As you know, the largest joint in our body is the hip. Takes almost all the load when walking. But also, he is quite often exposed to such diseases as arthrosis or coxarthrosis. What is hip arthrosis and how is it treated? We will talk about this in our article.
What is coxarthrosis?
To understand the essence of the disease coxarthrosis, the treatment of which is extremely problematic, you need to delve a little deeper into the structure of the hip joint itself. It itself has the shape of a "hinge", and its function is to connect to the pelvis of the femur. The attachment is made with the help of a spherical head, which is embedded in the cavity of the femur. Both the surface of the head and the surface of the cavity arecovered with cartilage They perform shock-absorbing functions and protect against wear.
So the violation of the structure of these cartilages becomes the cause of arthrosis, which contributes to the development. That is, the elastic and durable cartilage, due to some internal or external factors, dries up, hardens and its surface becomes rough instead of smooth. Such a structure interferes with normal functioning and leads to slow and painful destruction of the hip joint. That is why it is important here to know how to relieve the pain of coxarthrosis of the hip joint, but more on that later.
In an advanced stage, the bone deforms so much that the patient loses the ability to walk. Summarizing all this, it is possible to form a definition of such a disease as arthrosis of the hip joint - destruction of the complete or partial integrity of the surface of the joints. It is also important to understand that the concepts of arthrosis, coxarthrosis and osteoarthritis are practically the same thing. It's just that osteoarthritis is a broader definition, and the other two are the same and refer only to the hip joint.
Causes of manifestation
According to doctors, there can be many reasons for the appearance of coxarthrosis, but we will consider only the most common:
- Congenital pathologies. The most common are dysplasia (distortion) and congenital luxation of the hip joint. They almost always cause grade 1 dysplastic coxarthrosis of the hip.
- hereditary predisposition. This is when this disease is quite common in your family.
- Passive lifestyle. With inactivity, cartilage loses its elasticity and elasticity and can deform.
- Disturbance of the hormonal background. Such a violation can easily cause inflammation of the tissues of the joint.
- Age. In 70% of cases, arthrosis occurs in people over 40 years old. It all has to do with the natural aging of the body and maintaining a mostly sedentary lifestyle as we age.
- Injuries. Injury to the joint leads to thinning of the cartilage or even to its deformation, and this is an inevitable pre-hip joint.
- Overweight. Sign - a lot of weight, which will constantly overload the hip joint. Such prolonged loads inevitably lead to cartilage wear, resulting in the destruction of the hip joint.
- Large loads. Athletes are in this risk category.
- Common circulatory disorder. For one reason or another, blood circulation in the human body can fail. So in the periarticular tissues, a lot of residues after metabolism accumulate and this leads to the production of enzymes, but they, in turn, destroy the cartilage tissue.
- Diseases of the hip joint. Another fairly common cause of coxarthrosis. The thing is that incorrect or untimely treatment of any other diseases of the hip joint (various infections or even necrosis of the femoral head) easily leads to the development of osteoarthritis.
Symptoms
Symptoms in the early stages of the disease are mild, so no one thinks about the treatment of arthrosis of the hip joint of the 1st degree. Symptoms include stiffness and discomfort in the hip joint in the morning, right after waking up. Discomfort or pain intensifies during physical exertion, and during rest weakens or disappears completely. Patients often do not pay attention to such symptoms, but the prevention of coxarthrosis will not help here.
In a more advanced stage, the disease already begins to bother completely, even during rest, and everyone thinks about which doctor treats coxarthrosis in order to contact him in time. In addition, the joint begins to become inflamed, its mobility is lost and the cartilage breaks down, forming bone spurs. The pain does not subside even with prolonged rest, movement is quite limited. Here you will need information on how to treat coxarthrosis grade 3, which you can find with us.
Then comes the complete disappearance of the cartilage and the bones begin to rub against each other. It becomes quite difficult to move. As a result of inactivity, which leads to weakening or even atrophy of the muscles, deforming arthrosis of the hip joint begins. The length of the legs can also be changed. There is obvious lameness. Here, conservative treatment of coxarthrosis of the 3rd degree will no longer help. The last stage is the complete loss of the ability to walk.
Diagnosis
In order to correctly diagnose and treat arthrosis of the hip joint, you should consult a doctor. So which doctor treats osteoarthritis of the hip without surgery? You should contact a rheumatologist or orthopedic traumatologist. The diagnosis will begin with questioning the patient, i. e. what hurts, where exactly it hurts, how often the pain is felt, etc. To assess the strength of the pain, the doctor will perform several manipulations of the joint. It will flex, extend and rotate the lower limb. In addition, the patient may be asked to walk to assess the external configuration of the joint.
However, a clinical blood test can more accurately confirm the diagnosis. Here, the rate of sedimentation of erythrocytes will be significantly increased, namely from 30 mm / h and more. An increase in globulins, seromucoids, immunoglobulins and C-reactive protein are also symptoms of coxarthrosis. To determine their level, a biochemical blood test is required. But while such tests are not enough to prescribe treatment for coxarthrosis of the hip joint.
A mandatory event is radiography. But here a significant minus creeps in - only bones and bone seals are visible in the photo, cartilage and soft tissues are not visible. Thus, diagnosis at an early stage will be quite difficult. In this case, computed tomography will help to make a complete picture, and already based on it, it will be possible to say how to treat arthrosis of the hip joint. But all these procedures will become unnecessary if you have doa or deforming arthrosis of the hip joint of the 4th degree. After all, the disease will be visible to the naked eye, and prevention of arthrosis and treatment without surgery will no longer be useful.
Degrees and types
Based on the neglect and symptoms of the disease, 4 degrees of its manifestation can be distinguished.
| Degree | Description |
|---|---|
| First | Grade 1 osteoarthritis of the hip is easy to overlook. Its symptoms are recurrent pain in the hip joint after prolonged physical exertion. The pain disappears as soon as the load stops. An x-ray will show only slight narrowing of the inter-articular space. If you orient yourself in time, then the disease can be easily prevented. |
| Second | Osteoarthritis of the hip joint of the 2nd degree - the symptoms of which begin to appear, this is the beginning of the destruction of cartilage tissue. The pain intensifies and radiates to the thigh and groin. They begin to manifest even in a state of calm. There may be obvious lameness. Morning stiffness syndrome periodically occurs in the morning. We will talk about how to treat coxarthrosis of the hip joint of the 2nd degree next. |
| third | The third stage is when the disease is already very advanced. There is almost no cartilage left. X-ray shows severe thread-like narrowing of the joint space. The pains at this stage are constant and can only be eliminated with the help of medication. At the same time, the patient is severely limited in his movements and in order to move he needs crutches or a cane on which he can lean. Soft tissue atrophy begins, swelling appears in the joint area. This raises the question of how to treat hip arthrosis of the 3rd degree: conservative methods or surgical intervention. |
| Fourth | The fourth stage is the most neglected and cannot be bypassed without surgical intervention. Accompanied by severe pain in the joint area. The joint as such is almost gone, the bones begin to grow together. The symptoms are the same as in the third stage, but there is no possibility of any movement of the pelvic joint. |
With the types of coxarthrosis, I seem to have understood. Now a few words about the types of this disease. So, the most popular are 2 classifications. The first is a classification based on how many joints are affected - 1 or 2. Here everything is simple, if 1, then they say that coxarthrosis is unilateral. If the joints on both sides of the hip bone are affected, then it is called bilateral arthrosis.
But there is another no less popular classification that designates a disease based on the causes of its occurrence. There are 7 types here:
- The change of the joint and cartilage with the age of the person is the so-called involutive coxarthrosis.
- Coxarthrosis caused by a complication of Perthes disease. As a result, necrosis of the spongy tissue that covers the head of the femur.
- Congenital maldevelopment of a joint or joints is called dysplastic coxarthrosis. A fairly common phenomenon, according to doctors, every tenth case is the result of congenital subluxation of the femoral head, or so-called dysplasia.
- Complication after arthritis or post-infectious coxarthrosis.
- Post-traumatic coxarthrosis. This is a consequence of improper constant loading of the joint, which leads to microtraumas, which in turn slowly destroy the cartilage tissue.
- The next risk group includes people taking antidepressants and corticosteroids, as well as others suffering from any hormonal disorders. This type is called dyshormonal arthrosis.
- Well, if it is not possible to establish the cause of the disease, then you are diagnosed with idiopathic coxarthrosis.
Methods of treatment
There are many methods of treating arthrosis of the hip joint, but the disease cannot be completely cured. The entire treatment can be divided into three stages.
- Disease prevention or prevention.
- Treatment of the early stages (first and second).
- Treatment of advanced stages (third and fourth).
Conservative treatment
This includes treatment of the first and second stages of the development of coxarthrosis. As already mentioned, the disease cannot be cured, you can simply remove everything that leads to a constant increased load on the joint. Moderate loads that will develop the joint will not be superfluous. This includes light exertion, for example, therapeutic exercise, swimming, cycling, etc. Such training will help not only to develop the joint, but also to keep it in good shape.
Equally important is the correction of excess weight, as well as proper nutrition. You should also take care of constant enough sleep and rest. Massages, both special and self-massage, will also help. In the second stage, with increasing pain, it is necessary to take non-steroidal anti-inflammatory drugs. Well, if the disease progresses and reaches grade 3, it can be treated without surgery, but you don't have to neglect a stick or crutches to relieve the additional load on the pelvis.
surgery
The attending physician may decide on surgical intervention already in the third stage to cure arthrosis of the hip joint. 4 types of operations are performed:
- Arthroplasty - cartilage modeling of the joint is performed. With its help, you can almost completely restore the functionality of the joint.
- Osteotomy is a bone dissection that is performed in such a way as to completely eliminate the deformed areas and not deform the normal tissue.
- Arthrodesis - the joint is attached to the bone using special plates and screws. A more radical method of intervention. After that, the joint remains immobile.
- Arthroplasty is a complex operation of the hip joint. To be honest, this is not an operation of the joint, but its complete replacement with a prosthesis, which is made taking into account the anatomical features of the patient. In this way, a complete or partial replacement is performed, which is why it is possible to cure coxarthrosis. The success rate is approximately 70%. What procedures are carried out before the operation and how to heal from a psychological point of view after the operation, we will tell in the next article.
Prevention
Many people think that arthrosis in the elderly cannot be treated at all, but if attention is paid in time at an early age, then it can be cured. This is not true. Since it is possible to treat coxarthrosis only in the case of arthroplasty, it is better to warn him in advance. This includes controlling excessive stress on the joint, maintaining an active lifestyle, controlling nutrition and weight. Normal sleep and rest are also important. You can go for regular massage treatments. Regular intake of chondroprotectors is recommended.