As you know, the largest joint in our body is the hip. It takes almost all the load while walking. But also, he is quite often exposed to diseases such as arthrosis or coxarthrosis. What is osteoarthritis of the hip 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, you need to dig a little into the structure of the hip joint itself. It itself has the form of a "pendant" and its function is to connect to the femoral pelvis. Clamping occurs with the help of a spherical head, which is embedded in the cavity in the hip bone. Both the surface of the head and the surface of the cavity are covered with cartilage. They perform absorbent functions and protect against wear.
So, a violation of the structure of these cartilages becomes the cause of arthrosis that contributes to the development. That is, the elastic and stable cartilage, due to some internal or external factors, dries up, hardens and its surface becomes rough and not smooth. Such a structure interferes with normal functioning and leads to a 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 this later.
In advanced stages, the bone deforms so much that 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 - the destruction of the complete or partial integrity of the joint surface. It is also important to understand that the concepts of arthrosis, coxarthrosis and osteoarthritis are practically the same. Only that arthrosis is a broader definition, and the other two are one and the same and they apply only to the hip joint.
Causes of manifestation
According to doctors, there can be many reasons for the occurrence 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 its elasticity and elasticity and can deform.
- Violation of the hormonal background. Such a violation can easily cause inflammation of the joint tissues.
- Age. In 70% of cases, arthrosis occurs in people over 40 years old. It's all about the body aging naturally and maintaining, for the most part, a sedentary lifestyle as you age.
- Injuries. Joint injury leads to cartilage thinning or even deformation, and this is an inevitable joint before the hip.
- Overweight. Sign - too much 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.
- Large loads. Athletes are in this risk category.
- A simple blood circulation disorder. For one reason or another, blood circulation in the human body can fail. So, in the periarticular tissues, after metabolism, a lot of waste accumulates and this leads to the production of enzymes, but they, on the other hand, destroy the cartilage tissue.
- Hip diseases. Another quite common cause of coxarthrosis. The thing is that incorrect or premature treatment of any other disease of the hip (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 is thinking about treating osteoarthritis of the hip joint grade 1. Symptoms include stiffness and discomfort in the hip joint in the morning, right after waking up. The 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 the most advanced stages, the disease already begins to annoy completely, even during rest, and everyone thinks which doctor treats coxarthrosis in order to contact him in time. Further, 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 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 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 muscle atrophy, begins the deformation of osteoarthritis of the hip joint. The length of the legs can also vary. There is an obvious limp. Here, conservative treatment of coxarthrosis of the 3rd degree will no longer help. The last stage is the complete loss of the ability to walk.
Diagnosing
To correctly diagnose and treat osteoarthritis of the hip joint, you should consult a doctor. So which doctor treats arthrosis of the hip joint without surgery? You should contact a rheumatologist or orthopedic traumatologist. The diagnosis will begin with questioning the patient, that is, what hurts, 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, extend and rotate the lower limb. In addition, the patient may be asked to walk to assess the external configuration of the joint.
However, a clinical blood test can confirm the diagnosis more accurately. Here, the sedimentation rate of erythrocytes will increase significantly, namely from 30 mm / hour and more. An increase in globulins, seromucoids, immunoglobulins and c-reactive protein are also symptoms of coxarthrosis. To determine their level, a biochemical blood analysis is needed. But while such tests are not enough to prescribe treatment for coxarthrosis of the hip joint.
A mandatory event is radiography. But here slips an important minus - only bones and bone seals are visible in the photo, cartilage and soft tissues are not visible. Thus, diagnosis at 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 say how to treat arthrosis of the hip joint. But all these procedures will become unnecessary if you have doa or deforming arthrosis of the hip joint of the 4th degree. After all, the disease will be visible to the naked eye, and prevention of arthrosis 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.
| diploma | Description |
|---|---|
| First | Osteoarthritis of the hip joint of the first degree is easy to overlook. Its symptoms are repeated pain in the hip joint after prolonged physical exertion. The pain goes away as soon as the load stops. X-rays will show only mild narrowing of the inter-articular space. If you orient yourself in time, then the disease can be easily prevented. |
| Secondly | Osteoarthritis 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 begin to manifest even in a state of calm. There may be noticeable limping. Morning stiffness syndrome occurs periodically in the morning. We will talk further about how to treat coxarthrosis of the hip joint of the 2nd degree. |
| Third | The third stage is when the disease is already very advanced. There is almost no cartilage left. The radiograph shows a thread-like narrowing of the gap between the joints. The pains in this stage are permanent and can only be eliminated with the help of medication. At the same time, the patient is very limited in his movements and in order to move 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 osteoarthritis of the hip joint: conservative methods or surgical intervention. |
| Fourthly | The fourth stage is the most neglected and cannot be done without surgical intervention. It is accompanied by severe pain in the joint area. This joint as such is almost gone, 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 the types of coxarthrosis it seems to be 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 the number of affected joints - 1 or 2. Everything is simple here, if 1, then they say that coxarthrosis is unilateral. If the joints on both sides of the thigh bone are affected, then they speak of bilateral arthrosis.
But there is another no less popular classification, which indicates a disease based on the causes of its occurrence. Here are 7 types:
- The change of the joint and cartilage with the age of a person 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 femur bone.
- Congenital maldevelopment of a joint or joints is called dysplastic coxarthrosis. A fairly common occurrence, according to doctors, every tenth case is the result of congenital subluxation of the femoral head or so-called dysplasia.
- Complications after post-infectious arthritis or coxarthrosis.
- Posttraumatic coxarthrosis. It is a consequence of a constant wrong load on the joints, which leads to microtraumas, and they, in turn, slowly destroy the cartilage tissue.
- The other risk group includes people who take antidepressants and corticosteroid drugs, as well as others who suffer from any hormonal disorder. This type is called dihormonal arthrosis.
- Well, if it is not possible to determine the cause of the disease, then you have been diagnosed with idiopathic coxarthrosis.
Methods of Treatment
There are many treatment methods for arthrosis 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 eliminate everything that leads to a constantly increasing load on the joints. Moderate loads that will develop the joint will not be excessive. 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 condition.
Equally important is weight correction, with its excess, as well as proper nutrition. You should also take care of enough sleep and continuous rest. Massages, both special and self-massages, 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 need to despise a stick or crutches to relieve the extra load on the pelvis.
Surgery
The attending physician may decide on a surgical intervention already in the third stage to cure arthrosis of the hip joint. There are 4 types of operations performed:
- Arthroplasty - modeling of the cartilage in the joint is performed. With its help, you can almost completely restore the functionality of the node.
- Osteotomy is a bone dissection, which is performed in such a way as to completely eliminate the deformed areas and not deform the 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 that, the joint remains stationary.
- Endoprosthetics 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 made according to the anatomical features of the patient. Thus, a complete or partial replacement is performed, therefore it is possible to cure coxarthrosis. The success rate is approximately 70%. What procedures are carried out before the operation and how to cure yourself from a psychological point of view after the operation, we will tell you in the next article.
prevention
Many people think that arthrosis in the elderly is not treated at all, but if it is treated in time at an early age, then it can be cured. This is not true. Since coxarthrosis can be cured only in the case of arthroplasty, it is better to warn it in advance. This includes controlling excessive stress on the joints, maintaining an active lifestyle, controlling nutrition and weight. Normal sleep and rest are also important. You can go for regular massage treatments. Regular intake of chondroprotectors is recommended.