Coxarthrosis is a disease of the hip joints caused by changes in the structure of the tissues contained therein.The disease has another name - arthrosis of the hip joint or osteoarthritis.
Coxarthrosis is a complex degenerative disease caused by changes in the cartilaginous tissue of the joint.Cartilaginous tissue cannot be restored after the formation of the human skeleton is completed, therefore, any damage to it will affect the condition of the tissue in the future.The condition of the cartilage is also affected by joint fluid, which performs the function of lubricating the tissues.Due to insufficient lubrication and increased friction, the articular cartilage becomes thinner and eventually wears out completely.The absence of cartilage causes an increase in the load on the surface of the bones, friction occurs between the bones, which leads to a change in their shape and position, leading to pain.
Most often, people in old age suffer from coxarthrosis, since by this time the functions of cartilaginous tissue have already been lost.
Types of Coxarthrosis
In medicine, primary and secondary coxarthrosis are distinguished.
In the primary case, the causes of the disease are unclear.
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 articular cartilage);
- aseptic necrosis of the femoral head (death of the femoral head).
Coxarthrosis stages
In medical practice, there are 4 stages of coxarthrosis:
Stage 1
Characterized by the appearance of periodic pain in the joint.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 impaired.The x-ray shows small bone growths and a slight narrowing of the joint space.
Stage 2
The occurrence of pain during moderate physical activity, as well as at rest.The appearance of lameness during prolonged walks.The pain may appear in the knee or lower back.The x-ray shows: changes in the shape of the femoral head, irregular bone contour, thickening of the bone neck, significant growth of bone tissue, narrowing of the joint space by 2 times.
Step 3
Constant pain occurs regardless of physical activity, both in an active and calm state.Pain can cause insomnia.Due to limited joint mobility, the person is forced to walk with support.The x-ray reveals a significant increase in the width of the bone neck and a decrease in its length in relation to normal, and 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 feels unbearable pain at rest.Any movement causes extreme pain, the patient is unable to move with support (crutches, cane).The only method of treating coxarthrosis is surgery.
Causes of Coxarthrosis
The appearance of Coxarthrosis is influenced by several reasons, but the most important is impaired 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;
- microtraumas that do not cause pain to the patient;
- endocrine disorders;
- changes in articular surfaces due to age;
- increased load on joints (more often found in athletes);
- inflammatory and infectious processes in the joints;
- foot pathologies (flat feet) and spine (scoliosis);
- obesity (increased load on the joint due to excess weight) and other reasons.
Taking into account the health status of the entire organism, the exact causes of the disease in a particular patient are determined.
Coxarthrosis symptoms
Cosarthrosis affects men and women after 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);
- irregular and uncertain gait (limping);
- the appearance of a crisis in the joint;
- the mobility of the injured leg is limited (at the initial stage, heaviness and stiffness in movements, fatigue and general malaise are felt);
- the appearance of thigh muscle atrophy (the volume and tone of the muscles change, causing knee pain).
Coxarthrosis diagnosis
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 you to identify inflammatory processes and distinguish arthritis from arthrosis);
- X-ray (used to detect damage and changes in bone tissue);
- MRI of the joint (detects small changes in cartilaginous tissue).
Coxarthrosis treatment
To treat the disease, specialists use medical procedures and medications.
Treatment methods for Coxarthrosis include:
- therapeutic exercises and massages;
- physiotherapy;
- ozone therapy;
- cryotherapy;
- medication treatment;
- surgical treatment, etc.
In specialized clinics, an individual treatment program for Coxarthrosis is selected for each patient, taking into account age, concomitant diseases and the stage of Coxarthrosis.An individual approach contributes to the patient's fastest recovery.
Therapeutic gymnastics and massage
Gymnastics helps to strengthen muscles and improve blood circulation.Morning exercises not only wake up the body after sleep, but also lift the synovial fluid from the lower parts of the joint.Synovial fluid lubricates cartilage tissue with essential nutrients, which increase cartilage resistance to stress throughout the day.
However, for Coxarthrosis, physical exercises must be selected wisely.Very sudden and vigorous movements can cause severe pain and joint injuries.It is recommended to go to the pool, as swimming helps to strengthen muscles, relieves stress on joints and does not cause injuries.
Massage for thigharthrosis 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, due to which synovial fluid is distributed throughout the cartilage.
Physiotherapy
Physiotherapy combines several 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.
Drug treatment
There are many medications that perform different 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 misconception because the healing properties of such drugs are not able to reach the hip joint due to its deep location.They help to only temporarily improve blood circulation and relieve spasms.The causes of Coxarthrosis are not eliminated and the disease continues to gradually progress to a more complex stage.
- Nonsteroidal anti-inflammatory drugs.They are used to eliminate inflammatory processes, relieve swelling and pain.As a result of prolonged use of non-steroidal medications, side effects arise that negatively affect internal organs (gastritis).These medications do not restore the cartilaginous tissue necessary for normal joint function.
- Muscle relaxants(drugs that relax muscles).Improve blood circulation and relieve muscle tension around the joint.The effect of the drugs is temporary, joint functions are not restored.
- Hormonal steroid drugs.Intra-articular hormonal injections help in the treatment of concomitant diseases, for example, in the case of inflammation of the femoral tendons.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 provide the necessary nutrients to the cartilage tissue.When used correctly, vasodilator medications provide a significant therapeutic effect.However, the effectiveness of treatment is affected by individual drug tolerability.
- Chondroprotectors(medicines that restore cartilage).These are the most effective modern medicines, as they affect the restoration of cartilaginous 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 end of taking the drug, the process of cartilage restoration will continue.
Surgical treatment of coxarthrosis
Surgical intervention is resorted to in case of significant destruction of cartilaginous tissue, the 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.
Endoprosthetics 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 during walking, running, etc.
Endoprosthesis useful life
Like anything, an endoprosthesis has its own useful 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.With moderate load and mobility, the endoprosthesis will last about 15 years.There are also prosthetic models whose useful life is 20 to 25 years, but the main disadvantage is the 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 repeated endoprosthetics, it is necessary to use conservative treatment methods for as long as possible.
It is worth highlighting the risks of hip arthroplasty - the number of deaths after surgery is 1 to 2%.
Rehabilitation after endoprosthetics
Joint replacement surgery is quite complex and will take time to restore lost mobility.The recovery period includes methods that strengthen the body: massages, gymnastics and breathing exercises.The volume and complexity of loads must be increased gradually so that the body gets used 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 contribute to the restoration of cartilage tissue.
The rehabilitation period lasts about 6 months.The patient is hospitalized for observation for 5 to 10 days.Next, a set of rehabilitation measures is carried out to strengthen the hip muscles.First the patient will have to walk with crutches, then with a cane and finally alone, without any support.
At the end of the rehabilitation period, the patient regains lost working capacity and the joy of easy walking!
Coxarthrosis prevention
To prevent thigharthrosis it is necessary:
- adhere to an active lifestyle (do morning exercises, take short walks);
- do not play sports professionally;
- maintain a balanced diet, as it helps to avoid weight gain, which causes additional stress on the joints;
- take a course of chondroprotectors once every 1-2 years after the age of 40 (in cases of family predisposition to coxarthrosis or joint injuries).