As you know, the largest joint in our body is the hip. It takes almost the entire load while running. But also, he is often prone to diseases such as arthrosis or coxarthrosis. What is it and how is osteoarthritis of the hip joint treated? We will talk about this in our article.
What is coxarthrosis?
To understand the essence of coxarthrosis disease, a very problematic treatment, you need to delve a little into the structure of the hip joint. It itself has a "hinge" shape, and its function is to connect with the femoral pelvis. Binding occurs with the help of a spherical head, which is embedded in a cavity in the hip bone. Both the surface of the head and the surface of the cavity are covered with cartilage. They perform the function of absorbing shock and protecting against wear.
So, this violation of the structure of cartilage becomes the cause of arthrosis that contributes to its development. That is, elastic and durable cartilage, due to some internal or external factors, becomes dry, hardens, and its surface becomes rough instead of smooth. Such structures interfere with normal function and lead 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 more on that later.
At a later stage, the bone becomes deformed until the patient loses the ability to walk. Summarizing all this, it is possible to form a definition of a disease such as arthrosis of the hip joint - complete or partial destruction of the integrity of the joint surface. It is also important to understand that the concepts of arthrosis, coxarthrosis and osteoarthritis are practically the same thing. Only arthrosis is a broader definition, and the other two are one and the same, and it only occurs in the hip joint.
The cause of the manifestation
According to doctors, there are several reasons for the appearance of coxarthrosis, but we will consider only the most common:
- Congenital pathology. The most common are dysplasia (curvature) and congenital dislocation of the hip. They almost always cause grade 1 dysplastic coxarthrosis of the hip.
- hereditary tendencies. It is during this time that the disease is quite common in your family.
- Passive lifestyle. With inactivity, cartilage loses its elasticity and resilience, and can change shape.
- Violation of hormonal background. Such violations can easily lead to inflammation of joint tissue.
- Age. In 70% of cases, arthrosis occurs in people over 40 years of age. It’s all about the natural aging of the body and maintaining, for the most part, an inactive lifestyle according to age.
- injuries. Injury to the joint leads to thinning of the cartilage or even its deformation, and this is an unavoidable pre-hip joint.
- Overweight. Signs - a lot of weight, which will always burden the hip joint. Such prolonged loading inevitably leads to cartilage wear, as a consequence - the destruction of the hip joint.
- Big load. Athletes fall into this risk category.
- Simple circulatory disorders. For one reason or another, blood circulation in the human body can fail. So, in periarticular tissue, a lot of waste accumulates after metabolism, and this leads to the production of enzymes, but they, in turn, destroy cartilage tissue.
- Hip disease. Another relatively common cause of coxarthrosis. The problem is that improper or untimely treatment for any other disease of the hip (various infections or even necrosis of the femoral head) can easily lead 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 stage 1. Symptoms include stiffness and discomfort in the hip joint in the morning, immediately after waking up. The discomfort or pain worsens with physical exertion, and during rest it becomes weak or disappears altogether. Patients often do not pay attention to such symptoms, but prevention of coxarthrosis will not help here.
At a later stage, the disease is already starting to get completely annoying, even during breaks, and everyone thinks about which doctor is treating coxarthrosis to contact him in a timely manner. Subsequently, the joint begins to become inflamed, its mobility is lost, and the cartilage collapses forming a bone spur. The pain does not subside even with prolonged rest, movement is somewhat restricted. Here you need information on how to treat grade 3 coxarthrosis, which you can find with us.
Then came the complete loss of cartilage and the bones began to rub against each other. It becomes quite difficult to move. As a result, inactivity, which leads to muscle weakness or atrophy, begins to change the form of osteoarthritis of the hip joint. Leg length may also change. There are obvious flaws. Here, conservative treatment of stage 3 coxarthrosis will no longer help. The last stage is the complete loss of the ability to walk.
Diagnostics
To properly diagnose and treat osteoarthritis of the hip joint, you need to consult a doctor. So which doctor treats hip arthrosis without surgery? You should contact a rheumatologist or orthopedic traumatologist. The diagnosis will begin by asking the patient, that is, what is painful, where exactly it hurts, how often the pain is felt, etc. To assess the strength of the pain, the doctor will perform some manipulations with the joint. It will flex, lengthen and rotate the lower limbs. In addition, the patient may be asked to walk to assess the external configuration of the joint.
However, clinical blood tests can confirm the diagnosis more accurately. Here, the erythrocyte sedimentation rate will increase significantly, i. e. from 30 mm / h and more. Elevated globulins, seromucoids, immunoglobulins and c-reactive proteins are also symptoms of coxarthrosis. To determine their levels, biochemical blood tests are required. But while such tests are not enough to prescribe treatment for coxarthrosis of the hip joint.
Mandatory event is radiography. But here a significant minus slips - only the bone and bone sealants visible in the picture, cartilage and soft tissue are not visible. Therefore, diagnosing the early stages is quite difficult. In this case, computed tomography will help to draw a complete picture, and already basically it is possible to say how to treat arthrosis of the hip joint. But all these procedures will be unnecessary if you have prayer or deformity of the hip joint arthrosis in the 4th degree. After all, the disease will be visible to the naked eye, and arthrosis prevention and non -surgical treatment are no longer useful.
Degree and type
Based on the neglect and symptoms of the disease, 4 degrees of its manifestation can be distinguished.
| Degree | Description |
|---|---|
| First | Level 1 osteoarthritis of the hip joint is easy to ignore. The symptom is recurrent pain in the hip joint after prolonged physical exercise. The pain disappears as soon as the load stops. X-rays will show only a slight narrowing of the interarticular space. If you instruct yourself on time, then the disease can be easily prevented. |
| Second | Osteoarthritis of the hip joint stage 2 - the symptoms begin to appear, this is the beginning of the destruction of cartilage tissue. The pain gets stronger and radiates to the thighs and groin. They began to appear even in a state of calm. There may be obvious flaws. Morning stiffness syndrome appears periodically in the morning. We will talk about how to treat stage 2 hip joint coxarthrosis further. |
| Third | The third stage is when the disease is already very advanced. Almost no cartilage left. Radiographic images show a strong thread -like narrowing in the gap between the joints. Pain at this stage is permanent and is eliminated only with the help of medications. At the same time, the patient is very constrained in his movements and to move he needs a cane or crutches, 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 osteoarthritis of the hip joint: conservative methods or surgical intervention. |
| Fourth | The fourth stage is the most neglected and one cannot do it without surgical intervention. Accompanied by severe pain in the joint area. Such joints are almost gone, 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 joints. |
With the type of coxarthrosis seems to have been understood. Now, a few words about this type of 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 coxarthrosis is unilateral. If the joints on both sides of the hip bone are affected, then they are talking about bilateral arthrosis.
But there is another no less popular classification, which marks a disease based on its cause. There are 7 types here:
- Changes in joints and cartilage with a person’s age are what is called involuntary coxarthrosis.
- Coxarthrosis is caused by a complication of Perthes disease. As a result, necrosis of the sponge tissue that covers the head of the femoral bone.
- Congenital defects in a joint or joints are called dysplastic coxarthrosis. A relatively common occurrence, according to doctors, every tenth case is the result of congenital subluxation of the femoral head or what is called dysplasia.
- Complications after arthritis or post -infectious coxarthrosis.
- Post -traumatic coxarthrosis. It is the result of improper constant load on the joints, which leads to microtraumas, and they, in turn, slowly destroy cartilage tissue.
- The next risk group includes people taking antidepressants and corticosteroid medications, as well as others who have any hormonal disorders. This type is called dishormonal arthrosis.
- Well, if it is not possible to determine the cause of the disease, then you are diagnosed with idiopathic coxarthrosis.
Methods of Treatment
There are many treatment methods for hip arthrosis, but the disease cannot be completely cured. All treatments can be divided into three stages.
- Prevention or prevention of disease.
- Early stage treatment (first and second).
- Advanced treatment (third and fourth).
Conservative treatment
This includes treatment of the first and second stages of the development of coxarthrosis. As already mentioned, this disease is incurable, you can only eliminate everything that leads to a constant increase in load on the joints. The moderate load that will develop the joint will not be excessive. This includes light loads, for example, therapeutic exercises, swimming, cycling, etc. Such exercises will help not only develop the joint, but also keep it in good condition.
Equally important is weight correction, with its advantages, as well as proper nutrition. You also need to maintain adequate sleep and rest. Massages, both special and self-massage, will also help. In the second stage, with an increase in pain, it is necessary to take non-steroidal anti-inflammatory drugs. Well, if the disease progresses and reaches grade 3, it can also be treated without surgery, but you don’t have to insult with a cane or crutches to relieve the extra load on the pelvis.
Surgery
The treating physician can decide on a surgical intervention that is already in the third stage to cure arthrosis of the hip joint. There are 4 types of operations performed:
- Arthroplasty - cartilage modeling of the joints is performed. With its help, you can almost completely restore joint function.
- Osteotomy is a bone surgery, performed in such a way as to completely remove the deformed area and not change the shape of the normal tissue.
- Arthrodesis - joints are fastened to the bone with the help of special plates and screws. More radical methods of intervention. After that, the joint remains immobile.
- Endoprosthetics is a complex operation on the hip joint. Honestly, this is not an operation on the joint, but its complete replacement with a prosthesis, which is made based on the anatomical features of the patient. Therefore, complete or partial replacement is carried out, which is why it is possible to cure coxarthrosis. The success rate is about 70%. What procedures take place before surgery, and how to heal yourself from a psychological point of view after surgery, we will tell in the next article.
Prevention
Many people think that arthrosis in the elderly is not treated at all, but if it is treated in a timely manner at an early 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 him in advance. These include controlling excessive stress on the joints, maintaining an active lifestyle, controlling diet and weight. Normal sleep and rest are also important. You can go for a regular massage treatment. Regular intake of chondroprotectors is recommended.