One of the most serious pathologies of the musculoskeletal system is coxarthrosis of the hip joint. If a visit to a medical institution is delayed, the disease may progress - up to the appearance of acute pain syndrome, which cannot be relieved by painkillers, and the complete loss of motor ability of the joint.
In this article we will talk in detail about all the nuances related to eliminating the consequences of this pathological process, its stages and preventive procedures.
What is coxarthrosis of the hip?
We are talking about a 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 absolute loss. In terms of frequency of manifestation, coxarthrosis comes in second place after deforming osteoarthritis 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 the cartilaginous tissue, synovial layer, subchondral bone plate, muscular structures, capsule and ligaments.
The following forms of the disease are also distinguished:
- Primary coxarthrosis. It is considered the most common condition of the hip joint. In older people, this pathology manifests itself against the background of age-related changes;
- Secondary coxarthrosis. Manifests itself as a result of any illness.
Causes of coxarthrosis
The development of pathology can be provoked by reasons of an external, acquired and hereditary nature.
In particular, coxarthrosis can manifest itself against the background of congenital inferiority of the hip joint, degenerative-dystrophic changes, trauma, inflammatory processes, bone marrow necrosis of the femoral head, disordersmetabolic factors, 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 joint fluid increases, which causes the appearance of microcracks and leads to dehydration of the cartilage surface. This, in turn, contributes to the appearance of crunches and limited mobility. A person experiences 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 neighboring structures.
Currently, there are 3 stages of development of the disease:
- First of all. At this stage, coxarthrosis of the hip joint has mild, inconsistent symptoms appearing in the affected area. At the same time, motor activity is preserved, and to relieve pain, it is enough to take medications;
- Second. When a patient is diagnosed with coxarthrosis of the hip at stage 1, the disease does not cause much discomfort, but when it comes to stage 2 of the disease, the symptoms become more pronounced. The pain becomes more intense and begins to radiate to other parts of the body. Motor ability deteriorates significantly, which becomes especially noticeable after prolonged walking or increased physical exertion;
- Third. If 2nd degree coxarthrosis of the hip 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 around without crutches. In the absence of appropriate therapeutic measures, atrophy of cartilaginous and muscular structures occurs.
Types of coxarthrosis
The classification of hip joint pathology is based on one criterion: how the disease appeared 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 at the hip and is acquired. At the initial stage, it affects the synovial capsule, after which it passes into the area of 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 modifications;
- Secondary coxarthrosis. This anomaly is hereditary. It manifests itself in the joints and musculoskeletal system. The development of the pathological process can begin already in the uterus after a woman has received an injury, as well as against the background of bone marrow necrosis of the femoral head.
Types of coxarthrosis due to their occurrence:
- Post-infectious. Identified in the presence of consequences after infectious diseases;
- Posttraumatic. Diagnosed with complications after limb injury;
- Dishormonal. Occurs against the background of metabolic disorders or drug overdose;
- Involutive. It appears in people over 50 years old due to the aging of the body.
Diagnostic measures
If you suspect grade 1 or 2 coxarthrosis of the hip joint, before starting treatment, you should conduct a complete examination of the body. It is also important to get a consultation with an orthopedic doctor, who will conduct an examination, give recommendations regarding laboratory tests and develop an effective treatment plan. As a rule, diagnostic measures are limited to the following procedures:
- X-ray. Allows you to study the parameters of the gap between cartilages, diagnose the presence of pathological growths, and also assess the condition of the femoral head;
- Ultrasound. Allows you to track the etiology of changes in bone structures and ligaments, as well as study the dynamics of the patient's condition and determine the degree of development of the anomaly;
- CT. Allows you to obtain more detailed information on the condition of the joints and tissues located in their immediate vicinity;
- MRI. This method provides a detailed picture of the condition of all structures in the hip joint.
Treatment of coxarthrosis of the hip joint
If the patient has been diagnosed with coxarthrosis of the hip of 1 or 2 degrees, it is possible to achieve effective results using conservative methods. Such therapy is prescribed to the patient individually and covers several techniques, which together give only a positive effect. So, if a patient is diagnosed with coxarthrosis of the hip joint of 1 or 2 degrees and the corresponding symptoms are observed, the following measures can be recommended:
- Use of medications;
- Physiotherapeutic procedures;
- Shock wave therapy;
- Physiotherapy.
To achieve positive dynamics using conservative methods, the causes that provoked the appearance of coxarthrosis of the hip joint must be eliminated. First of all, you need to reduce body weight, which will reduce the load on the joint and minimize the risk of further development of the degenerative-dystrophic process.
In addition, you should eliminate the consumption 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 help securely fix the joint and provide the necessary support during physical activity.
Drugs
Medications are also prescribed on an individual basis. Typically, patients are recommended to take the following medications:
- Non-steroidal anti-inflammatories. These drugs allow you to achieve a double effect: relieving pain and eliminating the inflammatory process;
- Preparations containing chondroitin, glucosamine and collagen. They enable cartilage restoration processes to be activated;
- Steroid hormones. Medicines with a strong anti-inflammatory effect. Used in situations where NSAIDs are not significantly effective;
- Muscle relaxers. Medicines that relieve muscle tone, a necessary condition for relieving pain of increased intensity;
- Means that normalize blood circulationand improve the trophism of tissues located 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 the affected structures.
In case of significant pain, it is also recommended to perform periarticular blocks. They are carried out only under the supervision of professional specialists in a clinical setting. In this case, special solutions containing steroid hormones and anesthetics are injected into the joint.
Gymnastics for coxarthrosis of the hip joint
Special exercises recommended for coxarthrosis of the hip joint are especially effective in restoring motor function and reducing muscle spasms. Thanks to the optimally selected load, it is possible to relieve pain and increase the range of motion. In addition, a correctly composed 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.
In addition, gymnastics for coxarthrosis of the hip joint helps to improve blood circulation in the affected area and allows you to speed up recovery processes.
When choosing exercises, the specialist must take into account the destruction of the hip joint and the physical condition of the patient.
Physiotherapeutic methods
Massage procedures and physiotherapy can provide a special analgesic, anti-inflammatory and decongestant effect. They also help maintain muscle tone in the limbs, thus preventing atrophic processes.
In case of abnormalities of the hip joint, the following procedures are performed:
- Ultra-high frequency;
- Laser exposure;
- Ultrasound treatment;
- Magnetotherapy;
- Exposure to direct electric current in combination with medications;
- Paraffin therapy;
- Phonophoresis.
The above treatment will have a positive effect only if the patient has been diagnosed with coxarthrosis in the primary stages.
Shock wave therapy for coxarthrosis
For coxarthrosis of the first or second stage, shock wave treatment provides significant positive dynamics. For example, a series of 10-15 shock wave therapy procedures can reduce the negative manifestations characteristic of stage 2 pathology to the signs of the initial stage of the disease.
It is important to understand that only timely treatment sessions can provide the best recovery effect. At the same time, it will be possible to reduce the number of SWT procedures.
However, the key positive aspect when impacting shock waves on the affected joint is the ability to normalize blood circulation, which facilitates the accelerated delivery of important nutrients involved in regeneration processes to various structures ofthe hip joint.
In addition, as part of the implementation of shock wave therapy, it is possible to crush pathological bone growths, which contribute to significant irritation of joint tissues and prevent their regeneration.
Physiotherapists and neurologists with professional experience operate in the clinics. They are fully versed in the latest physiotherapeutic methods, including the shock wave method. In addition, specialists have the ability to work with modern equipment. This provides a guaranteed positive effect and allows you to shorten the duration of treatment.
Surgery
Unfortunately, many patients delay contacting a medical institution and only consult a specialist when irreversible processes begin to occur in the hip joint.
For advanced third or fourth stages of the disease, the only effective method is surgery. It will restore motor ability and eliminate acute pain, i. e. significantly improve the patient's quality of life.
Typically, surgery is prescribed in the following situations:
- Painful sensations of increased intensity that cannot be relieved by medication;
- Lack of interarticular 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, the following types of interventions can be prescribed to patients:
- Arthrodesis. An intervention that creates complete immobility of the joint. For this purpose, special metal plates are used;
- Osteotomy. Surgical intervention which consists of an artificial fracture of the femur in order to straighten its axis. The resulting parts are placed in the most optimal position, which allows you to remove excessive load from the affected joint;
- Arthroplasty. The only method by which it is possible to restore the full functionality of the hip joint and achieve complete recovery of the patient. After using this method of eliminating coxarthrosis, a person forgets about joint problems for 20-30 years.
Medical centers carry out surgical interventions in the hip joint area, regardless of their complexity. They are carried out by highly qualified specialists using modern tools and technology, which eliminates any errors during the intervention.
Complications of the disease
When the pathological process is in an advanced stage, joint mobility is significantly limited, the person loses the ability to walk and take care of himself, and fusion of pathological tissues is observed. In addition, such an anomaly can have an adverse effect on gait, caused by the appearance of lameness and a decrease in the size of the limb.
Preventive actions
Patients suffering from pain in the hip joint should be observed by a specialist and use special orthopedic devices when performing work and physical activities. In addition, after surgery, it is necessary to undergo an x-ray 3 times a year to monitor the condition of the joint.