As you know, the largest joint in our body is the hip. It takes almost all the load while walking. But also, it is often exposed to ailments such as arthrosis or coxarthrosis. What is osteoarthritis of the hip joint 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 into the very structure of the hip joint. It has the shape of a "hinge", and its function is to connect with the pelvis of the femur. Fixation occurs with the help of a spherical head, which is embedded in the socket of the hip bone. Both the surface of the head and the surface of the socket are covered with cartilage. They perform damping and wear protection functions.
So, a violation of the structure of these cartilages becomes the cause of arthrosis that contributes to the development. That is, elastic and durable cartilage, due to some internal or external factors, dries out, 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. Therefore, it is important here to know how to relieve pain in coxarthrosis of the hip joint, but we will talk about that later.
In advanced stages, the bone becomes so deformed 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 - the destruction of the complete or partial integrity of the surface of the joints. It is also important to understand that the concepts of osteoarthritis, coxarthrosis and osteoarthritis are practically the same. It's just that osteoarthritis is a broader definition, and the other two are the same thing, and they only apply to the hip joint.
Causes of manifestation
According to doctors, there can be quite a few reasons for the appearance of coxarthrosis, but we will consider only the most common:
- Congenital pathologies. The most common are dysplasia (curvature) and congenital dislocation of the hip. They almost always cause grade 1 hip dysplastic coxarthrosis.
- 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 become misshapen.
- Violation of the hormonal background. Such a violation can easily cause inflammation of the joint tissues.
- Years. In 70% of cases, osteoarthritis occurs in people over 40 years of age. It's all about the natural aging of the body and maintaining, for the most part, a sedentary lifestyle with age.
- injuries. Joint injury leads to cartilage thinning or even deformation, and this is an unavoidable anterior hip joint.
- Over weight. Sign - a lot of weight, which will constantly overload the hip joint. Such prolonged loads inevitably lead to cartilage wear, as a result - the destruction of the hip joint.
- Big loads. Athletes are in this risk category.
- A simple circulatory disorder. For one reason or another, blood circulation in the human body can fail. So, in the periarticular tissues, a lot of waste accumulates after metabolism, and this leads to the production of enzymes, but these, in turn, destroy cartilage tissue.
- Hip diseases. Another fairly common cause of coxarthrosis. The thing is that the wrong or untimely treatment of any other hip diseases (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 osteoarthritis of the hip joint of the first degree. Symptoms include stiffness and discomfort in the hip joint in the morning, immediately after waking up. Discomfort or pain is aggravated by physical exertion, and during rest weakens or disappears altogether. Patients often do not pay attention to such symptoms, but the prevention of coxarthrosis will not help here.
In more advanced stages, the disease already begins to bother completely, even during rest, and everyone thinks which doctor treats coxarthrosis in order to contact him in time. In addition, the joint begins to swell, its mobility is lost, and the cartilage collapses, forming bone spurs. The pain does not subside even with long rest, movement is quite limited. Here you will need information on how to treat grade 3 coxarthrosis, which you can find with us.
Then comes the complete disappearance of cartilage, and the bones begin to rub against each other. It becomes quite difficult to move. As a result, inactivity, leading to weakening or even atrophy of the muscles, begins to deform arthrosis of the hip joint. The length of the legs can also change. There is obvious lameness. Here, conservative treatment of coxarthrosis of the third degree will no longer help. The last stage is the complete loss of the ability to walk.
Diagnosis
To properly diagnose and treat osteoarthritis of the hip joint, you need to see a doctor. So, which doctor treats osteoarthritis of the hip joint without surgery? You should contact a rheumatologist or orthopedic traumatologist. The diagnosis will begin with a questioning of the patient, that is, what hurts, where exactly does it hurt, how often does the pain feel, etc. To assess the intensity of pain, the doctor will perform various manipulations with the joint. It will flex, extend and rotate the lower limb. Additionally, 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 erythrocyte sedimentation rate will increase significantly, that is, from 30 mm / h and above. An increase in globulins, seromucoids, immunoglobulins and c-reactive protein are also symptoms of coxarthrosis. To determine its level, a biochemical blood test is needed. But while such tests are not enough to prescribe treatment for coxarthrosis of the hip joint.
A mandatory event is radiography. But a significant disadvantage creeps in here: only bones and bone seals are visible in the image, cartilage and soft tissues are not visible. Therefore, diagnosing an early stage will be quite difficult. In this case, computed tomography will help to draw a complete picture, and on its basis it will be possible to say how to treat arthrosis of the hip joint. But all these procedures will be unnecessary if you have doa or deforming osteoarthritis of the hip joint of the fourth degree. After all, the disease will be visible to the naked eye, and the prevention of arthrosis and treatment without surgery will no longer be useful.
degrees and types
Depending on the neglect and symptoms of the disease, 4 degrees of its manifestation can be distinguished.
| Degree | Description |
|---|---|
| First | First-degree osteoarthritis of the hip joint is easy to miss. Its symptoms are recurring pain in the hip joint after prolonged physical exertion. The pain disappears as soon as the load is stopped. The radiograph will show only a slight narrowing of the joint space. If it is oriented in time, the disease can be easily prevented. |
| Second | Osteoarthritis of the hip joint of the second 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 themselves even in a calm state. There may be obvious lameness. Morning stiffness syndrome appears periodically in the morning. We will talk more about how to treat coxarthrosis of the hip joint of the second degree. |
| Third | The third stage is when the disease is already very advanced. Almost no cartilage left. The radiographic image shows a strong filiform narrowing of the space between the joints. Pains at this stage are permanent and are eliminated only with the help of medication. At the same time, the patient is very limited in his movements and to move around 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 grade 3 arthrosis of the hip joint: conservative methods or surgical intervention. |
| Four | The fourth stage is the most neglected and surgical intervention cannot be dispensed with. Accompanied by severe pain in the joint area. The joint as such almost disappears, 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 types of coxarthrosis seems 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. Everything is simple here, if 1, then they say that the coxarthrosis is one-sided. If the joints on both sides of the hip bone are affected, then they speak of bilateral osteoarthritis.
But there is another, no less popular classification, denoting a disease based on the causes of its occurrence. There are 7 types here:
- The change in the joint and cartilage with the age of a person is the so-called involutional coxarthrosis.
- Coxarthrosis caused by a complication of Perthes disease. As a result, necrosis of the spongy tissue covering the head of the femoral bone.
- Congenital maldevelopment of a joint or joints is called dysplastic coxarthrosis. A fairly common occurrence, according to doctors, one in ten cases is the result of congenital subluxation of the femoral head or the so-called dysplasia.
- Complication after arthritis or post-infectious coxarthrosis.
- Post-traumatic coxarthrosis. It is a consequence of an incorrect constant load on the joint, which leads to microtrauma, which in turn slowly destroys the cartilage tissue.
- The next risk group includes people taking antidepressants and corticosteroids, as well as others with hormonal disorders. This type is called dehormonal osteoarthritis.
- Well, if it is not possible to establish the cause of the disease, then idiopathic coxarthrosis is diagnosed.
treatment methods
There are many treatment methods for osteoarthritis of the hip joint, but the disease cannot be completely cured. The entire treatment can be divided into three stages.
- Prevention or prevention of diseases.
- Treatment of early stages (first and second).
- Treatment of advanced stages (third and fourth).
Conservative treatment
This includes the 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 increase in the load on the joint. Moderate loads that will develop the joint will not be superfluous. This includes light loads, for example therapeutic exercises, 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 weight, with its excess, as well as proper nutrition. You should also take care of constant and sufficient sleep and rest. Massages, both special and self-massage, will also help. At the second stage, with increased pain, it is necessary to take nonsteroidal anti-inflammatory drugs. Well, if the disease progresses to grade 3, it can also be treated without surgery, but a cane or crutches are not necessary to disdain to relieve the additional load on the pelvis.
Surgery
The attending physician may decide on surgical intervention already at the third stage to cure arthrosis of the hip joint. 4 types of operations are performed:
- Arthroplasty: modeling of the cartilage in the joint is performed. With their help, you can almost completely restore the functionality of the joint.
- Osteotomy is a dissection of the bones, which is performed in such a way that the deformed areas are completely removed and the normal tissue is not deformed.
- Arthrodesis - the joint is attached to the bone with the help of special plates and screws. A more radical method of intervention. After that, the joint remains immobilized.
- Endoprosthesis is a complex operation on the hip joint. To be honest, this is not an operation on the joint, but its complete replacement with a prosthesis, which is performed in view of the anatomical features of the patient. Thus, a full or partial replacement is carried out, due to which it is possible to cure the coxarthrosis. The success rate is about 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 osteoarthritis in the elderly is not treated at all, but if it is treated in time at a young age, then it can be cured. This is not true. Since it is possible to cure coxarthrosis only in the case of arthroplasty, it is better to warn in advance. This includes managing excessive stress on the joint, maintaining an active lifestyle, managing nutrition and weight. Normal sleep and rest are also important. You can opt for regular massage treatments. Regular intake of chondroprotectors is recommended.