Coxarthrosis is a disease of the hip joints caused by changes in the structure of the tissues in them.Another name for this disease is arthrosis, or osteoarthritis, of the hip joint.
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 complete, so any damage caused to it affects the condition of the tissue in the future.The condition of the cartilage is also influenced by joint fluid, which serves to lubricate the tissues.Due to inadequate lubrication and increased friction, the articular cartilage becomes thin and eventually completely destroyed.The absence of cartilage increases the load on the surface of the bones, causing friction between the bones and causing changes in their shape and position, causing pain.
Most often, people suffer from coxarthrosis in old age, because by this time the function of cartilage tissue is 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:
- receiving various injuries and fractures;
- Congenital defect in the hip joint (congenital hip dislocation);
- The presence of inflammatory processes in the hip area;
- rheumatoid arthritis (a connective tissue disease that destroys joint cartilage);
- Aseptic necrosis of the femoral head (death of the femoral head).
Stages of coxarthrosis
In medical practice, coxarthrosis has 4 stages:
Step 1
It is characterized by the presence of periodic pain in the joints.Pain occurs when you begin to walk after a state of rest, but the pain goes away in the process of resuming strenuous activity.Pain does not appear in a calm state.Joint mobility is not impaired.X-rays show slight growth of bone and slight narrowing of the joint space.
Step 2
The occurrence of pain during moderate physical activity as well as at rest.Appearance of lameness during prolonged walking.Pain may appear in the knee or lower back.X-ray shows: change 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.
step 3
There is persistent pain, regardless of physical activity, in both active and quiet states.Pain can cause insomnia.Due to limited mobility of 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 deformity of the femoral head.The joint space is practically absent.Physical condition is extremely limited.The patient may be recognized as disabled.
step 4
The patient experiences unbearable pain at rest.Any movement causes extreme pain, the patient becomes unable to move with support (crutches, cane).The only method of treatment for coxarthrosis is surgical.
Causes of coxarthrosis
The appearance of coxarthrosis is influenced by many reasons, but the most important is impaired blood circulation in the hip area.Due to improper blood circulation, the metabolism in the joints slows down, and this causes the leg muscles to gradually weaken.
Other causes of coxarthrosis are:
- sedentary lifestyle;
- Subtle trauma that does not cause pain to the patient;
- endocrine disorders;
- Changes in joint surfaces due to age;
- increased load on the joints (often found in athletes);
- Inflammatory and infectious processes in the joints;
- deformities of the foot (flat feet) and spine (scoliosis);
- Obesity (increased load on joints due to excess weight) and other reasons.
The exact causes of the disease are determined for a particular patient, taking into account the state of health of the whole organism.
Symptoms of coxarthrosis
Costrarthrosis affects men and women after the age of 40.Women experience more painful symptoms.
Symptoms of coxarthrosis are:
- Pain in the hip joint (occurs from time to time and is aching in nature);
- Uneven, uncertain gait (limping);
- presence of crunch 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 presence of thigh muscle atrophy (the volume and tone of the muscles changes, 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 differentiate 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.
Treatment methods for coxarthrosis include:
- therapeutic exercises and massage;
- Physiotherapy;
- ozone therapy;
- cryotherapy;
- treatment with medicines;
- 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 to strengthen muscles and improve blood circulation.Morning exercise not only wakes up the body after sleep, but also increases synovial fluid from the lower parts of the joint.Synovial fluid lubricates the cartilage tissue with essential nutrients, which increases the cartilage's resistance to stress throughout the day.
However, physical exercises for coxarthrosis should be selected wisely.Too sudden and forceful movement can cause severe pain and injure the joint.It is advisable to visit the pool, as swimming strengthens the muscles, relieves stress on the joints and does not cause injuries.
Massage for coxarthrosis is a very effective and safe method.It improves blood circulation, strengthens muscles, relieves painful cramps, inflammation and muscle tension.During massage of the hip joint, lower back and back the muscles relax, allowing the synovial fluid to be distributed throughout the cartilage.
physiotherapy
Physiotherapy combines different methods:
- electrotherapy;
- UHF therapy;
- ultrasound therapy;
- laser therapy;
- Paraffin Therapy, etc.
All these procedures are aimed at improving blood circulation, relieving spasms and swelling, this is due to the fact that access to the hip joint is limited.
drug treatment
There are several medications that have 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 method.However, this is a misconception as the healing properties of such medicines do not reach them due to the deep location of the hip joint.They only help to temporarily improve blood circulation and relieve cramps.The causes of coxarthrosis have not been eliminated, and the disease is gradually developing into a more complicated 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 drugs, side effects appear that negatively affect the internal organs (gastritis).These medications do not restore the cartilage tissue needed for normal joint function.
- muscle relaxants(Medicines 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 medications,Intra-articular hormonal injections help with concomitant diseases, for example, in case of inflammation of the tendons of the femur.They have side effects and short-term therapeutic effects.
- 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 articular circulation and help deliver nutrients needed by the cartilage tissue.When used correctly, vasodilator drugs provide a significant therapeutic effect.However, the effectiveness of treatment is affected by the individual tolerance of the drugs.
- Chondroprotectors(Medicines that restore cartilage).They are the most effective modern drugs, as they affect the restoration of cartilage tissue and nourish it with the necessary substances.It is possible to prevent the development of coxarthrosis with regular use of chondroprotectors.A positive result appears over time, and after the cessation 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 cartilage tissue, impossibility of its restoration and immobility of the joints.In some cases, the only possible way to restore a person's ability to walk without pain is surgery.
Endoprosthetics is an operation to remove the affected joint and replace it with an artificial analog, endoprosthesis.The shape of the endoprosthesis resembles a real joint, it performs all the functions of the joint and can withstand heavy loads during walking, running, etc.
endoprosthesis service life
Like anything, endoprostheses have their own service life.Wear of endoprostheses depends on load and mobility.Being overweight increases the load significantly, and the service life of the prosthesis will be about 10 years.With moderate loads and mobility, the endoprosthesis will last about 15 years.There are also models of prostheses that have a service life of 20-25 years, but their main disadvantage is their high cost.
After the endoprosthesis wears out, another operation is necessary to replace it.However, replacement of the prostheses is complicated by the fact that the hip bone becomes thinner over time and problems arise in fixing the prostheses.Therefore, it is necessary to use conservative treatment methods as long as possible, avoiding repeated endoprosthetics.
It is worth mentioning the risks of hip replacement – the number of deaths after surgery is 1-2%.
Rehabilitation after endoprosthetics
Joint replacement surgery is quite complex and will take time to restore lost mobility.The recovery period includes body strengthening methods: massage, gymnastics and breathing exercises.The volume and complexity of the load 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, as their properties contribute to the restoration of cartilage tissue.
The rehabilitation period lasts about 6 months.The patient remains under observation in the hospital for 5 to 10 days.Then a set of rehabilitation measures is carried out aimed at strengthening the hip muscles.First, the patient will have to walk with the help of crutches, then with the help of a stick and finally on his own without any support.
At the end of the rehabilitation period, the patient gets back his lost ability to work and enjoy easy gait!
Coxarthrosis prevention
To prevent coxarthrosis it is necessary:
- Follow an active lifestyle (exercise in the morning, take a short walk);
- Do not engage in sports professionally;
- Maintain a balanced diet, as this helps avoid weight gain, which puts additional stress on the joints;
- Take a course of chondroprotectors once every 1-2 years after 40 years (in cases of coxarthrosis or familial tendency to joint injuries).