One of the most serious diseases of the musculoskeletal system is coxarthrosis of the hip joint. If the visit to a medical institution is delayed, the disease can progress - up to the appearance of an acute pain syndrome that cannot be relieved with analgesics and the complete loss of motor skills of the joint.
In this article we will talk in detail about all the nuances associated with eliminating the consequences of this pathological process, its stages and preventive measures.
What is coxarthrosis of the hip joint?
It is a degenerative-dystrophic disease of the hip joint in severe form, which can lead to an impairment of the joint's functionality or even its complete loss. In terms of frequency of manifestation, coxarthrosis is second only to deforming arthrosis of the knee joint.
Coxarthrosis of the hip joint is accompanied by degenerative damage to cartilage, the appearance of pathological growths, bone resorption, inflammatory processes and other complications.
That is, this pathology is characterized by damage to the entire joint, which includes cartilaginous tissue, synovial layer, subchondral bone plate, muscular structures, capsule and ligaments.
In addition, the following forms of the disease are distinguished:
- Primary coxarthrosis. It is considered the most common disease of the hip joint. In older people, this pathology manifests itself against the background of age-related changes;
- Secondary coxarthrosis. Manifests itself as a result of any disease.
Causes of coxarthrosis
The development of pathology can be provoked by external, acquired and hereditary reasons.
In particular, coxarthrosis can manifest itself against the background of congenital inferiority of the hip joint, degenerative-dystrophic changes, trauma, inflammatory processes, necrosis of the bone marrow of the femoral head, metabolic disorders, genetic factors, age-related changes, obesity, vascular anomalies and work in difficult conditions.
It should be noted that almost all joint structures are subject to inflammation.
3 stages of development of coxarthrosis of the hip joint
During the development of the pathological process, the viscosity of the synovial fluid increases, which leads to the formation of microcracks and drying out of the cartilage surface. This, in turn, contributes to the appearance of grinding and limited mobility. A person feels such unpleasant phenomena during everyday stress and physical activity. As pressure on the lower extremities increases, the exhausted joint adapts to the forced position and begins to destroy surrounding structures.
Currently there are three stages of development of the disease:
- First. At this stage, coxarthrosis of the hip joint presents with mild, inconsistent symptoms that occur in the affected area. At the same time, motor activity is maintained and medication is sufficient to relieve pain;
- Second. If a patient is diagnosed with coxarthrosis of the hip joint at stage 1, the disease does not cause much discomfort, but at stage 2 of the disease the symptoms intensify. The pain becomes stronger and begins to radiate to other parts of the body. Motor skills deteriorate significantly, which is particularly noticeable after prolonged walking or increased physical exertion;
- Third. If coxarthrosis of the hip joint of the 2nd degree can still be treated, the pathology becomes chronic in the third stage. It is accompanied by constant pain and is transmitted to the lower body. The patient loses the ability to move without crutches. Without appropriate therapeutic measures, atrophy of the cartilage and muscle structures occurs.
Types of coxarthrosis
The classification of the pathology of the hip joint is based on one criterion - how the disease arose in the musculoskeletal system. There are two main risk factors that can trigger the onset of the disease - genetic and acquired due to age-related changes. The pathological process is also divided into several types depending on the source of its origin:
- Primary coxarthrosis. This pathology manifests itself in the hip area and is acquired. In the initial stage it affects the synovial capsule and then reaches the area of the tissue surrounding the joint. Risk factors include increased pressure on the pelvic bones, excessive physical activity, and the presence of foci of inflammation in the lower extremities and spine. Degenerative lesions are concentrated in tissues that have already undergone changes;
- Secondary coxarthrosis. This anomaly is hereditary. It manifests itself in the joints and musculoskeletal system. The development of the pathological process can begin already in the womb, after a woman has received an injury, as well as against the background of necrosis of the bone marrow of the femoral head.
Types of coxarthrosis based on their occurrence:
- Post-infectious. Identified in the presence of consequences after infectious diseases;
- Post-traumatic. Diagnosed with complications following a limb injury;
- Dishormonal. Occurs against the background of metabolic disorders or drug overdose;
- Involutive. Due to aging of the body, it occurs in people over 50 years old.
Diagnostic measures
If you suspect coxarthrosis of the hip joint of the 1st or 2nd degree, you should carry out a complete examination of the body before starting treatment. It is also important to seek advice from an orthopedic doctor who will conduct an examination, make recommendations on laboratory tests and draw up an effective treatment plan. Typically, diagnostic measures are limited to the following procedures:
- Radiography. Allows you to study the parameters of the gap between the cartilages, diagnose pathological growths and assess the condition of the femoral head.
- Ultrasonic. Allows you to trace the etiology of changes in bone structures and ligaments, as well as study the dynamics of the patient's condition and determine the degree of development of the anomaly;
- CT. Allows you to obtain more detailed information about the condition of the joints and tissues in their immediate vicinity;
- MRI. This method provides a detailed picture of the condition of all structures of the hip joint.
Treatment of coxarthrosis of the hip joint
If the patient has been diagnosed with coxarthrosis of the hip joint of 1 or 2 degrees, it is possible to achieve effective results using conservative methods. Such therapy is prescribed to the patient individually and includes several techniques that only together produce a positive effect. So, if a patient is diagnosed with coxarthrosis of the hip joint of 1 or 2 degrees and the corresponding symptoms are observed, the following measures can be recommended:
- Taking medication;
- Physiotherapeutic procedures;
- shock wave therapy;
- Physical therapy.
In order to achieve positive dynamics using conservative methods, the causes that led to the appearance of coxarthrosis of the hip joint should be eliminated. First of all, you should reduce body weight to reduce the load on the joint and minimize the likelihood of further development of the degenerative-dystrophic process.
In addition, you should avoid consuming tobacco products and increase physical activity to avoid excessive exertion. To prevent the progression of pathology, experts recommend using orthopedic aids (orthoses and bandages). They enable the joint to be firmly fixed and provide the necessary support during physical activity.
Medication
Medications are also prescribed individually. As a rule, patients are recommended to take the following medications:
- Non-steroidal anti-inflammatory drugs. These drugs allow you to achieve a double effect: relieve pain and eliminate the inflammatory process;
- Preparations with chondroitin, glucosamine and collagen. They allow you to activate restorative processes in cartilage;
- Steroids. Drugs with strong anti-inflammatory effects. Used in situations where NSAIDs do not show significant effectiveness.
- Muscle relaxants. Drugs that relieve muscle tone, which is a necessary condition for relieving pain of increased intensity;
- Means that normalize blood circulationand improving the trophism of tissues near the joint;
- vitamin B. Complexes containing this vitamin are prescribed to improve nerve transmission, which is especially important when the ends are compressed by affected structures.
If the pain is severe, it is also recommended to carry out periarticular blocks. They are only carried out under the supervision of professional specialists in a clinical setting. Special solutions containing steroid hormones and anesthetics are injected into the joint.
Gymnastics for coxarthrosis of the hip joint
Special exercises recommended for coxarthrosis of the hip joint are particularly effective in restoring motor function and reducing muscle spasms. Through the optimally selected load, it is possible to relieve pain and increase the amplitude of movement. In addition, a properly composed complex allows you to prevent atrophic processes in the muscles and relieve spasms when pinched nerve endings are observed against the background of the disease.
In addition, gymnastics for coxarthrosis of the hip joint helps to improve blood circulation in the affected area and accelerate the recovery processes.
When choosing exercises, the specialist must take into account the destruction of the hip joint and the physical condition of the patient.
Physiotherapeutic methods
Massage procedures and physiotherapy can have a special pain-relieving, anti-inflammatory and decongestant effect. They also help maintain muscle tone in the limbs, thereby preventing atrophic processes.
In case of anomalies of the hip joint, the following procedures are carried out:
- UHF;
- laser exposure;
- ultrasound treatment;
- magnetic field therapy;
- exposure to direct electrical current in combination with medication;
- paraffin therapy;
- Phonophoresis.
The above treatment will have a positive effect only if the patient has been diagnosed with coxarthrosis in the primary stage.
Shock wave therapy for coxarthrosis
With coxarthrosis in the first or second stage, shock wave treatment provides significantly positive dynamics. For example, a course of 10-15 shock wave therapy procedures can reduce the negative manifestations characteristic of stage 2 pathology to signs of the initial stage of the disease.
It is important to understand that only timely treatment sessions can achieve the best recovery effect. At the same time, it will be possible to reduce the number of SWT procedures.
However, the main positive aspect of the effect of shock waves on the affected joint is the ability to normalize blood circulation, which allows an accelerated supply of important nutrients involved in regenerative processes to various structures of the hip joint.
In addition, as part of shock wave therapy, it is possible to crush pathological bone growths, which lead to significant irritation of the joint tissue and prevent regeneration.
Physiotherapists and neurologists with professional experience work in the clinics. You will be able to use the most modern physiotherapeutic methods, including the shock wave method. In addition, specialists have the ability to work with modern equipment. This guarantees a positive effect and allows you to shorten the duration of treatment.
surgery
Unfortunately, many patients delay contacting a medical institution and only see a specialist when irreversible processes occur in the hip joint.
In advanced third or fourth stages of the disease, surgery is the only effective method. This restores motor skills and eliminates acute pain, i. e. H. the patient's quality of life is significantly improved.
As a rule, surgery is prescribed in the following situations:
- Painful sensations of increased intensity that cannot be relieved with medication;
- lack of interarticular space;
- Violation of the integrity of the femoral neck;
- Significant limitation of physical activity.
Given the intensity of joint damage and changes in bone tissue, patients may be prescribed the following types of procedures:
- Arthrodesis. A procedure that causes complete immobility of the joint. For this purpose, special metal plates are used;
- Osteotomy. A surgical procedure consisting of an artificial fracture of the femur to straighten its axis. The resulting parts are placed in the most optimal position, which allows you to relieve excessive stress on the affected joint.
- Arthroplasty. The only method by which it is possible to restore all functionality of the hip joint and achieve complete recovery of the patient. After using this method of eliminating coxarthrosis, a person forgets about joint problems for 20-30 years.
Medical centers carry out surgical interventions in the area of the hip joint of any complexity. They are performed by highly qualified specialists using modern tools and technologies, which eliminates errors during the procedure.
Complications of the disease
When the pathological process is at an advanced stage, joint mobility is significantly reduced, a person loses the ability to walk and care for himself, and pathological tissue fusion is observed. In addition, such an anomaly can have an undesirable impact on gait, caused by the appearance of lameness and a reduction in limb size.
Preventive measures
Patients with pain in the hip joint should be observed by a specialist and use special orthopedic devices when performing work and physical activity. In addition, after surgery, an X-ray is required three times a year to monitor the condition of the joint.