Coxarthrosis or osteoarthritis of the hip joint is a degenerative-dystrophic disease that leads to loss of elasticity and destruction of cartilaginous tissue, premature wear of the joint of the same name.Osteoarthritis is considered an age-related problem, which is confirmed by world statistics: after 40 years, every second person is diagnosed, and closer to 70 years old, pathology is detected in 80% of cases.Structural changes in the hip occur 2.5 times more often in women than in men.
Causes of disease
The hip joint is formed by the acetabulum, which includes the head of the femur.The greater trochanter is attached to the articular head, surrounded by a synovial bursa with a thick mucus-like mass.It is the synovium which nourishes the cartilages of the hip and ensures their easy sliding between them, without noise or pain.An age-related decrease in the production of synovial fluid and a change in its viscosity are the main causes of osteoarthritis of the hip joint.
Coxarthrosis of the mobile hip joints occurs when:
- Perthes disease.
- Hip dysplasia.
- Reactive or infectious coxitis.
- Metabolic disorders.Diabetes mellitus and gout can cause osteoarthritis.
- Chondromatosis of the joints.The disease is characterized by the formation of loose intra-articular bodies that damage hyaline cartilage.
- Mechanical injuries.This includes hip fracture or dislocation (including congenital), tear of the joint capsule and frequent joint microtrauma.
People who are overweight and have bad habits are at risk.In professional runners or weightlifters, connective tissue wears out quickly, and athletes are not immune to displacement of articular cartilage and tearing of hip muscles.Osteoarthritis of the hip joint itself is not hereditary, but the structural features of bone tissue or slow metabolism are genetically determined.
Evolution of the disease
First of all, osteoarthritis affects the large joints of the pelvic bones and knee joints (gonarthrosis);they are the ones who bear a huge load when moving.During the period of exacerbation, acute arthrosis occurs, then palpation of the tissues of the joint and hip is accompanied by pain.In case of incomplete or incorrect fusion of the femur after injury, neoarthrosis or a false joint is formed, filled not with callus, but with connective tissue.
There are 1st, 2nd and 3rd degree osteoarthritis of the hip, each stage of the disease has its own characteristics:
- 1st degree osteoarthritis develops slowly, without affecting the mobility of joint structures, muscle tone is normal.In the early stage of coxarthrosis, the disease can only be detected by x-ray.
- Osteoarthritis of the hip joint of the second degree is accompanied by severe pain in the hip area, sometimes a crunch is heard in the joint.With osteoarthritis, it is difficult to rotate the hip and move it to the side, the joint space narrows, and the tone of the hip muscles weakens.A contracture begins to form.
- With coxarthrosis of the 3rd degree, the pain syndrome is pronounced.Due to atrophy of the muscles in the hip region and expansion of the femoral neck, the leg is shortened.When walking, the patient uses support.Due to osteoarthritis, the joint space can disappear completely, this is called bone ankylosis.
In clinical practice, doctors are regularly faced with an involutional form of coxarthrosis (typical of elderly people) and post-infectious osteoarthritis of the hip joint.Patients taking corticosteroids and antidepressants are at risk of dyshormonal hip osteoarthritis;This type of osteoarthritis also affects the joints of women during menopause.In osteoarthritis-arthritis, the inflammatory rather than degenerative process predominates in the hip joint.
If the etiology of the disease is not established, we speak of primary or idiopathic coxarthrosis.Usually the disease affects the joints of people who have crossed the 50-year mark.Secondary osteoarthritis develops at a young age;as a rule, osteoarthritis of the left or right hip joint is diagnosed (unilateral coxarthrosis).
Symptoms
The symptoms of osteoarthritis of the hip joint do not bother the patient at first, only occasional prolonged loads on the affected area or awkward movements remind of the problem.
Coxarthrosis of the hip joint manifests itself:
- Pain in the hip.The intensity and nature of joint pain depend on the stage of osteoarthritis and climatic conditions.
- Increased body temperature.Chills and swelling of the joints are observed with osteoarthritis-arthritis of one or both hip joints.
- Weakening and subsequent atrophy of the muscles in the hip region.
- A distinct cracking sound in the joints.A possible sign of coxarthrosis, but not obligatory.
- Lameness.Due to the destruction of the hip bone due to osteoarthritis, an uncertain "duck" gait is formed.
People suffering from coxarthrosis often experience pain radiating to the kneecap, so an inexperienced doctor, having listened to the patient's complaints, can make an incorrect diagnosis and delay the healing process for several months.
Diagnosis
Osteoarthritis is diagnosed by a rheumatologist, traumatologist or orthopedist.After interviewing the patient, the doctor conducts an external examination of the hip, studies the mobility of the legs and assesses the gait of the patient with coxarthrosis.
The most effective methods for diagnosing osteoarthritis include:
- General and biochemical blood test.
- Simple x-ray of the hip region.
- Ultrasound and MRI examination.
If infectious osteoarthritis of the hip is suspected, the volume of synovial fluid is determined and its cellular composition is examined.To exclude the presence of auto-aggressive antibodies in the body, the patient is sent for analysis of RF in blood serum.
How is hip osteoarthritis treated?
Treatment of hip osteoarthritis is chosen taking into account the stage of hip osteoarthritis, the patient's age and concomitant diagnoses.Osteoarthritis of degrees 1 and 2 can be cured using 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 a limited range of motion, cardio training without running and jumping are selected for the treatment of the hip joint.At the final stage, treatment of hip arthrosis takes place in a sanatorium.
Drug treatment
Conservative treatment of the disease aims to relieve pain in the hip area and maintain joint functionality.The main goal is complete cure or stable remission of coxarthrosis.
Osteoarthritis treatment is not complete without the following:
- NSAIDs.Non-steroidal drugs relieve pain and inflammation of the movable joint, but tablets have nothing to do with restoring the structure of hyaline cartilage in coxarthrosis.
- Vasodilators.The medications provide nutrients to the joints affected by osteoarthritis and eliminate congestion in the hip area.
- Chondroprotectors.Saturate joint tissues with water, thereby improving its lubricating properties.Stops the destruction of joint structures at the hip level.Glucosamine and chondroitin sulfate are part of many chondroprotectants.
- Gels and ointments against osteoarthritis.They have warming, irritating or distracting effects.Medicines successfully cure osteoarthritis of the hip joints.
- It is advisable to inject steroids into the joint cavity to eliminate pain in the acute phase of coxarthrosis.
Compresses containing medical bile increase the effectiveness of the listed remedies for osteoarthritis.Therapeutic bandages cannot be applied to the hip in the event of damage to the lymphatic system and fever (infectious coxarthrosis).
Physiotherapy
Despite the deep location of the hip joints, physiotherapy methods relieve coxarthrosis.Popular physiotherapeutic procedures include electrophoresis, laser therapy and paraffin warming.Acupuncture improves the innervation of cartilage tissue and the functioning of internal organs.Phonophoresis with hydrocortisone for osteoarthritis combines the benefits of ultrasound and medicinal effects on the hip region.
Diet and nutrition
A special diet for coxarthrosis includes foods low in fat and rich in vitamins B, C, E, as well as calcium, potassium and magnesium.It is advisable that each new day begins with a glass of freshly squeezed juice.Give preference to boiled and steamed dishes.
The daily menu for osteoarthritis should include:
- Dairy products.
- Fresh vegetables and fruits.
- Low-fat varieties of fish and meat.
- Whole grain bread.
- Porridge cooked in water.
From your diet, exclude salty and spicy foods, nightshades, baked goods, smoked foods and carbonated drinks.When treating coxarthrosis, you should not buy ready-made meals in supermarkets or semi-finished products.
Endoprostheses
Replacement of the affected joint with an artificial joint is indicated at the last stage of coxarthrosis.Before the operation, the patient must undergo general blood and urine tests, an ultrasound of the hip and an ECG.
Main steps of the procedure:
- The surgeon cuts the head of the femur and inserts a pin inside to connect it to the titanium femoral head implant.
- A portion of the pelvic bone surface is removed and in its place a polymer bed connected to the titanium head is attached.
The best way to secure dentures is to use bone cement.If osteoarthritis affects the joints at a young age, cementless fixation methods are sometimes used.
Massage
Massage relieves muscle spasms and strengthens the ligamentous apparatus in cases of coxarthrosis.During the procedure, the patient suffering from osteoarthritis should take a comfortable position and relax.We first rub the back (10 minutes), then we massage the sacro-gluteal area.Using circular movements with bent fingers, we knead the problem thigh in the direction of lymphatic flow - from bottom to top.To slow down the development of osteoarthritis, the procedure is performed 3 times a day.
Exercises and exercise therapy
The level of load on the hip joints during osteoarthritis is determined by the physiotherapist doctor.It is advisable to practice physical therapy in a room specially equipped for this purpose.Swimming in the pool or skiing will speed up the recovery of joints affected by coxarthrosis.
The popularity of the method of combating osteoarthritis, presented by the practicing rheumatologist P. V. Evdokimenko, is constantly growing.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 and extend your right, then hold it in an elevated position for about 30 seconds, the muscles will begin to contract.For coxarthrosis, the task is performed in 5 approaches on each leg.
Folk remedies
Traditional methods of treating coxarthrosis are based on basic concepts about the properties of medicinal herbs.Before the development of the pharmaceutical industry, eucalyptus oils, cloves and fresh aloe juice were applied to painful joints for osteoarthritis.Celandine ointments relax the muscles and tendons of the hip.
Effective alternative medicine recipes:
- Grind 200 g of whitefoot roots and fill it with pork fat (300-400 g).Place on low heat, after 5-7 minutes the remedy for coxarthrosis is ready.Rub the cooled mass onto the affected joint at night for 2 weeks.
- Beat the egg white with 1 tbsp.L.flour.In case of osteoarthritis, the medicinal mixture should be applied to the hip before bedtime.Don't forget to wrap the sore joint with baking paper and a woolen scarf.
Shilajit has an intense restorative effect and improves mobility of the hip joints.For arthritis and osteoarthritis, 5 g of mumiyo is dissolved in 10-20 ml of water and 45 g of heated petroleum jelly is poured into it.The product is rubbed into the skin of the thigh with gentle movements.
Prevention
Prevention of osteoarthritis of the hip involves abandoning bad habits, a sedentary lifestyle, extra pounds load the hip region, exceeding the physiological limits of joint strength.Follow the daily routine and principles of NP for coxarthrosis, monitor your posture.An annual examination of the joints, from the age of 30, will help prevent the development of irreversible changes in the body of a patient suffering from osteoarthritis.
Among the pathologies of the musculoskeletal system, osteoarthritis of the hip occupies a preponderant place.The disease reduces the patient's quality of life and is the main cause of disability at a young age.Even if you cannot protect yourself from coxarthrosis, do not despair: take action!