In this article, we will consider the symptoms and treatment of coxarthrosis of the hip joint.
The disease is a deforming arthrosis of the hip joints. This pathology is a very common disease. The appearance of the disease is influenced by various facts, in particular the abnormal development of the pelvic bones, lower limbs and spine. The statistics of coxarthrosis today are disappointing. Among all varieties of osteoarthritis, the share of the development of pathologies of large joints accounts for fifty percent. The incidence of this pathology is twenty-five percent.
Treatment of coxarthrosis will be described in detail below.
Disease data
Today, coxarthrosis of unclear etiology occurs in forty percent of cases. The secondary form of the disease is formed in twenty percent of cases. The remaining forty percent is a consequence of various injuries, excessive physical and professional stress. More often this disease affects people of middle working age. Lately, significantlyrejuvenated coxarthrosis of the hip joint. Symptoms and treatment are of interest to many.
Mechanism of occurrence of pathology
In the human hip joint, the innominate and the femur are articulated. In the pelvis there is an acetabulum, in which the head of the femur is located. The acetabulum is covered with cartilage. It is thinner at the bottom and in front, and slightly thicker at the top and at the back. Directly the head of the femur is covered with cartilaginous tissues. The slit-like space inside the joint is completely filled with a special synovial fluid. It is usually transparent and resembles the white of an egg. Synovial fluid carries out metabolic functions in the joint, it acts as one of the representatives of the immune defense.
Because the joint bears heavy loads, it is equipped with supporting ligaments that form its capsule. The cartilage lacks a sensitive nerve field that could signal excessive stress. Therefore, the cartilage tissue can gradually loosen, and, in addition, the chemical properties of the cell matrix change. Each renewed cartilage cell is defective. As a result, the cartilage loses its biomechanical properties.
Synovial fluid affects particles of exfoliated cartilage. These pieces penetrate into the joint capsule and synovium. As a result of this, the shell becomes inflamed, much more fluid is released, but its quality is worse. This whole process increases the destruction of the joint. It starts to swell andcovered with bone growths that create pain during movements. In addition to physiology, the biomechanics of the joint deteriorate excessively.
Treatment of symptoms of coxarthrosis of the hip joint should be timely.
Causes of coxarthrosis and types of its classification
Distinguish between primary and secondary forms of coxarthrosis. In the first case, the disease is formed in the joint, the cartilage of which was he althy from birth, and the problems arose due to excessive load. In the secondary form, the process of degeneration of already altered cartilage occurs. The reasons for the development of coxarthrosis include the following factors:
- The presence of congenital subluxation of the femoral head, which accounts for about twenty percent of all arthrosis of the hip joints, and occurs predominantly among women.
- Obtaining fractures of the acetabulum or pelvis.
- Getting hip fractures.
- Presence of fractures and necrosis of the femoral head.
- Presence of benign or malignant bone tumors.
- The appearance of arthrosis caused by Paget's disease.
- Presence of ankylosing spondylitis and rheumatoid arthritis.
Symptoms and treatment of coxarthrosis are interrelated.
Symptoms of pathology development
A symptom of coxarthrosis is the appearance of pain in the joints, especially in the legs. The next day, such pain can last all day. And later, the person simply won't be able to sleep.
In such patients, the muscles of the buttocks and thighs begin to atrophy. Walking can be very difficult. Limbs can subsequently shorten, and the person begins to limp. Next comes the damage to the joint, which leads to its change, and it completely ceases to perform its functions. At an early stage, the joint is only limited in its movement, and later it can generally immobilize a person. A significant limitation of mobility appears with the second or third degree of coxarthrosis of the hip joint. Treatment is selected depending on this.
Initial degree and its symptoms
The first degree of this disease is characterized, as a rule, by the appearance of aching pain, localized in the area of the joint after heavy loads. Against this background, the biomechanics of movements are not disturbed, and the pain, in turn, quickly disappears. A slight narrowing of the joint spaces can be seen on x-rays.
Treatment of grade 2 coxarthrosis is much more common.
Second degree and its symptoms
At the background of the second degree, patients experience the following symptoms:
- Pain increases and joint mobility is impaired.
- The extension process is not brought to a twenty-degree angle. The abduction amplitude is less than forty-five degrees. In particular, the violation with the restriction of rotational movements is strongly felt.
- Pain is given to the groin and popliteal ligament. Often such pains are associated with diseases of the spine or knee joints.
- The appearance of aching pains at rest, which are caused by developing inflammation.
- Violationbiomechanics, and at the same time functional abilities decrease.
- The appearance of characteristic sounds in the joints during movement.
- The appearance of gluteal dystrophy along with a slight specific lameness. In this case, the limb may visually be shortened due to the skew of the pelvis.
- X-rays show growth of osteophytes and deformity of the femoral head and its contours. The joint space narrows to a third of the standard physiological state. The head of the femur moves upward.
Treatment of coxarthrosis of the 2nd degree of the hip joint is detailed below.
The third degree of the disease and its symptoms
Against the background of the third degree, patients experience the following symptoms:
- Muscles are severely atrophied.
- Pain becomes permanent and disturbs at night.
- The biomechanics of the functioning of the joint is significantly impaired.
- The appearance of a sharp starting pain makes any movement much more difficult.
- The pelvic tilt increases significantly, and the limb, in turn, shortens.
- A person's gait becomes specific.
- X-ray shows deformity of the head of the bone along with a large number of osteophytes. The joint gap is completely absent, and the femoral neck thickens significantly.
With the development of the third degree of coxarthrosis, doctors are already talking about the disability of patients. Often these patients are unable to walk without a cane.
Surgery in the treatment of coxarthrosis of the hip is used, but not always.
Prediction of pathology
Depending on the position of the affected joint, a prognosis of the course of the disease is made. In the event that the lesion fell on the central part, then we can hope for a longer and calmer course of the disease. Against this background, pain will have an average severity. The joint space will narrow in the central region of the acetabulum. In this position, it is possible to support the patient for a long time through conservative treatment of coxarthrosis of the hip joint, without resorting to surgical intervention.
In case of localization of the lesion in the lower region, the pain will appear slightly. In this case, internal rotation will be more disturbed compared to external rotation. There will be sclerosis of the end plates. This type of coxarthrosis may not be particularly aggressive for many years. The prognosis against the background of conservative treatment is usually positive.
The most difficult is coxarthrosis with lesions of the upper region. This situation is more common in congenital anomalies of the joints. Painful sensations are very strong and appear already in adolescence. In advanced stages, subluxations of the joints occur. Seriously impaired external rotation. Among other things, part of the acetabulum and the head of the bone are dead. The prognosis of the disease is not very comforting. Such patients undergo surgery.
Before talking about the treatment of coxarthrosis, let's consider diagnostic methods.
Diagnosisdiseases
In diagnosing an illness, a doctor's qualification plays an important role. In the event that an orthopedist treats the spine, forgetting to prescribe an x-ray of the hip joint, then time will be greatly missed. Unfortunately, this is often exactly what happens. The following modern methods are recognized as the most truthful and informative methods for establishing coxarthrosis:
- Taking x-rays. On the pictures, it will be possible to determine the size of the joint space, the presence or absence of osteophytes along with the condition of the femoral head.
- Performing an ultrasound. It makes it possible to determine the degree of the disease. Thanks to him, localization is clarified along with the number of growths and the condition of the acetabulum. Changes in the ligamentous apparatus are also determined.
- Computed tomography. In essence, this technique is not much different from an x-ray, but it makes it possible to obtain more detailed and voluminous images.
- The use of magnetic resonance imaging. This technique is considered the most complete and truthful. It allows you to study the joints in layers, fixing the most insignificant changes in the structures of bones and cartilage.
Additional laboratory tests usually help to identify the level of inflammation in the joint. In this case, an examination by an orthopedist is an integral part of the diagnosis. Only by summing up all the data in a complex, it is possible to make a diagnosis with confidence, indicating the degree of development of the disease.
How is it donecoxarthrosis treatment?
Treatment of this disease is divided into several areas. First of all, we are talking about drug therapy, physiotherapy and non-traditional methods. Medical treatment for coxarthrosis typically includes:
- Correction of disorders inside the joints.
- Pain relief.
- Effect on improving blood supply.
- Stimulation of metabolic processes.
- Reduction or complete removal of the inflammatory process.
- Carrying out chondroprotective treatment.
Physiotherapy includes the following methods:
- Electrical procedures.
- Performing mud treatment.
- Performing massages and manual therapy.
- Plasmolifting. This procedure is a new technique based on the injection of autoplatelet plasma.
Treatment of coxarthrosis of the 2nd degree by non-traditional methods involves acupuncture along with reflexology and apitherapy. In addition, for the treatment of this disease, it is possible to turn to traditional therapeutic exercises, author's methods and surgical intervention. Next, we will dwell in more detail on the treatment of coxarthrosis without surgery with the help of drugs.
Performing medication
Different groups of drugs are used to treat this disease. Among them, the most important is the use of anti-inflammatory drugs. After all, the first step that needs to be taken isThis is to relieve inflammation along with pain. The following means are used for this:
- Use of acetylsalicylic acid. It does not have a sufficient effect, but for patients at risk of thrombosis, such an acid in low dosages is necessary. For example, "Kurantil" is often used for this.
- Preparations in the form of "Olfen", "Naklofen" and "Indomethacin" can relieve pain very quickly, but they are not suitable for long-term use, as they have many side effects. These medicines are emergency medicines for exacerbations.
- "Meloxicam", "Nabumeton" and "Nimesil" cause fewer side effects. Meloxicam is considered the best option for long-term use; it is better to use it in the form of candles.
The use of antispasmodics improves blood circulation in the treatment of coxarthrosis of the hip joint of the 2nd degree. Against the background of the disease, the thigh muscles are in a state of spasm. This has an extremely negative effect on general blood circulation. To solve this problem, muscle relaxants with agents that reduce vascular permeability are used. Muscle relaxants include "No-shpu" along with "Mydocalm", "Sirdalud" and "Riabal". Well reduce permeability and improve peripheral blood circulation drugs in the form of "Ascorutin", "Upsavit", "Trental" and "Cavinton".
Physiotherapy and massages
Physiotherapy is aimed at relieving pain, and, in addition, to improve penetrationmedicines to the joints. The most effective and common of these include the following procedures:
- Performing electrophoresis with novocaine.
- Performing radiotherapy.
- Performing an ultrasound.
- Performing magnetotherapy.
It is also advisable to carry out massages for such patients, as they significantly improve blood circulation, increase tissue trophism, strengthen the ligamentous apparatus and relieve the tone of spasmodic muscles. Vibration massages are especially useful for coxarthrosis, which work best on deep joints.
What other treatment for symptoms of coxarthrosis of the hip is carried out?
Mud therapy and manual therapy
This method of treatment is a very effective method for combating coxarthrosis. Therapeutic mud of various compositions, whether peat or silt, can enhance regeneration along with tissue trophism. Mud therapy saturates the human joints with useful minerals, stimulating the restoration of cartilage and well relieving various inflammations.
In the treatment of coxarthrosis of the joints, an application technique is used. Mud is applied from the lumbar region to the middle of the thighs. For therapeutic purposes, mud treatment must be done twice a year. Manual treatment includes:
- Carrying out various manipulations, for example, the implementation of sudden movements that are aimed at relieving spasms and returning the range of motion.
- Mobilization in progress. Whereinelongation of the limbs is carried out, due to which the distance between the head of the femoral bone and the acetabulum increases.
A very common and effective method for the treatment of coxarthrosis of the hip joint of the 2nd degree is the complex of manual therapist Gitt. Non-traditional methods like acupuncture and apitherapy are very effective additions.
What else does the treatment of coxarthrosis of the hip joint involve?
Operation
With advanced pathogenesis, surgery on the hip is a necessary measure. Only surgery in the last stages of the disease can restore lost motor abilities, eliminate pain.
Depending on the characteristics of the pathology, the patient may be offered:
- Arthrodesis - correction of only the support function. The articular bones are firmly fixed with metal plates to completely immobilize the anatomical structure.
- Arthroplasty is the best way of surgical intervention, thanks to which it is really possible to solve the problem with coxarthrosis radically (almost 100% success).
- Osteotomy - Provides temporary delay in joint replacement. The bone is aligned along the axis with its artificial fracture, and then the osteotomized areas are fused in an advantageous position for the joint. This relieves the painful area a little, reduces pain and improves gait.
Coxarthrosis has always been attributed to age-related diseases, in this regardpreventive diagnostics should be carried out in patients over the age of thirty-five years. This will enable timely detection of this pathology and successful treatment. In accordance with medical indications, patients are referred for all kinds of tests and diagnostics in cases of complaints of characteristic pain in the hip area during movement. It should be understood that against the background of advanced forms of pathology, surgical intervention may be necessary, so it is best to determine the disease in advance.
We reviewed the symptoms and treatment of coxarthrosis of the hip.
