Coxarthrosis is a disease of the hip joints caused by changes in the structure of their tissues.The disease has another name: osteoarthritis of the hip joint or osteoarthritis.
Coxarthrosis is a complex degenerative disease caused by changes in the cartilage tissue of the joint.Cartilage tissue cannot be restored after the formation of the human skeleton is completed, so any damage affects the condition of the tissue in the future.The condition of the cartilage is also affected by joint fluid, which serves to lubricate the tissues.Due to insufficient lubrication and increased friction, the articular cartilage becomes thinner and eventually wears away completely.The absence of cartilage causes an increase in the load on the surface of the bones, friction occurs between the bones, which causes a change in their shape and position, causing the appearance of pain.
Most often, people in old age suffer from coxarthrosis, since at that time the functions of the cartilage tissue have been lost.
Types of coxarthrosis
In medicine, primary and secondary coxarthrosis are distinguished.
In the primary case, the causes of the disease are not clear.
The development of secondary coxarthrosis is influenced by the following reasons:
- receive various injuries and fractures;
- congenital defects in the hip joint (congenital hip dislocation);
- the presence of inflammatory processes in the hip area;
- rheumatoid arthritis (a connective tissue disease that destroys cartilage in the joints);
- aseptic necrosis of the femoral head (death of the femoral head).
Stages of coxarthrosis
In medical practice, 4 stages of coxarthrosis are distinguished:
Stage 1
It is characterized by the appearance of periodic pain in the joint.The pain occurs when you begin to move after a state of rest, but disappears in the process of resuming vigorous activity.In a calm state, pain does not appear.Joint mobility is not affected.The x-ray shows minor bone growths and slight narrowing of the joint space.
Stage 2
The appearance of pain during moderate physical activity, as well as at rest.The appearance of lameness during a long walk.Pain may appear in the knee or lower back.The x-ray shows: changes in the shape of the femoral head, uneven bone contour, thickening of the bone neck, significant growth of bone tissue, narrowing of the joint space 2 times.
Stage 3
Constant pain occurs regardless of physical activity, both in an active state and in a calm state.The pain can cause insomnia.Due to limited joint mobility, a person is forced to walk with support.The x-ray reveals a significant increase in the width of the neck of the bone and a decrease in its length compared to the norm, as well as a deformation of the femoral head.The joint space is practically absent.Physical condition is severely limited.The patient may be recognized as disabled.
Stage 4
The patient experiences unbearable pain at rest.Any movement causes extreme pain, the patient is unable to move with support (crutches, cane).The only method to treat coxarthrosis is surgical.
Causes of coxarthrosis
The appearance of coxarthrosis is influenced by many reasons, but the most important is the alteration of blood circulation in the hip area.Due to inadequate blood circulation, the metabolism in the joints slows down and this leads to gradual atrophy of the leg muscles.
Other causes of coxarthrosis are:
- sedentary lifestyle;
- microtrauma that does not cause pain in the patient;
- endocrine disorders;
- changes in joint surfaces due to age;
- increased load on the joints (most often found in athletes);
- inflammatory and infectious processes in the joints;
- pathologies of the foot (flat foot) and spine (scoliosis);
- obesity (increased load on the joint due to excess weight) and other reasons.
Taking into account the state of health of the entire organism, the exact causes of the disease in a particular patient are determined.
Symptoms of coxarthrosis
Cosarthrosis affects men and women from the age of 40.Women experience more painful symptoms.
Signs of coxarthrosis are:
- pain in the hip joint (occurs periodically and is painful in nature);
- uneven and unsteady gait (limping);
- the appearance of a crunch in the joint;
- the mobility of the injured leg is limited (in the initial stage, heaviness and stiffness in movements, fatigue and general malaise are felt);
- the appearance of atrophy of the thigh muscles (the volume and tone of the muscles change, causing pain in the knee).
Diagnosis of coxarthrosis.
To determine the diagnosis of coxarthrosis, it is necessary to undergo diagnostic procedures:
- examination of the patient by a specialist;
- Carrying out general and biochemical blood tests (allows us to identify inflammatory processes and distinguish arthritis from osteoarthritis);
- X-rays (used to detect damage and changes in bone tissue);
- Magnetic resonance imaging of the joint (detects minor changes in cartilage tissue).
Treatment of coxarthrosis
To treat the disease, specialists use medical procedures and medications.
Treatment methods for coxarthrosis include:
- therapeutic exercises and massages;
- physiotherapy;
- ozone therapy;
- cryotherapy;
- drug treatment;
- surgical treatment, etc.
In specialized clinics, an individual treatment program for coxarthrosis is selected for each patient, taking into account his age, concomitant diseases and the stage of coxarthrosis.An individual approach contributes to the patient's recovery as quickly as possible.
Therapeutic gymnastics and massage.
Gymnastics helps strengthen muscles and improve blood circulation.Morning exercises not only wake up the body after sleeping, but also raise the synovial fluid in the lower parts of the joint.Synovial fluid lubricates cartilage tissue with essential nutrients, which increase the cartilage's resistance to stress throughout the day.
However, in case of coxarthrosis, physical exercises should be selected wisely.Movements that are too sudden and vigorous can cause severe pain and damage the joint.It is recommended to go to the pool, as swimming helps strengthen muscles, relieves stress on the joint and does not cause injuries.
Massage for coxarthrosis is a very effective and safe method.Improves blood circulation, strengthens muscles, relieves painful spasms, swelling and muscle tension.During a massage of the hip joint, lower back and back, the muscles relax, so the synovial fluid is distributed throughout the cartilage.
Physiotherapy
Physiotherapy combines several methods:
- electrotherapy;
- UHF therapy;
- ultrasound therapy;
- laser therapy;
- paraffin therapy, etc.
All of these procedures are aimed at improving blood circulation, relieving spasms and inflammation, this is because access to the hip joint is limited.
Drug treatment
There are many medications that perform various functions in the treatment of coxarthrosis:
- Topical medications(ointments, compresses, lotions).Under the influence of advertising, most patients think that treatment with various ointments and creams is the most effective way.However, this is a mistake because the healing properties of these medications cannot reach the hip joint due to its deep location.They only temporarily help to improve blood circulation and relieve spasms.The causes of coxarthrosis are not eliminated and the disease continues to gradually develop into a more complex stage.
- Non-steroidal anti-inflammatory drugs.They are used to eliminate inflammatory processes, relieve swelling and pain.As a result of long-term use of non-steroidal drugs, side effects appear that negatively affect internal organs (gastritis).These medications do not restore the cartilage tissue necessary for normal joint function.
- muscle relaxants(medicines that relax the muscles).Improves blood circulation and relieves muscle tension around the joint.The effect of the medications is temporary, joint functions are not restored.
- Hormonal steroid medications.Intra-articular hormonal injections help in concomitant diseases, for example, in the case of inflammation of the tendons of the femur.They have side effects and a short-term therapeutic effect.
- Vasodilators.They are used to relax the smooth muscles of blood vessels, expand the lumen between them, relieve pain in small vessels and eliminate night pain.Vasodilators also improve joint circulation and help supply the nutrients needed by cartilage tissue.When used correctly, vasodilator drugs provide a significant therapeutic effect.However, the effectiveness of treatment is affected by the individual tolerability of the drugs.
- Chondroprotectors(medicines that restore cartilage).They are the most effective modern drugs, since they affect the restoration of cartilage tissue and nourish it with the necessary substances.With regular use of chondroprotectors, it is possible to stop the development of coxarthrosis.A positive result appears over time, and after the treatment is completed, the cartilage restoration process will continue.
Surgical treatment of coxarthrosis.
Surgical intervention is resorted to in case of significant destruction of cartilaginous tissue, impossibility of its restoration and immobility of the joints.In some cases, surgery is the only possible way to restore a person's ability to walk without pain.
Endoprosthesis is an operation to remove the affected joint and replace it with an artificial analogue, an endoprosthesis.The shape of the endoprosthesis resembles a real joint, performs all the functions of a joint and can withstand heavy loads when walking, running, etc.
Endoprosthesis useful life.
Like everything, a stent has its own useful life.Endoprosthesis wear depends on load and mobility.Excess weight significantly increases the load and the useful life of the prosthesis will be about 10 years.With moderate loading and mobility, the endoprosthesis will last about 15 years.There are also prosthesis models whose useful life is 20 to 25 years, but their main disadvantage is their high cost.
After the endoprosthesis wears out, a second operation is necessary to replace it.However, replacing the prosthesis is complicated by the fact that the hip bone becomes thinner over time and the problem of fixing the prosthesis arises.Therefore, to avoid repeat stenting, it is necessary to use conservative treatment methods for as long as possible.
It is worth mentioning the risks of hip replacement: the number of deaths after surgery is 1 to 2%.
Rehabilitation after endoprosthesis.
Joint replacement surgery is quite complex and will take time to restore lost mobility.The recovery period includes methods that strengthen the body: massage, gymnastics and breathing exercises.The volume and complexity of loads should be increased gradually so that the body gets used to all the changes.
Eating healthy also speeds up the healing process.It is recommended to include foods rich in phosphorus and phospholipids in the diet, since their properties contribute to the restoration of cartilage tissue.
The rehabilitation period lasts about 6 months.The patient remains in the hospital for observation for 5 to 10 days.Then a series of rehabilitation measures are carried out aimed at strengthening the hip muscles.First the patient will have to walk with crutches, then with a cane and finally on his own without any support.
At the end of the rehabilitation period, the patient regains the lost working capacity and the joy of walking calmly!
Prevention of coxarthrosis
To prevent coxarthrosis it is necessary:
- follow an active lifestyle (do morning exercises, take short walks);
- not playing sports professionally;
- maintain a balanced diet, as this helps prevent weight gain, which causes additional stress on the joints;
- take treatment with chondroprotectors once every 1-2 years after the age of 40 (in cases of family predisposition to coxarthrosis or joint injuries).