One of the most serious pathologies of the musculoskeletal system is coxarthrosis of the hip joint. If a visit to a medical institution is delayed, the disease can progress - to the appearance of an acute pain syndrome, which cannot be alleviated by analgesics, and a complete loss of motor ability 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?
It is a degenerative-dystrophic disease of the hip joint in a severe form, which can cause impairment of the functional ability of the joint, up to its complete loss. In terms of frequency of manifestation, coxarthrosis ranks second 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.
That is, this pathology is characterized by damage to the entire joint, which covers the cartilage tissue, synovial layer, subchondral bone plate, muscle structures, capsule and ligaments.
The following forms of the disease also differ:
- Primary coxarthrosis. It is considered the most common disease in the hip joint. In older people, this pathology manifests itself against the background of age changes;
- Secondary coxarthrosis. It manifests itself as a result of any disease.
Causes of coxarthrosis
The development of pathology can be caused by reasons of an external, acquired and hereditary nature.
In particular, coxarthrosis can manifest against the background of congenital inferiority of the hip joint, degenerative-dystrophic changes, trauma, inflammatory processes, bone marrow necrosis of the femoral head, metabolic disorders, genetic factors, age changes, obesity, vascular abnormalities 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 crunching and limited mobility. A person 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 inconsistent and appear in the affected area. At the same time, motor activity is preserved, and it is enough to take medication to relieve pain;
- A second. When the patient is diagnosed with coxarthrosis of the hip joint in the 1st stage, the disease does not cause much discomfort, but when it comes to the 2nd stage of the disease, the symptoms become more pronounced. The pain becomes more intense and begins to spread to other parts of the body. Motor ability deteriorates significantly, which becomes especially visible after long-term walking or increased physical effort;
- Third. If coxarthrosis of the hip joint of the 2nd degree is still curable, in the third stage the pathology becomes chronic. It is accompanied by constant pain and is transmitted to the lower part of the body. The patient loses the ability to move without crutches. In the absence of appropriate therapeutic measures, cartilage and muscle structures atrophy.
Types of coxarthrosis
The classification of hip joint pathology is based on one criterion - how the disease originated in the musculoskeletal system. There are two main risk factors that can cause the disease - genetic and acquired due to age changes. The pathological process is also divided into several types, depending on the source of the phenomenon:
- Primary coxarthrosis. This pathology manifests itself in the hip area and becomes acquired. In the initial phase, it affects the synovial capsule, after which it moves to the tissue area 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 uterus after the woman receives an injury, as well as against the background of necrosis of the bone marrow of the femoral head.
Types of coxarthrosis due to occurrence:
- Post-infectious. It is identified in the presence of consequences after infectious diseases;
- Post-traumatic. It is diagnosed in the case of complications after a limb injury;
- Dyshormonal. Appears against the background of metabolic disorders or drug overdose;
- Involutive. It appears in people over 50 years old due to the aging of the organism.
Diagnostic measures
If you suspect grade 1 or 2 coxarthrosis of the hip joint, you should have a full body examination before starting treatment. Consultation with an orthopedist is also important, who will perform an examination, give recommendations for laboratory tests and create an effective treatment plan. Typically, diagnostic measures are limited to the following procedures:
- Radiography. It allows you to study the parameters of the gap between the cartilage, diagnose the presence of pathological growths, as well as assess the state of the femoral head;
- Ultrasonography. It enables monitoring the etiology of changes in bone structures and ligaments, as well as studying the dynamics of the patient's condition and determining the degree of development of the anomaly;
- CT. It allows you to get more detailed information about the condition of the joints and tissues located 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 is diagnosed with coxarthrosis of the hip joint of the 1st or 2nd degree, it is possible to achieve effective results with conservative methods. Such therapy is prescribed to the patient individually and includes several techniques that only together give a positive effect. Therefore, if the patient is diagnosed with coxarthrosis of the hip joint of the 1st or 2nd degree and if 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 conservative methods, it is necessary to eliminate the causes that caused the appearance of coxarthrosis of the hip joint. First of all, you should reduce your body weight, which will reduce the load on the joint and reduce the likelihood of further development of the degenerative-dystrophic process.
In addition, you should exclude the use of tobacco products and increase physical activity, avoiding excessive exertion. In order to prevent the progression of the pathology, experts advise the use of orthopedic devices (orthoses and bandages). They allow you to firmly fix the joint and provide the necessary support during physical activity.
Medicines
Medicines are also prescribed on an individual basis. As a rule, patients are recommended to take the following drugs:
- Nonsteroidal anti-inflammatory drugs. These drugs allow you to have a double effect: pain relief and removal of the inflammatory process;
- Preparations containing chondroitin, glucosamine and collagen. They allow you to activate the cartilage renewal processes;
- 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 improvement of tissue trophism 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 blockades. They are performed only under the supervision of professional specialists in a clinical setting. In this case, special solutions with steroid hormones and anesthetics are injected into the joint.
Gymnastics for coxarthrosis of the hip joint
Particularly effective in restoring motor function and reducing muscle spasm are special exercises that are recommended for performing in coxarthrosis of the hip joint. Due to 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 if pinched nerve endings are observed in the background of the disease.
Also, gymnastics for coxarthrosis of the hip joint helps 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 maintain muscle tone in the limbs, preventing atrophic processes.
For abnormalities of the hip joint, the following procedures are performed:
- UHF;
- Laser exposure;
- Ultrasound treatment;
- Magnetotherapy;
- Exposure to direct current in combination with medication;
- Paraffin therapy;
- Phonophoresis.
The above treatment will give a positive effect only if the patient is diagnosed with coxarthrosis in the primary stages.
Shock wave therapy for coxarthrosis
For coxarthrosis of the first or second stage, treatment with shock waves provides significant positive dynamics. For example, a course of 10-15 procedures of shock wave therapy can reduce the negative manifestations characteristic of the 2nd stage of the pathology to the signs of the initial stage of the disease.
It is important to understand that only timely treatments can provide the best recovery effect. At the same time, it will be possible to reduce the number of SWT procedures.
However, the key positive aspect of hitting the affected joint with shock waves is the ability to normalize blood circulation, which facilitates the accelerated supply of important nutrients involved in regenerative processes to the various structures of the hip joint.
Moreover, as part of the application of shock wave therapy, it is possible to crush pathological bone growths that contribute to significant irritation of joint tissues and prevent regeneration.
Physiotherapists and neurologists with professional experience work in the clinics. They work fluently with the latest physiotherapeutic methods, including the shock wave method. In addition, experts have the ability to work with modern equipment. This ensures a guaranteed positive effect and allows you to shorten the treatment period.
Operation
Unfortunately, many patients delay contacting a medical institution and go to a specialist only when irreversible processes begin to appear in the hip joint.
For advanced third or fourth stage disease, the only effective method is surgery. It will restore motor skills and eliminate acute pain, i. e. significantly improve the patient's quality of life.
As a rule, the operation is prescribed in the following situations:
- Painful feelings of increased intensity that cannot be alleviated by medication;
- Lack of interarticular space;
- Violation of the integrity of the neck of the femur;
- Significant limitation of physical activity.
Given the intensity of joint damage and changes in bone tissue, 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 consisting of an artificial fracture of the femur to correct 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 complete recovery of the patient. After using this method of eliminating coxarthrosis, a person forgets about joint problems for 20-30 years.
Medical centers perform surgical interventions in the area of the hip joint of any complexity. They are performed by highly qualified specialists using modern tools and technology, which eliminates any errors during the intervention.
Complications of the disease
When the pathological process is in an advanced stage, the mobility of the joints is significantly limited, the person loses the ability to walk and take care of himself, and pathological tissue fusion is observed. Moreover, such an anomaly can have an undesirable effect on gait, which is caused by the appearance of lameness and a decrease in the size of the limbs.
Preventive actions
Patients with pain in the hip joint should be supervised by a specialist and use special orthopedic devices when performing work and physical activity. In addition, after the operation, it is necessary to take radiographs 3 times a year in order to monitor the condition of the joint.