Coxarthrosis is a disease of the hip joints caused by changes in the structure of the tissues in them.The disease has another name - arthrosis 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 completion of 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 synovial fluid, which performs the function of lubricating 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, and this leads to a change in their shape and position, which leads to the appearance of pain.
Most often, people suffer from coxarthrosis in old age, as the functions of the cartilage tissue at this time have been lost.
Types of coxarthrosis
In medicine, a distinction is made between primary and secondary coxarthrosis.
In the primary case, the causes of the disease are unclear.
The development of secondary coxarthrosis is affected by the following reasons:
- receive various injuries and fractures;
- congenital defects of 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, 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 reduced.The X-ray shows less bone growth and a slight narrowing of the joint space.
Stage 2
The occurrence of pain during moderate physical activity, as well as at rest.The occurrence of lameness during prolonged walking.Pain may occur 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 by 2 times.
Stage 3
Constant pain occurs regardless of physical activity, both in an active and calm state.The pain can cause insomnia.Due to limited joint mobility, a 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 in comparison with the norm and deformation of the femoral head.The common room is practically absent.The physical condition is severely limited.The patient can 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 of treating coxarthrosis is surgical.
Causes of coxarthrosis
The appearance of coxarthrosis is influenced by many reasons, but the most important is reduced blood circulation 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:
- sedentary lifestyle;
- microtraumas that do not cause pain to 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 feet) and spine (scoliosis);
- obesity (increased load on the joint due to excess weight) and other causes.
Taking into account the state of health of the whole organism, the exact causes of the disease are determined for a particular patient.
Symptoms of coxarthrosis
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);
- uneven, unsteady gait (limping);
- the appearance of a crunch in the joint;
- the mobility of the injured leg is limited (in the initial phase, heaviness and stiffness in movements, fatigue and general malaise are felt);
- the appearance 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 distinguish arthritis from arthrosis);
- X-ray (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 massage;
- physical therapy;
- ozone therapy;
- cryotherapy;
- treatment with medication;
- 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 sleep, but also raise synovial fluid from the lower parts of the joint.Synovial fluid lubricates cartilage tissue with essential nutrients that increase the cartilage's resistance to stress throughout the day.
But for coxarthrosis, physical exercises should be chosen carefully.Too sudden and forceful movements can cause severe pain and damage the joint.It is recommended to go to the pool, as swimming helps to strengthen the muscles, relieves stress on the joint and does not cause damage.
Massage for coxarthrosis is a very effective and safe method.It improves blood circulation, strengthens muscles, relieves painful spasms, swelling and muscle tension.When massaging the hip joints, lower back and back, the muscles relax, whereby the synovial fluid is distributed throughout the cartilage.
Physiotherapy
Physiotherapy combines different methods:
- electrotherapy;
- UHF therapy;
- ultrasound treatment;
- laser therapy;
- paraffin treatment 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 drugs that perform different functions in the treatment of coxarthrosis:
- Current medicine(ointments, compresses, lotions).Under the influence of advertising, most patients believe 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 only temporarily help 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.
- 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 adversely affect internal organs (gastritis).These drugs do not restore the cartilage tissue necessary for normal joint function.
- Muscle relaxants(medicines that relax the muscles).Improve blood circulation and relieve muscle tension around the joint.The effect of the substances is temporary, joint functions are not restored.
- Hormonal steroids.Intra-articular hormone injections help with 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 articular circulation and help deliver nutrients needed by cartilage tissue.When used correctly, vasodilatory drugs provide a significant therapeutic effect.However, the effectiveness of the treatment is influenced by the individual tolerability of the drugs.
- Chondroprotectors(drugs 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.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 continues.
Surgical treatment of coxarthrosis
Surgical intervention is resorted to in case of significant destruction of cartilage 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, it performs all the functions of a joint and can withstand heavy loads during walking, running, etc.
Endoprosthesis lifetime
Like anything, an endoprosthesis has its own lifespan.Wear on the endoprosthesis depends on load and mobility.Excess weight significantly increases the load, and the lifespan of the prosthesis will be around 10 years.With moderate loading and mobility, the endoprosthesis will last around 15 years.There are also models of prostheses whose service life is 20-25 years, but their main disadvantage is their high cost.
After wear of the endoprosthesis, it is necessary to perform another operation to replace it.However, replacement of the prosthesis is complicated by the fact that the hip bone becomes thinner over time, and the problem of fixing the prosthesis arises.To avoid repeated endoprosthetics, it is therefore necessary to use conservative treatment methods for as long as possible.
It is worth mentioning the risks of hip replacement - the death rate 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 methods that strengthen the body: massage, gymnastics and breathing exercises.The volume and complexity of the 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, as their properties contribute to the recovery of cartilage tissue.
The rehabilitation period lasts about 6 months.The patient is in the hospital under observation for 5 to 10 days.Then a set of rehabilitation measures is carried out with the aim of strengthening the hip muscles.First, the patient must walk with crutches, then with a cane, and finally on his own without support.
At the end of the rehabilitation period, the patient regains his lost ability to work and the joy of easy walking!
Prevention of coxarthrosis
To prevent coxarthrosis, it is necessary:
- adhere to an active lifestyle (do morning exercises, take short walks);
- not engage in sports professionally;
- maintain a balanced diet, as this helps to avoid weight gain, which causes additional stress on the joints;
- take a course of chondroprotectors once every 1-2 months.years after age 40 (in case of family predisposition to coxarthrosis or joint damage).