Coxarthrosis is a disease of the hip joint caused by changes in the tissue structure in it.This disease has another name - arthrosis of the hip joint, or osteoarthritis.
Coxarthrosis is a complex degenerative disease caused by changes in the joint cartilage tissue.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 joint fluid, which performs the function of lubricating the tissue.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 bone surface, friction occurs between the bones, and this leads to changes in their shape and position, which leads to the appearance of pain.
Often, people in old age suffer from coxarthrosis, because at this time the function of the cartilage tissue has been lost.
Types of coxarthrosis
In medicine, primary and secondary coxarthrosis are distinguished.
In the main case, the cause of the disease is not clear.
The development of secondary coxarthrosis is influenced by the following reasons:
- received various injuries and fractures;
- congenital defects in the hip joint (congenital hip dislocation);
- the presence of an inflammatory process in the hip area;
- rheumatoid arthritis (connective tissue disease that destroys joint cartilage);
- Aseptic necrosis of the femoral head (death of the femoral head).
Stage of coxarthrosis
In medical practice, there are 4 stages of coxarthrosis:
Stage 1
Characterized by the appearance of periodic pain in the joints.Pain occurs when you start to move after a state of rest, but disappears in the process of continuing vigorous activity.In a calm state, pain does not appear.Joint mobility is not affected.X-rays show small bone growths and slight narrowing of the joint space.
Level 2
Occurrence of pain during moderate physical activity, as well as at rest.The appearance of lameness during prolonged walking.Pain may appear in the knee or 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, narrowing of the joint space by 2 times.
Stage 3
Constant pain occurs regardless of physical activity, both in an active and restful state.Pain can cause insomnia.Due to limited joint movement, one has to walk with support.X-ray revealed a significant increase in the width of the bone neck and a decrease in its length compared to the norm, and deformation of the femoral head.Shared space is not present.Physical conditions are very limited.Patients can be recognized as disabled.
Stage 4
The patient experiences unbearable pain at rest.Any movement causes extreme pain, the patient cannot move with support (stick, cane).The only way to treat coxarthrosis is surgery.
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 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 the joint surface due to age;
- increased load on the joints (most often found in athletes);
- inflammatory and infectious processes in the joints;
- foot pathology (flat feet) and spinal column (scoliosis);
- Obesity (increased load on the joints due to excess body weight) and other reasons.
Taking into account the state of health of the whole organism, the exact cause of the disease for a particular patient is determined.
Symptoms of coxarthrosis
Cosarthrosis affects men and women after the age of 40.Women experience more painful symptoms.
The signs of Coxarthrosis are:
- pain in the hip joint (occurring periodically and painful);
- uneven, erratic (limping);
- the appearance of a crisis in the joints;
- The mobility of the injured leg is limited (at the initial stage, heaviness and stiffness in movement, fatigue, and general fatigue are felt);
- The appearance of thigh muscle atrophy (the amount 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 patients by specialists;
- Carry out general blood and biochemical tests (allow us to identify the inflammatory process and distinguish arthritis from arthrosis);
- X-ray (used to detect damage and changes in bone tissue);
- Magnetic resonance imaging of the joint (detects small changes in the cartilage tissue).
Treatment of coxarthrosis
To treat this disease, experts use medical procedures and drugs.
Treatment methods for coxarthrosis include:
- therapeutic exercises and massage;
- physiotherapy;
- ozone therapy;
- Cryotherapy;
- treatment with drugs;
- Surgical treatment, etc.
In a specialized clinic, an individual treatment program for coxarthrosis is selected for each patient, taking into account his age, concomitant diseases and the degree of coxarthrosis.An individual approach contributes to the patient's recovery as quickly as possible.
Gymnastics and therapeutic massage
Gymnastics helps strengthen muscles and improve blood circulation.Morning exercise not only wakes up the body after sleep, but also raises the synovial fluid from the bottom of the joint.Synovial fluid lubricates the cartilage tissue with essential nutrients, which increases the cartilage's resistance to stress throughout the day.
However, for coxarthrosis, physical exercises should be chosen wisely.Movements that are too sudden and forceful can cause severe pain and injure the joints.It is recommended to go to the swimming pool, because swimming helps to strengthen the muscles, relieves pressure 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 spasms, swelling and muscle tension.During the massage of the hip joint, the lower part and the back, the muscles relax, because the synovial fluid is distributed throughout the cartilage.
Physiotherapy
Physiotherapy combines various methods:
- electrotherapy;
- uhf therapy;
- ultrasound therapy;
- laser therapy;
- Paraffin therapy, etc.
All these procedures aim to improve blood circulation, relieve 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 various functions in the treatment of coxarthrosis:
- Topical medicine(ointment, compress, lotion).Under the influence of advertising, most patients think that treatment with various ointments and creams is the most effective way.However, this is a misunderstanding because the healing properties of such drugs cannot reach the hip joint due to its deep location.They only help temporarily increase blood circulation and relieve cramps.The cause of coxarthrosis is not eliminated, and the disease continues to develop gradually into a more complex stage.
- Nonsteroidal anti-inflammatory drugs.They are used to eliminate the inflammatory process, relieve swelling and pain.As a result of long-term use of non-steroidal drugs, side effects appear that affect the internal organs (gastritis).These drugs do not restore the cartilage tissue necessary for normal joint function.
- Muscle relaxants(A drug that relaxes muscles).Increases blood circulation and relieves muscle tension around the joints.The effect of the drug is temporary, joint function is not restored.
- Hormonal steroid medication.Intra-articular hormone injections help with concomitant diseases, for example, in case of femoral tendon inflammation.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 relieve night pain.Vasodilators also improve articular circulation and help deliver nutrients needed by 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(medicine that restores cartilage).They are the most effective modern drugs, because they affect the recovery of cartilage tissue and nourish it with the necessary substances.With the regular use of chondroprotectors, it is possible to stop the development of coxarthrosis.Positive results appear over time, and after the end of taking the drug, the cartilage recovery process will continue.
Surgical treatment of coxarthrosis
Surgical intervention is carried out in case of significant destruction of cartilage tissue, impossibility of recovery and joint immobility.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 joint functions and can withstand heavy loads while walking, walking, etc.
Endoprosthesis service life
Like any thing, endoprosthesis has its own 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.With moderate load and mobility, the endoprosthesis will last about 15 years.There are also models of prostheses whose service life is 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 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 as long as possible.
It is worth mentioning the risk of hip replacement - the number of deaths after surgery is 1-2%.
Rehabilitation after endoprosthetics
Joint replacement surgery is quite complicated and will take time to restore lost mobility.The recovery period includes methods that strengthen the body: massage, gymnastics and breathing exercises.The amount 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 recovery of cartilage tissue.
The recovery period lasts about 6 months.The patient is in the hospital under observation for 5 to 10 days.Then a set of rehabilitation measures are carried out aimed at strengthening the hip muscles.First, the patient has to walk with crutches, then with crutches, and finally by himself without any support.
At the end of the recovery period, the patient regains his ability to work and simple joy!
Prevention of coxarthrosis
To prevent coxarthrosis, it is necessary:
- adhere to an active lifestyle (do morning exercises, short walks);
- Do not engage in sports professionally;
- Maintain a balanced diet, as this helps avoid weight gain, which causes additional stress on the joints;
- Take a course of chondroprotectors once every 1-2 years after 40 years (in cases of family tendency to coxarthrosis or joint injuries).