Coxarthrosis or osteoarthritis of the hip joint is a degenerative-dystrophic disease that causes loss of elasticity and destruction of cartilage tissue, premature wear of the joint of the same name.Osteoarthritis is considered an age-related problem, as confirmed by world statistics: after 40 years, every second person is diagnosed, 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 is attached to the articular head, surrounded by a synovial bursa with a thick mucus-like mass.It is the synovial membrane that nourishes the cartilages of the hip and ensures their easy sliding relative to each other, 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 mobile joints in the hip area 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 the 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, the 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 inherited, but the structural features of bone tissue or slow metabolism are genetically determined.
Course of the disease
First of all, osteoarthritis affects the large joints of the bones of the pelvis and knees (gonarthrosis);it is they who bear a huge load when moving.During the period of exacerbation, acute arthrosis occurs, then palpation of the joint and tissue of the hip is accompanied by pain.In case of incomplete or incorrect fusion of the femur after injury, neoarthrosis or false joint is formed, filled not with callus, but with connective tissue.
There are osteoarthritis of the hip joint of the 1st, 2nd and 3rd degree, each stage of the disease has its own characteristics:
- First degree osteoarthritis develops slowly, without affecting the mobility of the joint structures, muscle tone is normal.In the early stage of coxarthrosis, the disease can only be detected by x-rays.
- 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 third degree, the pain syndrome is pronounced.Due to the atrophy of the muscles in the hip region and the expansion of the neck of the femur, the leg becomes shorter.When walking, the patient uses support.Due to osteoarthritis, the joint space can disappear completely, in which case we speak of bone ankylosis.
In clinical practice, doctors commonly face a type of involutive coxarthrosis (typical of older people) and post-infectious osteoarthritis of the hip joint.Patients taking corticosteroids and antidepressants are at risk for Dishormonal coxarthrosis;This type of osteoarthritis also affects a woman's joints during menopause.In osteoarthritis-arthritis, the inflammatory process predominates more than the degenerative process in the hip joint.
If the etiology of the disease is not established, we are talking about primary or idiopathic coxarthrosis.The disease usually affects the joints of people over 50 years of age.Secondary osteoarthritis develops at an early age;As a rule, osteoarthritis of the left or right hip joint (unilateral coxarthrosis) is diagnosed.
Symptoms
The symptoms of osteoarthritis of the hip joint at first do not bother the patient, only occasionally prolonged loads on the affected area or uncomfortable movements remind of the problem.
Coxarthrosis of the hip joint manifests itself:
- Pain in the hip area.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 two hip joints.
- Weakening and subsequent atrophy of the muscles in the hip region.
- A distinctive crunching sound in the joints.A possible sign of coxarthrosis, but not mandatory.
- Limp.Due to the destruction of the hip bone during osteoarthritis, an unsafe, "duck" gait is formed.
Those suffering from coxarthrosis often experience pain that radiates to the kneecap, so an inexperienced doctor, after listening to the patient's complaints, can make an erroneous diagnosis and delay the recovery process for many months.
Diagnosis
Osteoarthritis is diagnosed by a rheumatologist, traumatologist or orthopedist.After interviewing the patient, the doctor performs an external examination of the hip area, studies the mobility of the legs and evaluates 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 area.
- Ultrasound and MRI examination.
If infectious osteoarthritis of the hip joint is suspected, the volume of synovial fluid is determined and its cellular composition is examined.To exclude the presence of autoaggressive antibodies in the body, the patient is sent for RF analysis on blood serum.
How is osteoarthritis of the hip joint treated?
Treatment for osteoarthritis of the hip joint is selected taking into account the stage of coxarthrosis, the patient's age and concomitant diagnoses.Osteoarthritis of degrees 1 and 2 can be cured using an integrated approach: taking medications in combination with physiotherapy methods, massage and a special diet.
After the acute period of coxarthrosis is over, cardiovascular training without running or jumping is allowed for the treatment of the hip joint.
After the acute period of coxarthrosis is over, gentle gymnastic exercises with a limited range of motion, cardiovascular training without running and jumping are selected for the treatment of the hip joint.At the final stage, the treatment of osteoarthritis of the hip joint is carried out in a sanatorium-resort.
Pharmacological treatment
Conservative treatment of the disease is aimed at relieving pain in the hip area and maintaining joint functionality.The main goal is complete recovery or stable remission of coxarthrosis.
Osteoarthritis treatment is not complete without the following:
- NSAIDs.Non-steroidal drugs relieve pain and inflammation in the mobile joint, but tablets have nothing to do with the restoration of the hyaline cartilage structure in coxarthrosis.
- Vasodilators.The medications ensure the delivery of nutrients to the joints affected by osteoarthritis and eliminate congestion in the hip area.
- Chondroprotectors.Saturate joint tissues with water, improving their lubricating properties.Stops the destruction of joint structures in the hip area.Glucosamine and chondroitin sulfate are part of many chondroprotectors.
- 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 with medicinal bile increase the effectiveness of the listed remedies for osteoarthritis.Therapeutic bandages cannot be applied to the hip area if the lymphatic system is affected and there is fever (infectious coxarthrosis).
Physiotherapy
Despite the deep location of the hip joints, physiotherapy methods relieve coxarthrosis.Popular physical therapy procedures include electrophoresis, laser therapy, and hot paraffin applications.Acupuncture improves the innervation of cartilage tissue and the functioning of internal organs.Phonophoresis with hydrocortisone for osteoarthritis combines the advantages of ultrasound and medicinal effects in the hip area.
Diet and nutrition
A special diet for coxarthrosis consists of foods low in fat and high in vitamins B, C, E, as well as calcium, potassium and magnesium.It is recommended that each new day start with a glass of freshly squeezed juice.Give preference to boiled and steamed dishes.
The daily menu for osteoarthritis should consist of:
- Milk products.
- Fresh vegetables and fruits.
- Low-fat varieties of fish and meat.
- Whole wheat bread.
- Oatmeal porridge cooked in water.
From your diet, exclude salty and spicy foods, nightshades, baked goods, smoked foods and carbonated drinks.When treating coxarthrosis, it is not advisable to buy ready-made foods in supermarkets or semi-finished products.
endoprostheses
Replacement of the affected joint with an artificial one is indicated in the last stage of coxarthrosis.Before the operation, the patient must undergo general blood and urine tests, ultrasound of the hip area and ECG.
Main stages 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.
- Part of the surface of the pelvic bone is removed and a polymer bed is placed in its place, which is connected to the titanium head.
The best way to fix dentures is with bone cement.If osteoarthritis affects the joints at a young age, cementless fixation methods are sometimes used.
massage
Massage relieves muscle spasms, strengthens the ligamentous apparatus in case of coxarthrosis.During the procedure, the patient with osteoarthritis should adopt a comfortable position and relax.First we rub the back (10 minutes), then we massage the sacro-gluteal area.With circular movements with bent fingers, we love the problem thigh in the direction of lymphatic flow, from bottom to top.To slow the development of osteoarthritis, the procedure is performed 3 times a day.
Exercises and physiotherapy.
The level of load on the hip joints during osteoarthritis is determined by the physiotherapist.It is advisable to carry out physiotherapy in a room specially equipped for this.Swimming in the pool or skiing will speed up the recovery of joints with coxarthrosis.
The popularity of the method of combating osteoarthritis, presented by practicing rheumatologist P. V. Evdokimenko, is growing.Evdokimenko's gymnastics consists of static exercises to strengthen the hip muscles, stretching them 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 leg, then hold it in an elevated position for about 30 seconds, your 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 rubbed on sore joints for osteoarthritis.Celandine ointments relax the muscles and tendons of the hip.
Effective alternative medicine recipes:
- Grind 200 g of pata blanca roots and fill them with pork fat (300-400 g).Place over low heat, after 5-7 minutes the remedy for coxarthrosis is ready.Rub the cooled dough on 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 area before going to bed.Don't forget to wrap the sore joint with parchment paper and a woolen scarf.
Shilajit has an intense restorative effect and improves the mobility of the hip joints.For arthritis and osteoarthritis, 5 g of mumiyo is dissolved in 10 to 20 ml of water and 45 g of hot Vaseline is poured.The product is rubbed into the skin of the thigh with gentle movements.
Prevention
Prevention of osteoarthritis of the hip joint involves abandoning bad habits, a sedentary lifestyle, extra kilos burden the hip area and exceed the physiological limits of strength of the joints.Follow the daily routine and principles of PN for coxarthrosis, take care of your posture.An annual examination of the joints, starting at the age of 30, will help prevent the development of irreversible changes in the body of a patient with osteoarthritis.
Among the pathologies of the musculoskeletal system, osteoarthritis of the hip joint occupies a leading position.The disease reduces the patient's quality of life and is the main cause of disability at an early age.Even if you could not protect yourself from coxarthrosis, do not despair: act!