Dysplastic coxarthrosis is a degenerative process, a disease of a dystrophic nature. Sometimes it provokes a congenital defect - the hip joint does not develop, as it should be for a normal organism. This phenomenon is commonly referred to as "dysplasia".
What about what?
Dysplastic coxarthrosis of the hip joint is characterized by the fact that in the bones the articular extremities are deformed under the influence of incorrect development, the shape becomes irregular, the acetabulum is of abnormal depth. The proximal section of the thigh bone changes. Investigations show an abnormal cervical-shaft angle.
More often the disease is fixed in women. The risk group is the age from 30 to 40 years, although, according to some doctors, it is up to 55 years.
How often?
Statistical data show that dysplastic coxarthrosiship joint is a fairly common disease. Among others, classified as degenerative, dystrophic pathologies affecting this joint, coxarthrosis, according to some researchers, occurs in every fourth case. But other scientists claim that it is diagnosed in 77% of patients. The most famous studies on this issue were carried out in 2006 by Finland under the leadership of Antti Eskelinen, and also in 1996 by S. V. Sergeev, in 2001 by V. I. Ugnivenko.
European researchers estimate the prevalence of the disease among the adult population of European countries at 7-25%. Scientific events dedicated to this were held in 1965 and 1996. If you study the statistics on pathological disorders of the musculoskeletal system, it becomes clear that dysplasia is about 16.5% of cases known to science. Against the background of such a high percentage, the question of how to treat dysplastic coxarthrosis of the hip joint becomes especially relevant. Up to 60% of all sick people lose their ability to work over time, and 11.5% become disabled.
Dysplastic coxarthrosis: what happens?
Classification of subtypes of the disease based on features:
- anatomical relationships change in the joint (how pronounced is the process?);
- articular cartilage changes (how is osteoarthritis active?).
In modern medicine, the classification called Crowe is most often used. This is a system that evaluates howthe femur is strongly displaced in the region of the head. There are 4 subtypes of the disease in total.
Dysplastic coxarthrosis of the 1st degree is expressed by a proximal displacement of no more than half the height, which will be within 10% relative to the pelvis. The second stage assumes displacement indicators of 50-75%, 10-15%, respectively. Dysplastic coxarthrosis grade 3 is a displacement of 75-100%, 15-20%. Finally, the fourth stage - when the displacement occurred more than by the size of the head of the bone, which, relative to the pelvis, shows a violation of the position by 20 percent or more.
Hartofilakidis classification system
This theory involves assessing how much the femur in the head area changes its position cranially. They also study the state of the acetabulum, assume the true position and identify the position of the head relative to it. This classification of dysplastic coxarthrosis distinguishes three degrees of development of pathology.
In the first type of disease, cavity dysplasia is expressed in the fact that the entrance of the cavity is larger than the normal size, that is, there is a subluxation. Dysplastic coxarthrosis of the 2nd degree in this terminology is diagnosed with low dislocation, subluxation, high displacement of the head. Diagnosis allows you to determine neoarthrosis associated with a true cavity. The figure formed by the organs in the picture is similar to the number "8". False cavity, head of the bone interact. Finally, the third type of pathology is a complete dislocation. False, true acetabular cavities are demarcated andnot connected. The femur has a connection only with the false socket.
If the Crowe technique is applicable when it comes to determining the effectiveness of a surgical intervention, Hartofilakidis is widely used due to its ease of use. It must be remembered that Crowe does not allow for the most accurate calculation of how much the cavities change due to dysplasia. This gives rise to the problems of arthroplasty of dysplastic coxarthrosis: the lack of information to draw up a clear plan creates difficulties in the implementation of surgical measures.
However, Hartofilakidis also has some imperfections. This methodology does not make it possible to track the position of the proximal section. Namely, these changes greatly affect the operation. To choose the logic of treatment, you need to apply different classifications: both those that reflect dysplasia and those that evaluate osteoarthritis.
Arthrosis: how does it happen?
So, where does bilateral dysplastic coxarthrosis come from? How do other subtypes of the disease develop? What does the joint undergo in this case?
The first thing that is subject to negative changes is the joint fluid. It thickens, becomes viscous. The reasons for this may be very different, but the result is the same - the cartilage does not receive proper lubrication, which dries up. The surface of the cartilage is covered with small cracks, roughness. The fabric becomes thinner over time, which is provoked by strong friction during any movements. The joints are separated by less and less distance. From undercartilage, the surface of the bone becomes visible, which leads to increasing pressure, and in the long term - to deformation. Therefore, dysplastic coxarthrosis is also known as deforming.
What's next?
Unfortunately, degenerative processes are not limited to changes in the joint fluid. Over time, the blood supply to the tissues is disrupted, the metabolism becomes slower than normal, since blood saturated with useful components, including oxygen, does not circulate through the vessels with the necessary activity.
Over time, bilateral dysplastic coxarthrosis causes atrophy of the muscles of the affected limb. But changes occur for a long time, gradually, so the patient often does not notice the progression of the disease. In some cases, a chronic disease worsens, which is accompanied by severe joint pain. The period is commonly referred to as "reactive inflammation". A severe pain syndrome forces a person to visit a doctor, and only then is the diagnosis of "dysplastic coxarthrosis" made for the first time.
Causes of disease
Dysplastic coxarthrosis can occur due to a variety of factors:
- Circulatory problems leading to tissue malnutrition and accumulation of metabolic products that are not oxidized to the right degree, which activates enzymes that damage cartilage.
- Mechanical, provoking excessive stress on the joint. Athletes, people who are overweight are susceptible to this. The latter are characterized by metabolic problems,lack of blood flow, which further negatively affects the joints.
- Biochemical reactions, metabolic problems, hormonal.
- Injuries, fractures, dislocations, often provoking illness at a young age.
- Pathologies of the spine.
- Infectious, inflammatory processes affecting the joints.
- Aseptic necrosis.
- Birth defects.
- Sedentary lifestyle.
- Age changes.
Strong influence is exerted by heredity, genetic predisposition to various arthrosis. Coxarthrosis cannot be inherited, but it is the mechanisms of inheritance that determine the specifics of cartilage tissue and metabolism. If the closest relative suffers from arthrosis, the likelihood of getting sick in a person increases dramatically.
How to suspect?
Medicine distinguishes the following symptoms of the disease:
- stiffness, movements are "tight";
- pain syndrome;
- femoral atrophy;
- shortening a diseased limb;
- mild lameness.
Most often, patients go to the doctor when the leg, joints start to hurt. This sign is the most characteristic and noticeable. You need to understand that the manifestations of pathology depend on the level to which it has developed.
The stage of the disease directly determines the duration of pain attacks, their intensity and the area in which the sensations are localized. Treatment of dysplastic coxarthrosis of the hip joint shows goodresults only when started early in the development of the disorder. But this happens infrequently, as the pain in the joints is not strong, and people delay going to the doctor.
Not turning to a specialist in time, patients lose time - the joint is destroyed more and more every day. Over time, mobility is lost, the pain intensifies, even the first steps are difficult, painlessly you can only not move. A person limps, atrophy of the femoral muscles occurs. Of course, all these signs stimulate a visit to the clinic, but it is already too late.
Pain and atrophy
In pathology, atrophy of the femoral muscles provokes an additional pain syndrome - it is localized where the tendons are attached. The knees hurt the most, but the syndrome is less pronounced in the groin and thigh. This leads to misdiagnosis. A common mistake is the definition of arthrosis of the knee joint, which leads to an incorrect choice of therapy.
Arthrosis is not the only cause of pain in the femoral, inguinal region. Perhaps this is an echo of the pain associated with inflammatory processes in the tendon, and injuries of the spine can also manifest themselves in this way.
Dysplastic coxarthrosis: treatment. Where do we start?
Several different methodologies have been devised to approach patients with this pathology. Each option has its positive and negative sides. But there is one general rule: self-medication is unacceptable. Even if you are convinced that you know exactly what is sick, how it can be cured, therapy is only allowedunder the supervision of a doctor with specialized education. Otherwise, there is a chance not only not to slow down the degenerative processes, but only to exacerbate them. It should also be understood that the stage of the disease greatly affects the approaches to its treatment.
If the first or second stage is diagnosed, conservative therapy can be practiced. In this case, the treatment of dysplastic coxarthrosis is carried out with the help of ointments, tablets and injectable drugs. When diagnosing the third stage, there is only one way - surgery. Endoprosthetics of the joint, produced with such a diagnosis, involves the replacement of the joint with an artificial product. The procedure is quite complicated, expensive, but effective. The implant is implanted in the pelvic and femoral bones. The prosthesis is identical to the biological joint.
First, second stage: how do we treat?
If it was possible to detect the disease before the development of the third degree began, it is possible to achieve positive results with conservative therapy. Widely used non-steroidal drugs against inflammation, the most effective in the reactive period. The main advantage of these drugs is the relief of pain, due to the strong effect on inflammatory processes. Medicines quickly relieve inflammation and eliminate puffiness.
However, everything has flaws. So, the regular use of anti-inflammatory drugs reduces the body's ability to recover by natural mechanisms. In addition, mostdrugs known to science have a wide range of side effects, affecting the body as a whole and individual organs and organ systems. The choice of medication should be entrusted to the doctor. It is strongly not recommended to use several drugs at the same time. If the prescribed medicine does not help relieve pain, you can increase the dose or ask your doctor for a prescription for another medication.
What else will help?
Pretty well proven drugs that can dilate blood vessels. At the same time, smooth muscles relax, the lumen of the vessels becomes larger. If coxarthrosis is diagnosed, such therapy shows good results fairly quickly.
On the one hand, with the correct use of this group of medicines under the supervision of a doctor, the result is good, it will not take long to wait. Also attracts a small list of contraindications. The joint recovers over time, as better blood flow is provided, that is, the tissues receive nutrition in the right amount. Vasodilating drugs have proven to be extremely effective against night pains.
But there are also weaknesses. Not all patients tolerate this group of drugs, and with individual intolerance to at least one component, therapy becomes inapplicable. Before you start, you need to consult a doctor, take tests. Starting a course of treatment, at first they take no more than a tablet per day - this dose is maintained for the first three days, controlling the body's indicators. If everything is in order,you can switch to the concentration recommended by the doctor and the manufacturer.
Miorelaxates and chondroprotectors
Miorelaxates are medications that help relax muscles. If coxarthrosis is diagnosed, such drugs are used very carefully, but they achieve the elimination of spasms, stop the pain syndrome. The use of medications helps improve blood flow to the affected area. But a depressing effect on the nervous system is possible, causing dizziness, consciousness slows down and a feeling similar to the effects of alcohol appears.
Chondroprotectors are aimed at restoring cartilage tissue. They are considered one of the most useful for arthrosis, as they improve the structure of cartilage tissue and direct useful, nutritious components to the cells. If such drugs are used regularly, the development of the disease stops. True, one cannot notice a quick positive effect when using chondroprotectors: this is felt only in the future. Even after discontinuation of the course of treatment tendencies to improve the condition of the cartilage persist. True, you can not practice taking these medications during pregnancy, inflammatory processes in the joints. Individual intolerance to the components is also possible.
Hormone Therapy
Finally, it is impossible not to mention hormonal steroid medications, which have become quite widespread in recent years. They are injected directly into the joint. The result often appears almost immediately after the start of treatment, most pronouncedhe, if the inflammation struck the femoral tendons. But the effect passes rather quickly, and the course of therapy is accompanied by side effects.
Doctors recommend no more than three injections per joint. Two weeks or more should be allowed between two injections.
