As you know, the largest joint in our body is the hip. Takes on almost the entire load while walking. But it is also quite often exposed to ailments such as osteoarthritis 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 of coxarthrosis, the treatment of which is extremely problematic, it is necessary to delve into the very structure of the hip joint a little. By itself 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 ball head, which is embedded in the hip bone cavity. Both the surface of the head and the surface of the cavity are covered with cartilage. They perform shock absorption functions and protect against wear.
Thus, a violation of the structure of these cartilages becomes the cause of arthrosis that contributes to 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. This 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 more on that later.
In advanced stages, the bone is so deformed that the patient loses the ability to walk. Summarizing all this, it is possible to formulate a definition of such a disease as osteoarthritis 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 and only apply to the hip joint.
Causes of manifestation
According to doctors, there may be some reasons for the appearance of coxarthrosis, but we will consider only the most common:
- Congenital pathologies. The most common are dysplasia (curvature) and congenital hip dislocation. They almost always cause grade 1 dysplastic coxarthrosis of the hip.
- hereditary predisposition. This is when this disease is quite common in your family.
- Passive lifestyle. With inactivity, the cartilage loses elasticity and elasticity and can deform.
- Violation of the hormonal background. Such a violation can easily cause inflammation of the tissues of the joint.
- Age. In 70% of cases, osteoarthritis occurs in people over the age of 40. It is about the natural aging of the body and the maintenance, for the most part, of a sedentary lifestyle with age.
- Injuries. Injury to the joint leads to thinning of the cartilage or even its deformation, and this is an inevitable pre-hip joint.
- Overweight. Sign - a lot of weight, which will constantly overload the hip joint. Such prolonged loads inevitably lead to wear of the cartilage, consequently, to 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. Hence, in the periarticular tissues, many residues accumulate after metabolism and this leads to the production of enzymes, but in turn they destroy the cartilage tissue.
- Diseases of the hip. Another fairly common cause of coxarthrosis. The fact is that incorrect or untimely treatment of any other hip disease (various infections or even necrosis of the femoral head) easily leads to the development of arthrosis.
Symptoms
Symptoms in the early stages of the disease are mild, so no one is thinking about the treatment of osteoarthritis of the 1st degree hip joint. Symptoms include stiffness and discomfort in the hip joint in the morning, right after waking up. Discomfort or pain is aggravated by physical exertion and weakens or disappears completely during rest. Patients often do not pay attention to such symptoms, but the prevention of coxarthrosis will not help here.
In the most advanced stages, the disease already begins to bother completely, even during rest, and everyone thinks about which doctor treats coxarthrosis to contact him in time. In addition, the joint begins to become inflamed, its mobility is lost, and the cartilage collapses, forming bone spurs. The pain does not subside even with a long rest, the movement is rather limited. Here you will need information on how to treat grade 3 coxarthrosis, which you can find from us.
Then comes the complete disappearance of the cartilage and the bones begin to rub against each other. It becomes quite difficult to move. As a result, inactivity, which leads to weakening or even atrophy of the muscles, begins to deform the osteoarthritis of the hip joint. The length of the legs can also change. There is an obvious lameness. Here, conservative treatment of 3rd degree coxarthrosis will no longer help. The last stage is the complete loss of the ability to walk.
Diagnostics
To correctly diagnose and treat osteoarthritis of the hip joint, you need to see a doctor. So which doctor treats hip joint osteoarthritis without surgery? It is necessary to contact a rheumatologist or an orthopedic traumatologist. The diagnosis will begin with an interrogation of the patient, i. e. what hurts, where exactly it hurts, how often the pain is felt, etc. To assess the strength of the pain, the doctor will perform several 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, i. e. from 30 mm / h and more. An increase in globulins, seromucoids, immunoglobulins and c-reactive protein are also symptoms of coxarthrosis. To determine their level, a biochemical blood test is required. But while such tests are not enough to prescribe treatment for hip joint coxarthrosis.
A mandatory event is radiography. But here slips a significant negative: in the photo only bones and bone seals are visible, cartilage and soft tissues are not visible. Therefore, the diagnosis of an early stage will be quite difficult. In this case, computed tomography will help to draw a complete picture, and already on its basis it will be possible to tell how to treat arthrosis of the hip joint. But all of these procedures will become useless if you have doa or deforming 4th degree hip joint osteoarthritis. After all, the disease will be visible to the naked eye, and the prevention of osteoarthritis and treatment without surgery will no longer be useful.
Grades and types
Based on the neglect and symptoms of the disease, 4 degrees of its manifestation can be distinguished.
| Level | Description |
|---|---|
| First | 1st degree hip joint osteoarthritis is easy to overlook. Its symptoms are recurrent pain in the hip joint after prolonged physical exertion. The pain disappears as soon as the load stops. The x-ray will show only a slight narrowing of the interarticular space. If you orient yourself in time, the disease can be easily prevented. |
| According to | Arthrosis of the hip joint of the 2nd 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 also begin to manifest themselves in a calm state. There may be an obvious lameness. Morning stiffness syndrome appears periodically in the morning. We will talk further about how to treat coxarthrosis of the 2nd degree hip joint. |
| Third | The third stage is when the disease is already very advanced. There is hardly any cartilage left. The radiographic image shows a strong filiform narrowing of the space between the joints. The pain at this stage is permanent and is eliminated only with the help of drugs. At the same time, the patient is very constrained in his movements and in order to move he needs crutches or a cane to lean on. 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 surgery. |
| Fourth | The fourth stage is the most neglected and one cannot do without surgical intervention. Accompanied by severe pain in the joint area. The joint as such has almost disappeared, the bones begin to grow together. The symptoms are the same as in the third stage, but there is no possibility of movement of the pelvic joint. |
With types of a coxarthrosis he seems to have understood. Now, a few words about the types of this disease. Hence, 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 one-sided. If the joints on both sides of the hip bone are affected, it is referred to as bilateral osteoarthritis.
But there is another no less popular classification, which denotes a disease according to the causes of its occurrence. There are 7 types here:
- The change in joint and cartilage with a person's age is the so-called involutive 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 one or more joints is called dysplastic coxarthrosis. A fairly common occurrence, according to doctors, every tenth case is the result of a congenital subluxation of the femoral head or the so-called dysplasia.
- Complication after post-infectious arthritis or coxarthrosis.
- Post-traumatic coxarthrosis. It is a consequence of an incorrect and constant load on the joint, which leads to microtraumas and these, in turn, slowly destroy the cartilage tissue.
- The next risk group includes people taking antidepressants and corticosteroid medications, as well as other people suffering from hormonal disorders. This type is called disharmonic osteoarthritis.
- Well, if it is not possible to establish the cause of the disease, then you are diagnosed with idiopathic coxarthrosis.
Methods of treatment
There are many methods of treatment for osteoarthritis of the hip joint, but the disease cannot be completely cured. All treatments can be divided into three phases.
- Disease prevention or prevention.
- Treatment of the early stages (first and second).
- Treatment of the 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 get rid of everything that leads to a constant increase in the load on the joint. The 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 also need to take care of sleep and rest constantly and sufficiently. Massages, both special and self-massage, will also help. In the second stage, with increased pain, it is necessary to take non-steroidal anti-inflammatory drugs. Well, if the disease progresses and reaches grade 3, it can be cured even without surgery, but it is not necessary to disdain with a cane or crutches to relieve the extra load on the pelvis.
Surgery
The attending physician can decide on surgery already in the third stage to treat osteoarthritis of the hip joint. There are 4 types of operations performed:
- Arthroplasty: modeling of the cartilage on the joint is performed. With its 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 as to completely eliminate the deformed areas and not to deform normal tissue.
- Arthrodesis - the joint is fixed to the bone with the help of special plates and screws. A more radical method of intervention. After it, 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 carried out in consideration of the anatomical features of the patient. Thus, a complete or partial replacement is performed, which is why it is possible to cure coxarthrosis. The success rate is around 70%. What procedures take place 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 cured at all, but if it is addressed in time at an early age, it can be cured. This is not true. Since it is possible to cure coxarthrosis only in case of arthroplasty, it is best to warn him in advance. This includes controlling excessive stress on the joint, maintaining an active lifestyle, and controlling nutrition and weight. Normal sleep and rest are also important. You can have regular massages. Regular intake of chondroprotectors is recommended.