One of the most severe pathologies of the musculoskeletal system is coxarthrosis of the hip joint. If the visit to a medical institution is delayed, the disease can progress - to the appearance of acute pain that cannot be relieved with analgesics, and a complete loss of mobility of the joint.
In this article, we will talk in detail about all the nuances related to the elimination of the consequences of this pathological process, its stages and preventive procedures.
What is coxarthrosis of the hip joint?
We are talking about a degenerative-dystrophic disease of the hip joint in a severe form, which can cause a violation of the functional ability of the joint to its complete loss. In terms of frequency of occurrence, coxarthrosis is in second place after deforming arthrosis of the knee joint.
Coxarthrosis of the hip joint is accompanied by degenerative cartilage damage, the appearance of pathological growths, bone resorption, inflammatory processes and other complications.
This means that this pathology is characterized by damage to the entire joint, which includes cartilage tissue, synovial layer, subchondral bone plate, muscle structures, capsule and ligaments.
The following forms of the disease are also distinguished:
- Primary coxarthrosis. It is considered the most common disease of the hip joint. In the elderly, this pathology manifests itself against the background of age-related changes;
- Secondary coxarthrosis. It occurs as a result of some disease.
Causes of coxarthrosis
The development of the pathology can be provoked by external, acquired and hereditary reasons.
In particular, coxarthrosis can occur against the background of congenital insufficiency of the hip joint, degenerative-dystrophic changes, trauma, inflammatory processes, necrosis of the bone marrow of the femoral head, metabolic disorders, genetic factors, age changes, obesity, vascularanomalies 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 joint fluid increases, which causes the appearance of microcracks and leads to dehydration of the cartilage surface. This, in turn, contributes to the appearance of crunch and limited mobility. One feels such unpleasant manifestations during daily stress and physical activity. As the pressure on the lower extremities increases, the exhausted joint adapts to the forced position and begins to destroy nearby structures.
There are currently 3 stages of disease development:
- First. Coxarthrosis of the hip joint at this stage has mild symptoms that are inconstant and appear in the affected area. At the same time, motor activity is preserved and to relieve pain it is enough to take medicines;
- Second. When the patient is diagnosed with coxarthrosis of the hip joint in stage 1, the disease does not cause much discomfort, but when it reaches stage 2 of the disease, the symptoms become more pronounced. The pain becomes more intense and begins to radiate to other parts of the body. Motor ability deteriorates significantly, which becomes especially noticeable after prolonged walking or increased physical effort;
- third. If coxarthrosis of the hip joint of the 2nd degree is still curable, at the third stage the pathology becomes chronic. It is accompanied by constant pain and is transmitted in the lower part of the body. The patient loses the ability to move without crutches. In the absence of appropriate therapeutic measures, atrophy of cartilaginous and muscular 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 changes. The pathological process is also divided into several types depending on the source of occurrence:
- Primary coxarthrosis. This pathology manifests itself in the area of the hip joint and is acquired. In the initial stage, it affects the synovial capsule, after which it passes into the area of the tissues around the joint. Risk factors include increased pressure on the pelvic bones, excessive physical activity and the presence of inflammatory foci in the lower limbs 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 the woman received an injury, as well as against the background of bone marrow necrosis of the femoral head.
Types of coxarthrosis due to the appearance:
- Post-infectious. Identified in the presence of consequences after infectious diseases;
- Post-traumatic. Diagnosed in case of complications after limb injury;
- Dyshormonal. Occurs against the background of metabolic disorders or drug overdose;
- Involutive. Appears in people over 50 years old due to the aging of the body.
Diagnostic measures
If you suspect coxarthrosis of the hip joint of the 1st or 2nd degree, before starting treatment, you should perform a full body examination. It is also important to get a consultation with an orthopedist who will perform an examination, give recommendations on laboratory tests and draw up an effective treatment plan. Typically, diagnostic measures are limited to the following procedures:
- Radiography. It allows you to examine the parameters of the gap between the cartilages, diagnose the presence of pathological growths, as well as assess the condition of the head of the femur;
- Ultrasound. It allows to trace the etiology of changes in bone structures and connections, as well as to study the dynamics of the patient's condition and to determine the degree of development of the anomaly;
- CT. It allows you to get more detailed information about the condition of the joints and the tissues located in close proximity to them;
- MRI. This method gives a detailed picture of the condition of all structures of the hip joint.
Treatment of coxarthrosis of the hip joint
If the patient is diagnosed with coxarthrosis of the hip joint of 1 or 2 degrees, it is possible to obtain effective results through conservative methods. Such therapy is prescribed individually to the patient and includes several techniques that only together give a positive effect. So, if the 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:
- Use of drugs;
- Physiotherapy procedures;
- Shock wave therapy;
- Physiotherapy.
In order to achieve positive dynamics with the help of conservative methods, the causes that provoke the appearance of coxarthrosis of the hip joint must be eliminated. First of all, you need to reduce your body weight, which will reduce the load on the joint and minimize the likelihood of further development of the degenerative-dystrophic process.
In addition, you should eliminate the use of tobacco products and increase physical activity, avoiding excessive exertion. To prevent the progression of the pathology, experts advise the use of orthopedic devices (ortheses and bandages). They allow you to firmly fix the joint and provide the necessary support during physical activity.
medicines
Medicines are also prescribed individually. As a rule, patients are recommended to take the following drugs:
- Nonsteroidal anti-inflammatory drugs. These drugs allow you to get a double effect: relieve pain and eliminate the inflammatory process;
- Preparations containing chondroitin, glucosamine and collagen. They allow you to activate the recovery processes in the cartilage;
- Steroid hormones. Medicines with a strong anti-inflammatory effect. It is used in situations where NSAIDs are not significantly effective;
- Muscle relaxants. Medicines 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 located near the joint;
- vitamin B. Complexes containing this vitamin are prescribed to improve nerve transmission, which is of particular importance when the endings are compressed by the affected structures.
In case of pain of significant intensity, it is also recommended to perform periarticular blocks. They are performed only under the supervision of professional specialists in clinical settings. In this case, special solutions with steroid hormones and anesthetics are injected into the joint.
Gymnastics for coxarthrosis of the hip joint
Particularly effective for restoring motor function and reducing muscle spasm are the special exercises that are recommended for coxarthrosis of the hip joint. Thanks to the optimally selected load, it is possible to relieve pain and increase the amplitude of movements. In addition, a properly composed complex allows you to prevent atrophic processes in the muscles and relieve spasms if pinched nerve endings are observed against the background of the disease.
Also, gymnastics for coxarthrosis of the hip joint helps to improve blood flow in the affected area and allows you to speed up the recovery process.
When choosing exercises, the specialist must take into account the destruction of the hip joint and the physical condition of the patient.
Physiotherapy methods
Massage procedures and physiotherapy can provide a special analgesic, anti-inflammatory and decongestant effect. They also help to maintain the muscle tone of the limbs, preventing atrophic processes.
In case of abnormalities of the hip joint, the following procedures are performed:
- UHF;
- Laser exposure;
- Ultrasound treatment;
- Magnetotherapy;
- Exposure to direct electric current in combination with drugs;
- Paraffin therapy;
- Phonophoresis.
The above treatment will give a positive effect only if the patient is diagnosed with coxarthrosis in the initial stages.
Shock wave therapy for coxarthrosis
In coxarthrosis of the first or second stage, shock wave treatment provides significant 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 can provide the best restorative effect. At the same time, it will be possible to reduce the number of SWT procedures.
But the main positive aspect of impacting the affected joint with shock waves is the ability to normalize blood circulation, which facilitates the accelerated supply of various structures of the hip joint with important nutrients involved in regenerative processes.
In addition, as part of the application of shock wave therapy, it is possible to crush pathological bone growths, which contribute to significant irritation of joint tissues and prevent regeneration.
Physiotherapists and neurologists with professional experience work in the clinics. They are fluent in working with the latest physiotherapy methods, among which is the shock wave method. In addition, specialists have the opportunity to work with modern equipment. This ensures a guaranteed positive effect and allows you to shorten the treatment period.
surgery
Unfortunately, many patients delay contacting a medical facility and turn to a specialist only when irreversible processes begin in the hip joint.
In advanced third or fourth stage of the disease, the only effective method is surgery. It will restore mobility and eliminate acute pain, that is, it will significantly improve the patient's quality of life.
As a rule, the operation is prescribed in the following situations:
- Painful sensations of increased intensity that cannot be relieved by medication;
- Lack of inter-articular space;
- Violation of the integrity of the neck of the femur;
- Significant limitation of physical activity.
Considering the intensity of joint damage and bone tissue changes, patients may be prescribed the following types of interventions:
- Arthrodesis. An intervention that creates complete immobility of the joint. Special metal plates are used for this purpose;
- Osteotomy. A surgical intervention that consists in artificially breaking the femur in order to straighten its axis. The resulting parts are placed in the most optimal position, which allows you to remove excessive load from the affected joint;
- Arthroplasty. The only method by which it is possible to restore all the functionality of the hip joint and achieve a full recovery of the patient. After using this method to eliminate coxarthrosis, a person forgets about joint problems for 20-30 years.
Medical centers perform surgical procedures in the area of the hip joint of any complexity. They are performed by highly qualified specialists using modern technology and equipment, which eliminates any errors during the intervention.
Complications of the disease
When the pathological process is in an advanced stage, the mobility of the joint is significantly limited, a person loses the ability to walk and take care of himself, a pathological fusion of tissues is observed. In addition, such an anomaly can have an undesirable effect on the gait, which is due to the appearance of lameness and a decrease in the size of the limb.
Preventive actions
Patients with hip pain should be monitored by a specialist and use special orthopedic devices when performing work and physical activity. In addition, after the operation, it is necessary to undergo radiography 3 times a year to monitor the condition of the joint.