One of the most serious pathologies in the musculoskeletal system is coxarthrosis of the hip joint. If the visit to a medical institution is delayed, the disease can progress - until the onset of acute pain syndrome, which cannot be relieved with analgesics and the 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 degenerative-dystrophic disease of the hip joint in a severe form, which can cause a violation of the functional capacity of the joint, up to its complete loss. In terms of frequency of occurrence, coxarthrosis is in second place after deforming arthropathy 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 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 condition in the hip joint. In the elderly, this pathology manifests itself in the context of age-related 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 occur against a background of congenital inferiority of the hip joint, degenerative-dystrophic changes, trauma, inflammatory processes, necrosis of the bone marrow of the femoral head, metabolic disorders, genetic factors, age-related changes, obesity, vascular anomalies 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 synovial fluid increases, which causes the appearance of microcracks and leads to dehydration of the cartilage surface. This, in turn, contributes to the appearance of creasing and limited mobility. A person feels such unpleasant manifestations during everyday 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.
Currently, there are 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 maintained and to relieve pain, it is enough to take medication.
- Second. When a patient is diagnosed with coxarthrosis of the hip joint in stage 1, the disease does not cause much discomfort, but when it comes to stage 2 of the disease, the symptoms become more intense. The pain becomes more intense and begins to radiate to other parts of the body. The motor ability deteriorates significantly, which is especially noticeable after prolonged walking or increased physical effort.
- Third. If coxarthrosis of the hip joint of the 2nd degree is still treatable, 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, atrophy of cartilage and muscle 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-related changes. The pathological process is also divided into several types, depending on the source of occurrence:
- Primary coxarthrosis. This pathology manifests itself in the hip area and is acquired. In the initial stage, it affects the joint capsule, after which it passes to the area of the tissues surrounding the joint. Risk factors include increased pressure on the pelvic bones, excessive physical activity, and the presence of inflammatory foci in the lower extremities and spine. Degenerative lesions are concentrated in tissues that have already undergone changes.
- Secondary coxarthrosis. This abnormality is hereditary. It manifests itself in the joints and the musculoskeletal system. The development of the pathological process can begin already in the uterus after an injury to a woman, as well as against the background of necrosis of the bone marrow of the femoral head.
Types of coxarthrosis due to appearance:
- Post-infectious. The presence of consequences after infectious diseases was detected.
- Post-traumatic. Diagnosed in case of complications after limb injury.
- Dysharmonic. It occurs against a background of metabolic disorders or drug overdose.
- Cohesive. It occurs in people over 50 years old due to the aging of the body.
Diagnostic measures
If you suspect a grade 1 or 2 coxarthrosis of the hip joint, before starting treatment, you should have a full body examination. It is also important to consult an orthopedic doctor, 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:
- X-ray. It allows you to study the parameters of the gap between the cartilages, diagnose the presence of pathological growths, and also assess the condition of the femoral head.
- Ultrasound. It makes it possible to monitor the etiology of changes in bone structures and ligaments, as well as to study the dynamics of the patient's condition and determine the degree of development of the abnormality.
- CT. It allows you to get more detailed information about the condition of the joints and tissues located in close proximity to them.
- 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 has been diagnosed with coxarthrosis of the hip joint of 1 or 2 degrees, it is possible to achieve effective results with conservative methods. Such treatment is prescribed to the patient individually and covers various techniques, which only together give a positive result. Thus, if a patient is diagnosed with a coxarthrosis of the hip joint of 1 or 2 degrees and the corresponding symptoms are observed, the following measures may be recommended:
- Medication use?
- Physiotherapy procedures?
- Shockwave therapy?
- Physiotherapy.
To achieve positive dynamics with the use of conservative methods, the causes that caused the appearance of coxarthrosis of the hip joint should be eliminated. First of all, you should reduce body weight, which will reduce the load on the joint and minimize the possibility 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 (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 advised to take the following drugs:
- Non-steroidal anti-inflammatory drugs. These drugs allow you to have a double effect: relieve pain and eliminate the inflammatory process.
- Preparations containing chondroitin, glucosamine and collagen. They allow you to activate the restoration processes in the cartilage.
- Steroid hormones. Drugs with strong anti-inflammatory action. 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 nutrition of tissues 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 affected structures.
In case of severe pain, it is also recommended to perform peri-articular blocks. They are only performed under the supervision of specialist professionals in a clinical setting. In this case, special solutions with steroid hormones and anesthetics are injected into the joint.
Exercise for coxarthrosis of the hip joint
Particularly effective in restoring motor function and reducing muscle spasm are special exercises recommended for coxarthrosis of the hip joint. Due to the optimally selected load, it is possible to relieve pain and increase the range of motion. In addition, a properly assembled 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 to the affected area and allows you to speed up the recovery processes.
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 specific analgesic, anti-inflammatory and decongestant effect. They also help maintain muscle tone in the extremities, preventing atrophic processes.
For abnormalities of the hip joint, the following procedures are performed:
- UHF?
- Laser exposure?
- Ultrasound therapy?
- Magnetic therapy?
- Exposure to direct current in combination with drugs.
- Paraffin therapy?
- Voicing.
The above treatment will have a positive effect only if the patient has been diagnosed with coxarthrosis in the early stages.
Shock wave therapy for coxarthrosis
For coxarthrosis of the first or second stage, shock wave therapy provides significant positive dynamics. For example, a course of 10-15 shock wave treatment procedures can reduce the negative manifestations that characterize stage 2 pathology in places of the initial stage of the disease.
It is important to understand that only timely treatment sessions can provide the best rehabilitation result. At the same time, it will be possible to reduce the number of SWT processes.
However, the main positive aspect when attacking 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 various structures of the hip joint.
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 synovial tissues and prevent regeneration.
The clinics are staffed by physiotherapists and neurologists with professional experience. They are fluent in working with the latest physiotherapy methods, which include the shock wave method. In addition, specialists have the opportunity to work with modern equipment. This provides a guaranteed positive result and allows you to shorten the treatment period.
Surgery
Unfortunately, many patients delay contacting a medical facility and visit 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 mobility and eliminate acute pain, that is, it will significantly improve the patient's quality of life.
As a rule, surgery is prescribed in the following cases:
- Painful sensations of increased intensity that cannot be relieved by medication.
- Lack of inter-articular space.
- Violation of the integrity of the femoral neck.
- Significant limitation of physical activity.
Taking into account the intensity of joint damage and changes in bone tissue, patients can be prescribed the following types of interventions:
- Arthrodesis. Intervention that creates complete immobility of the joint. For this purpose, special metal plates are used.
- Osteotomy. A surgical procedure consisting of an artificial fracture of the femur with the aim of straightening its axis. The resulting parts are placed in the most optimal position, which allows you to remove the excess load from the affected joint.
- Arthroplasty. The only method through which it is possible to restore all 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 surgeries in the area of the hip joint of any complexity. They are carried out by qualified specialists using modern tools and technology, which eliminates any errors during the intervention.
Complications of the disease
When the pathological process is at 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. In addition, 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 limb.
Preventive actions
Patients with hip joint pain should be monitored by a specialist and use special orthopedic devices when performing work and physical activity. In addition, after surgery, it is necessary to undergo X-rays 3 times a year to monitor the condition of the joint.