries,
- Obesity, even moderate overweight,
- unfavorable inheritance,
- Physical inactivity, sedentary work or certain professions with a high load on the joint,
- Excessive physical loads (of strength), professional sports.
Symptoms of the disease
Developing osteoarthritis of the hip joint and its symptoms cannot be overlooked. Even at an early stage, the disease makes itself felt and, above all, pain. Pain in emerging and progressive osteoarthritis of the hip joint increases as the disease progresses from stage to stage. They appear in the thigh area, damage to the knee, groin, even the lower abdomen. Usually after sleep, the pain goes away, but in an advanced stage it can be present all the time. On palpation, pain is not always felt, because joint damage can begin with deeply located parts.
Other possible signs of the disease:
- The creak that appears when moving, sometimes even with a slight,
- Limp, change pace,
- Shortening of the leg on the side where there is arthrosis of the hip joint,
- Stiffness of movement, limited rotation, movement of the leg.
As development progresses, other signs of pathology appear. Thus, palpation gives a feeling of deformation of the bone, the presence of growths. During the examination, the doctor notes muscle atrophy, and the patient, even in ordinary life, is forced to move with a cane, crutch - due to pain and weakness in the limb.
In general, pain and other clinical manifestations strongly depend on the stage. There are such stages of coxarthrosis:
- First.Symptoms are mild, but initial changes are already evident during diagnosis. Synovial fluid becomes denser, its volume decreases, the structure of the cartilage changes towards the end of the stage. Small cracks appear, which the body tries to heal with the formation of small "grains".
- Second.Pain at this stage is quite noticeable, crunching, restriction of motor function is noticeable. The pain syndrome radiates to other parts of the body, spreads down the entire leg. The picture shows: thinning of the cartilage, narrowing of the distance between the bones, violation of the structure of the joint surfaces, sometimes - displacement of the bone head from the cavity. The number of bone growths (osteophytes) increased.
- Third.The pain becomes unbearable, a person is severely limited in movement, many stop moving altogether. The cartilage is almost completely destroyed, the muscles atrophy, the joint is severely deformed. Bone osteophytes look like spikes and irritate nerve endings.
What are the risks and complications?
It is easy to understand that if, with a pathology such as osteoarthritis of the hip joint, the symptoms and treatment are determined incorrectly, out of time, this threatens disability. Excruciating pain syndrome, inability to walk, the need for constant care - this is what awaits a person without treatment for this disease.
Disability in case of damage to the thigh bones is established based on the severity of the disease, with the complete absence of the opportunity to work, they give the first group. Such patients are shown surgery - this is the only effective method of treatment in such a situation. But even modern operating methods can carry the risk of complications:
- infectious infection,
- thrombosis, thromboembolism,
- Significant blood loss.
The overall complication rate is small - 0. 5-2%, but they do occur. Most often, there is an infection of the prosthesis, which then needs to be replaced with a new one. That is why after the operation it is important to carry out a course of treatment with antibiotics.
Diagnostic measures for osteoarthritis
It is advisable to seek help from a traumatologist, surgeon, orthopedist already at the first signs of damage to the femoral area. Initially, if hip osteoarthritis is suspected, doctors do physical tests:
- Feel the upper thigh, reveal pain points, bone osteophytes,
- Performs passive movements of the legs - flexion, extension, abduction and adduction to determine the range of possible movements.
Instrumental diagnostics will help make a more accurate diagnosis and prescribe treatment for osteoarthritis of the hip joint. X-ray is usually done, which is the cheapest and most available method of research. It is recommended to take an x-ray on modern devices or to replace it with a CT scan, where the image quality is much higher. CT provides comprehensive information on the condition of bones, cartilage, and joint surfaces. If a detailed study of the condition of the soft tissues is required (for example, when a nerve root is pinched), the specialist will prescribe an MRI.
Other possible diagnostic measures:
- joint ultrasound,
- arthroscopy,
- Blood test for rheumatoid factor,
- tuberculin test,
- Biochemical analysis for suspected diabetes mellitus, gout.
It is very important to find the cause of secondary coxarthrosis, because without influencing it it will not be possible to stop the course of the disease.
Treatment of osteoarthritis of the hip joint - medicines and physiotherapy
If the signs of the disease are implied and it has not passed the stage of irreversible changes, then conservative treatment will help the patient. Drug therapy will also be needed when osteoarthritis of the hip joint has become severe, as part of a course of treatment.
How to treat osteoarthritis of the hip joint? There is a drug correction program of the disease:
- Non-steroidal anti-inflammatory drugs. Pills or injections will help get rid of pain, inflammation. They cannot be used uncontrollably: the ability of cartilage to regenerate will decrease, in addition, the stomach and intestines suffer a lot from NSAIDs.
- Vascular drugs. Treatment with such means helps to strengthen the nutrition of cartilage and contributes to its restoration.
- Muscle relaxants. Indicated for spastic pain in the muscles caused by injuries to the thigh area.
- Chondroprotectors. Osteoarthritis of the hip joint requires many mandatory months of taking such drugs. It is also necessary to apply injectable forms in the courses, including injection into the joint cavity. An even more effective technique is the introduction of hyaluronic acid preparations into the joint.
- Corticosteroids. Used in extreme cases in the form of intra-articular injections. Such treatment is necessary if the symptoms become unbearable.
External agents (ointments, gels) for coxarthrosis are usually ineffective due to the deep location of the joint. But physiotherapy techniques are often used and give serious pain relief. UHF, laser therapy, magnetotherapy are performed on the thigh area, UHF, massages are performed. Also, with osteoarthritis, manual therapy is indicated, in some cases - joint traction.
Folk remedies for osteoarthritis
Many people use alternative treatment for this pathology, although osteoarthritis of the hip joint does not respond well to various external methods. Only with severe pain syndrome it is possible to apply compresses with isolation on the sore spot, although this will be more annoying. Treatment of complicated and advanced osteoarthritis of the hip joint is best done with oral medications:
- Pour 100 g of dry cinquefoil herb with 500 ml of vodka, insist in the dark for 10 days, take 30 drops three times a day to relieve inflammation,
- Make jelly every day, in the absence of contraindications, make jelly regularly - dishes will serve no worse than chondroprotectors.
You can relieve pain with the help of such a compress. It is necessary to evenly mix honey, medical bile, ammonia, glycerin, apply to the joint, tie with a warm cloth. Leave the pack on for 3 hours, then rinse.
Other methods and operation
For the complete treatment of arthrosis, it is very important to follow the right diet, you will have to give up food that interrupts the blood supply and impairs the nutrition of the cartilage. These are smoked meats, vinegar, salty foods, fried foods, as well as foods with preservatives, trans fats. But there should be more dishes with magnesium, potassium, iodine, calcium in the diet.
What is needed to treat osteoarthritis of the hip joint are therapeutic exercises. All patients need to perform daily warm-up, special exercises in the supine position. For example, you need to slowly lift your leg and hold it above the floor for a few seconds. It is important to exclude sudden movements, to avoid long and fast walks - with coxarthrosis, this will only increase the progression of the disease. A cane, crutches can be used to unload the joint, and an orthopedist may also recommend special orthoses to mitigate the load.
Treatment of arthrosis of the hip joint of the third, last stage is carried out only with the help of surgical intervention, other methods are ineffective. In 95% of cases, the operation is successful, the leg movements are completely restored. But the prostheses are not eternal, their service life is up to 20 years, so the operation is a last resort. During arthroplasty, your own joint is replaced with an artificial one, and osteoarthritis of the hip joint no longer threatens it.
Prevention of coxarthrosis
In order not to carry out complex treatment of pathology, in order not to suffer from pain syndrome, it is important to start preventive measures from an early age. Prevention of coxarthrosis is especially important for those exposed to risk factors.
So that the blood supply to the cartilage does not suffer, you should:
- Eat with the inclusion of plant foods in the menu, a sufficient amount of lean meat, cottage cheese, jelly, sour-milk food,
- Stop smoking, do not abuse alcohol,
- At sedentary work, warm up regularly, do simple exercises,
- Give up a sedentary lifestyle in favor of skiing, swimming, and other low-intensity aerobic activities.
In order for a person not to be disturbed by arthrosis of the hip joint, it is necessary to control body weight, prevent obesity and the appearance of even 5-10 pounds more - this seriously increases the load on the femoral area. Coxarthrosis can only be prevented with an integrated approach and a healthy lifestyle!