Coxarthrosis is a disease of the hip joints caused by a change in the structure of the tissues in them.The disease has another name - arthrosis of the hip joint, or osteoarthrosis.
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, so any damage to it affects the condition of the tissue in the future.The condition of the cartilage is also affected by the joint fluid, which performs the function of lubricating the tissues.Due to insufficient lubrication and increased friction, the articular cartilage thins and eventually falls off completely.The absence of cartilage leads to an increase in the load on the surface of the bones, friction occurs between the bones, and this leads to a change in their shape and position, which causes pain.
Most often, elderly people suffer from coxarthrosis, because by this time the functions of the cartilage tissue have been lost.
Types of coxarthrosis
In medicine, primary and secondary coxarthrosis are distinguished.
In the first case, the causes of the disease are unclear.
The following causes influence the development of secondary coxarthrosis:
- receiving various types of injuries and fractures;
- congenital defects of the hip joint (congenital hip dislocation);
- the presence of inflammatory processes in the thigh area;
- Rheumatoid arthritis (connective tissue disease that destroys joint cartilage);
- Aseptic necrosis of the femoral head (death of the femoral head).
Stages of coxarthrosis
In medical practice, there are 4 stages of coxarthrosis:
Stage 1
It is characterized by periodic pain in the joint.The pain occurs when you begin to move after a state of rest, but disappears during the process of resuming vigorous activity.In a calm state, pain does not appear.The mobility of the joints is not disturbed.X-rays show slight bone growth and slight narrowing of the joint space.
Stage 2
Occurrence of pain during moderate physical activity, as well as during rest.Appearance of lameness during long walks.The pain may appear in the knee or in the lower back.X-ray shows: changes in the shape of the femoral head, uneven bone contour, thickening of the bone neck, significant growth of bone tissue, 2-fold narrowing of the joint space.
Stage 3
Constant pain occurs regardless of physical activity, both active and at rest.Pain can cause insomnia.Due to the limited mobility of the joints, the person is forced to walk with support.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, and deformation of the femoral head.There is practically no shared space.Physical condition is strictly limited.The patient may be recognized as disabled.
Stage 4
The patient experiences unbearable pain at rest.Any movement causes extreme pain, the patient cannot move with support (crutches, crutches).The only method of treatment of coxarthrosis is surgery.
Causes of coxarthrosis
The appearance of coxarthrosis is influenced by many reasons, but the most important is a blood circulation disorder in the hip area.Due to improper blood circulation, the metabolism in the joints slows down and this leads to gradual atrophy of the leg muscles.
Other causes of coxarthrosis are:
- lifeless lifestyle;
- microtraumas that do 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 of the joints;
- foot (flat feet) and spine (scoliosis) pathologies;
- Obesity (increased load on the joint due to excess weight) and other reasons.
Taking into account the health condition of the whole organism, the exact causes of a specific patient's disease are determined.
Symptoms of coxarthrosis
Osteoarthritis affects men and women after 40 years.Women experience more painful symptoms.
Signs of coxarthrosis are:
- pain in the hip joint (occurs periodically and is painful);
- uneven, unsteady gait (lameness);
- the appearance of cramping in the joint;
- The mobility of the injured leg is limited (at the initial stage, one feels heaviness and stiffness in movements, fatigue and general weakness);
- The appearance of atrophy of the thigh muscles (the volume and tone of the muscles changes, which causes pain in the knee).
Diagnosis of coxarthrosis
To determine the diagnosis of coxarthrosis, it is necessary to carry out diagnostic procedures:
- examination of the patient by a specialist;
- conducting general and biochemical blood tests (allows us to identify inflammatory processes and distinguish arthritis from arthrosis);
- X-ray (used to detect damage and changes in bone tissue);
- Magnetic resonance imaging of the joint (detects slight changes in the cartilage tissue).
Treatment of coxarthrosis
Specialists use medical procedures and medicines to treat the disease.
Coxarthrosis treatment methods include:
- therapeutic exercises and massage;
- physiotherapy;
- ozone therapy;
- cryotherapy;
- treatment with drugs;
- surgical treatment, etc.
In specialized clinics, an individual coxarthrosis treatment program is selected for each patient, taking into account his age, concomitant diseases, and coxarthrosis stage.An individual approach helps the patient recover as quickly as possible.
Therapeutic exercise and massage
Exercise helps strengthen muscles and improve blood circulation.Morning exercises not only wake up the body after sleep, but also raise the synovial fluid from the lower parts of the joint.Synovial fluid moisturizes the cartilage tissue with essential nutrients, which increases the cartilage's resistance to stress throughout the day.
However, physical exercises during coxarthrosis should be chosen wisely.Very sudden and vigorous movements can cause severe pain and damage to the joint.It is recommended to go to the pool, because swimming helps to strengthen the muscles, relieves stress on the joint and does not cause injury.
Coxarthrosis massage is a very effective and safe method.Improves blood circulation, strengthens muscles, relieves painful spasms, swelling and muscle tension.During the massage of the hip joint, back and back, the muscles relax, due to which the synovial fluid is distributed over the cartilage.
Physiotherapy
Physiotherapy combines various methods:
- electrotherapy;
- UHF therapy;
- ultrasound therapy;
- laser therapy;
- paraffin therapy, etc.
All these procedures are aimed at improving blood circulation, relieving spasms and inflammation, this is due to the fact that access to the hip joint is limited.
Treatment with drugs
There are many medications that perform different functions in the treatment of coxarthrosis:
- Local medicines(ointments, compresses, lotions).Influenced by advertising, most patients think that treatment with various ointments and creams is the most effective way.However, this is a misconception, because the healing properties of such drugs cannot reach the hip joint due to its deep location.They only temporarily improve blood circulation and relieve spasms.The causes of coxarthrosis have not been eliminated, and the disease continues to gradually develop into a more complicated stage.
- Nonsteroidal 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 have a negative effect on internal organs (gastritis).These drugs do not restore cartilage tissue, which is necessary for the normal functioning of joints.
- Muscle relaxants(drugs that relax muscles).Improves blood circulation and relieves muscle tension around the joint.The effect of drugs is temporary, joint functions are not restored.
- Hormonal steroid drugs.Intra-articular hormonal injections help in the case of accompanying diseases, for example, in the case of inflammation of the tendons of the thigh bone.They have side effects and short-term therapeutic effect.
- Vasodilators.They are used to relax the smooth muscles of blood vessels, including luminal dilation, to relieve pain in small blood vessels, and to relieve night pain.Vasodilators also improve joint circulation and help deliver nutrients to cartilage tissue.When used correctly, vasodilator drugs provide a significant therapeutic effect.However, the effectiveness of the treatment is affected by the individual tolerance of the drugs.
- Chondroprotectors(drugs that restore cartilage).They are the most effective modern drugs, because they affect the restoration of cartilage tissue and feed 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 end of taking the drug, the cartilage restoration process will continue.
Surgical treatment of coxarthrosis
Surgical intervention is applied in case of significant destruction of cartilage tissue, impossibility of its restoration and immobility of 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 damaged joint and replace it with an artificial counterpart, endoprosthesis.The shape of the endoprosthesis resembles a real joint, it performs all the functions of the joint and withstands heavy loads during walking, running, etc.
Period of service of endoprosthesis
Like anything, endoprosthesis has its service life.Endoprosthesis wear depends on load and mobility.Excess weight significantly increases the load, and the service life of the prosthesis will be about 10 years.Endoprosthesis with moderate load and mobility will last about 15 years.There are also models of prostheses with a service life of 20-25 years, but their main disadvantage is their high cost.
After wearing the endoprosthesis, it is necessary to perform a second operation to replace it.However, replacing the prosthesis is complicated by the fact that the femur bone thins over time and the problem of fixing the prosthesis appears.Therefore, in order to prevent repeated endoprosthetics, it is necessary to use conservative methods of treatment as long as possible.
It is worth noting the risks of hip replacement - the number of deaths after surgery is 1-2%.
Rehabilitation after endoprosthetics
Joint replacement surgery is quite difficult and it will take time to regain the lost mobility.The recovery period includes methods that strengthen the body: massage, gymnastics and breathing exercises.The volume and complexity of the loads should be gradually increased so that the body adapts to all the changes.
A healthy diet also speeds up the healing process.It is recommended to include foods rich in phosphorus and phospholipids in the diet, as their properties help to restore cartilage tissue.
The rehabilitation period lasts about 6 months.The patient is under observation in the hospital for 5 to 10 days.Then a complex of rehabilitation measures is carried out, aimed at strengthening the thigh muscles.First, the patient will have to walk with crutches, then with a cane, and finally independently without any support.
At the end of the rehabilitation period, the patient returns to the lost work capacity and the joy of easy walking!
Prevention of coxarthrosis
To prevent coxarthrosis, it is necessary:
- maintaining an active lifestyle (doing morning exercises, short walks);
- do not engage in sports professionally;
- maintain a balanced diet, as this contributes to weight gain, which causes additional stress on the joints;
- Take a course of chondroprotectors every 1-2 years after the age of 40 (in case of family predisposition to coxarthrosis or joint damage).