Osteoarthritis of the hip joint

coxarthrosis(osteoarthritis of the hip joint) is a type of deforming osteoarthritis of the joints, which is a chronic non-inflammatory disease that affects the hip joints (one or both at the same time). This disease has a degenerative-dystrophic character. This means that the cartilage that forms the hip joint undergoes degenerative changes, at the same time that the surface of the bones changes. In addition, bone growths (osteophytes) form, the joint becomes deformed, the volume of movement in the affected joint decreases, and they become extremely painful and uncomfortable.

The hip joint is one of the largest joints in our body. It is thanks to him that a very important motor function is carried out in the human body, and it is also responsible for our body being able to move. If the hip joint gets sick, then this affects the whole body as a whole and prevents a person from living in peace, walking, not to mention playing sports. Very often we see older people who are forced to rely on a cane due to hip joint disease.

Despite the fact that the hip joint is extremely massive and strong, at the same time it is quite vulnerable, especially over time. Hip joint pain significantly reduces the quality of human life.

Coxarthrosis (arthrosis of the hip joint)firmly ranks second among arthroses of the joints in terms of the frequency of cases diagnosed after gonarthrosis (arthrosis of the knee joint).

Classification of coxarthrosis (arthrosis of the hip joint)

Happenscoxarthrosisboth primary and secondary.

• The cause of primary coxarthrosis is mainly the inevitable wear and tear on the hip joints throughout life, and it usually affects people over 40 years of age.
• The causes of secondary coxarthrosis are usually the following diseases: congenital femoral dislocation, necrotic masses of the hip bone in the region of its head, Peter's disease, trauma to the anterior hip joint, inflammatory diseases of the hip joint hip. Whereosteoarthritis of the hip jointIt can affect one joint separately or both.

There are several types of coxarthrosis:

• Dysplastic (it is a congenital pathology and is characterized by an underdevelopment of the joint).
• Involutional (typical for people of the older age category and is associated with age-related changes).
• Post-infectious (it was preceded by purulent or purulent-allergic rheumatoid arthritis).
• Disease due to Peters disease (development of osteochondropathy in the head of the femur).
• coxarthrosisdue to trauma (fractures of the neck and head of the (femoral) bone).
• Coxarthrosis due to metabolic disorders (metabolism).
• Dyshormonal (taking glucocorticosteroids, antidepressants for a long time).
• Idiopathic (the cause of which could not be established).

Symptoms of coxarthrosis (arthrosis of the hip joint)

To correctly describe the symptoms of coxarthrosis, the stages of the disease must be considered simultaneously, because the symptomatology depends on the stage of the disease.

Stages of coxarthrosis (arthrosis of the hip joint)

In total, there are three stages of coxarthrosis (arthrosis of the hip joint):

• 1st stage of coxarthrosis. This is the initial stage of the disease, in which the symptoms are still mild. The joint at this stage does not hurt much, and the pain occurs only after physical exertion, such as heavy lifting or jogging, walking long distances. After the person rests, the pain goes away. The patient may also develop a limp if, for example, he walks more than two kilometers on foot. Increases pain when climbing stairs. The motor volume of the joint decreases slightly or is preserved. X-ray examination may show only small changes in bone structures.
• 2nd stage of coxarthrosis. This stage develops in the absence of treatment from the first stage. Added to the above symptoms is a specific fissure (crunch) in the joint. The pain becomes more intense and begins to radiate to the groin area, and can also spread to the thigh and knee. At this stage, not only strong movements, but also any movement can cause pain symptoms, even a slight load on the hip joint. Even getting out of bed or twisting your torso can cause pain. There is tension in the periarticular muscles, which does not go away even at night, so patients often complain that their thigh hurts at night. A person can begin to limp even after minor walks (up to 500 meters). At this stage, the disease forces the person to rely on a cane to walk. The limitation of movements in the joint becomes more pronounced. According to the results of X-ray diagnostics, emerging osteophytes are determined.
• Third stage of coxarthrosis. The final stage of the disease. At this stage, the pain becomes permanent and torments the patient. Any movement, even the slightest, increases the symptoms of pain several times. At this stage, the hip joint is completely immobilized. The muscle mass in the thighs and buttocks is reduced due to muscular dystrophy, which is very noticeable. The feature is the impossibility of standing directly from the patient, while the body will be skewed. Any arthrosis leads to the formation of a contracture (flexed position), in this case, the contracture is also formed due to the fact that the muscle fibers are in constant tension, while the leg on the side of the injury is shortened. As a result of the fact that the hip joint is immobilized, the entire leg ceases to perform its motor function, which has a very negative effect and leads to its osteochondral lesion. In addition, the spine also suffers, there are sensations of discomfort and pain in the sacral region.

Causes of coxarthrosis (arthrosis of the hip joint)

The main causes of coxarthrosis:

• Age-related changes in the joint. Typical of older people. The hip joint wears out over time, ceases to perform its functions over time, "dries out", which leads to a decrease in its function of cushioning and friction of the bones that form the joint with each other.
• Hip joint injury. The most common injury among people in this age group is a femoral neck fracture, which threatens disability in the absence of proper treatment. The joint can be injured at any age, but older people are more likely to suffer.
• altered metabolism. This is typical for people with a history of metabolic disorders and diseases associated with impaired metabolism.
• Violation of hormonal status. It is more characteristic of women, especially those who have been taking antidepressants and glucocorticoids for a long time.
• Hereditary abnormalities in the development of the musculoskeletal system, as well as congenital abnormalities. Unfortunately, at the moment, a large number of children are born with congenital pathologies of the musculoskeletal and nervous systems. As for abnormalities in the development of the hip joint, this may include its dysplasia, in which various structures of the joint do not develop.
• Systemic arthritis. Damage to various joints can also cause damage to the hip joint. In this case, one of the main risk factors will be the presence of an inflammatory process.
• Rheumatic affections and chronic arthritis. All this can also lead to the appearance of pain in the hip joint. Such diseases causing pain in the studied joint include: rheumatism; Rheumatoid arthritis; spondyloarthropathy; Juvenile rheumatoid arthritis.
• The defeat of osteochondrosis. Osteochondrosis of the spine is a fairly common and serious disease, which, in addition to the spine, can "disable" other structures of our body, in particular, the hip joint.
• Muscles and ligaments of the joint. Damage to these structures can also be the result of degenerative and dystrophic processes in the hip joint.
• Infectious lesions of both the joint itself and the femur. These types of injuries are very serious, because they have serious consequences and are sometimes difficult to treat. Osteomyelitis can occur, which simply "eats" or "dissolves" bone tissue. Tuberculous lesions may also occur, and most often such localization occurs in children of the prepubertal period. Abscesses in the pelvic area, which are most often the result of an untreated or poorly treated infectious process, for example, with appendicitis, inflammatory processes, especially when it comes to the genital organs of women (ovarian disease), the development of an abscess in the area of the ischiorectal deepening, which leads to impaired gait (appearance of limp). In most cases, pain and lameness are the result of compression or damage to nearby nerves (sciatic or obturator).
• Neoplasms of a malignant nature. Very rarely, malignant neoplasms affect the hip joint and the bones around it, because most often the cause of the disease is metastasis from other malignant areas, for example, with breast or lung cancer.
• Narrowing of the lumen of the aorta and iliac arteries (their stenosis and occlusion). At the same time, the joint receives less and less of the nutrients necessary for its normal function, which leads to its degeneration.

Coxarthrosis risk group (arthrosis of the hip joint)

The main risk group may include the following categories of people and damaging factors:

• Old people. This disease is typical of older people, the elderly, because degeneration processes occur that occur precisely in this age period.
• Feminine. According to statistics, women are more likely to have problems with the hip joints.
• People who are overweight or obese.
• Previous trauma to one or both hip joints.
• Hereditary predisposition to this type of disease and congenital anomalies in the development of the hip joint.
• The presence in the past of infectious lesions, such as abscesses, aseptic necrosis of the head of the coxal bone, osteomyelitis, etc.
• Hard physical work.
• Summer residents who are at extremely high risk of developing coxarthrosis.

Prevention of coxarthrosis (arthrosis of the hip joint)

The main measures for the prevention of coxarthrosis are the following:

• Dosed physical activity. It is important to do gymnastics and knead the joint in order to prevent the development of pathological processes in it and its slower aging. This will help not only improve the condition of the hip joint, but also the whole body.
• If there are metabolic disorders, they must be corrected. To do this, you need to contact a specialist.
• Watch your weight. Do not forget that the hip joint already bears a large load, almost the entire body, so you should not interfere with it in performing its functions. Also, too much weight will put so much pressure on the joints that they will gradually collapse. Overweight people are also prone to metabolic disorders.
• Avoid sudden turns of the body, especially if you are not warmed up and not prepared, this will prevent you from injuring the head and neck of the femur.
• It is better, of course, to choose the sport in which joint injuries are less dangerous, such as swimming or yoga, especially if there are hereditary predispositions or developmental abnormalities.
• A predisposition to joint diseases implies careful management of them, as well as regular visits to the doctor so as not to miss the possible development of a disease or any other pathological process in the joint.
• If a child is diagnosed with hip dysplasia, it should be treated, and right away! It is better to immobilize the child for a few weeks at a young age than to suffer a lifetime from it.
• Timely treatment of infectious diseases, especially those that threaten to spread to the hip joint.

Diagnosis of coxarthrosis (arthrosis of the hip joint)

When diagnosing coxarthrosis, it is very important to find the cause that caused it. After all, as we have already discussed above, there are many reasons, they are diverse andhip osteoarthritis treatment, respectively, will differ radically. Sometimes it's not that easy, and sometimes it's not possible at all. Emphasis is placed on the study of the manifestations of the disease and the selection of the appropriate treatment.

First of all, the doctor carefully interviews the patient, studying in detail the complaints, the causes of the disease, the hereditary load, the presence of lesions, etc. It is very important to have the complaints described above and how long they have been observed in the patient.

After the interview, the doctor personally examines the affected area in search of inflammatory and trophic changes, deformities, shortening of the limbs, asymmetries, etc. And children may have a "click" symptom.

An important point is additional examination methods: magnetic and computed tomography, ultrasound and X-ray examination, because they will help to make a final diagnosis. In the differential diagnosis of coxarthrosis from other diseases of the hip joint, this element is extremely important.