As you know, the biggest joint in our body is the hip. It assumes almost all the load during the walk. But also, he is often exposed to diseases such as osteoarthritis or coxarthrosis. What is hip joint osteoarthritis and how is it treated? We'll talk about it in our article.
What is coxarthrosis?
To understand the essence of the disease coxarthrosis, the treatment of which is extremely problematic, you need to delve a little deeper into the very structure of the hip joint. It is itself shaped like a "hinge" and its function is to connect with the pelvis of the femur. Fixation takes place with the help of a spherical head, which is built into the cavity of the hip bone. Both the surface of the head and the surface of the socket are covered with cartilage. They perform shock absorbing functions and protect against wear and tear.
Thus, a violation of the structure of these cartilages becomes the cause of osteoarthritis that contributes to development. That is, the elastic and durable cartilage, due to some internal or external factors, becomes dry, hardens and its surface becomes rough instead of smooth. Such a structure interferes with normal functioning and leads to a slow and painful destruction of the hip joint. So, it is important here to know how to relieve hip joint coxarthrosis pain, but more on that later.
In advanced stages, the bone is so deformed that the patient loses the ability to walk. Summing up all this, it is possible to form a definition of such a disease as arthrosis of the hip joint - the destruction of the complete or partial integrity of the surface of the joints. It is also important to understand that the concepts of osteoarthritis, coxarthrosis and osteoarthritis are practically the same thing. It's just that osteoarthritis is a broader definition, and the other two are the same thing, and they only apply to the hip joint.
Causes of Manifestation
According to doctors, there can be several reasons for the appearance of coxarthrosis, but we will consider only the most common ones:
- Congenital pathologies. The most common are dysplasia (curvature) and congenital dislocation of the hip. They almost always cause grade 1 dysplastic coxarthrosis of the hip.
- hereditary predisposition. That's when this disease is quite common in your family.
- Passive lifestyle. With inactivity, cartilage loses its elasticity and elasticity and can be deformed.
- Violation of the hormonal background. Such a violation can easily cause inflammation of the tissues of the joint.
- Was. In 70% of cases, osteoarthritis occurs in people over 40 years of age. It is about the natural aging of the body and the maintenance, in most cases, of a sedentary lifestyle with age.
- injuries. Injury to the joint leads to cartilage thinning or even deformation, which is an inevitable pre-hip joint.
- Overweight. Sign - too much weight, which will constantly strain the hip joint. Such prolonged loads inevitably lead to wear and tear of the cartilage, as a result - the destruction of the hip joint.
- Big loads. Athletes are in this risk category.
- A simple circulatory disorder. For one reason or another, blood circulation in the human body can fail. So, in the periarticular tissues, a lot of waste products accumulate after metabolism, and this leads to the production of enzymes, but they in turn destroy the cartilage tissue.
- Hip diseases. Another very common cause of coxarthrosis. The fact is that incorrect or premature treatment of any other diseases of the hip (various infections or even necrosis of the femoral head) easily leads to the development of osteoarthritis.
Symptoms
Symptoms in the early stages of the disease are mild, so no one is thinking about treating 1st degree hip joint osteoarthritis. Symptoms include stiffness and discomfort in the hip joint in the morning, immediately after waking up. Discomfort or pain is aggravated by physical exertion and, during rest, weakens or disappears completely. Patients usually do not pay attention to these symptoms, but the prevention of coxarthrosis will not help here.
In more advanced stages, the disease begins to bother completely, even during rest, and everyone thinks about which doctor treats coxarthrosis to get in touch with him in time. In addition, the joint starts to become inflamed, its mobility is lost, and the cartilage collapses forming bone spurs. Pain does not subside even with a long rest, movement is quite restricted. Here you will need information on how to treat grade 3 coxarthrosis, which you can find with us.
Then comes the complete disappearance of the cartilage and the bones start rubbing against each other. It becomes quite difficult to move around. As a result, inactivity, which leads to weakening or even atrophy of the muscles, begins to deform osteoarthritis of the hip joint. The length of the legs can also change. There is obvious lameness. Here, conservative treatment of 3rd degree coxarthrosis will no longer help. The last stage is the complete loss of the ability to walk.
Diagnosis
To correctly diagnose and treat hip joint osteoarthritis, you need to see a doctor. So which doctor treats osteoarthritis of the hip joint without surgery? You need to contact a rheumatologist or orthopedic traumatologist. The diagnosis will begin with a questioning of the patient, i. e. what hurts, where exactly it hurts, how often the pain is felt, etc. To assess the strength of the pain, the doctor will perform various manipulations with the joint. He will flex, extend and rotate the lower limb. In addition, the patient may be asked to walk to assess the external configuration of the joint.
However, a clinical blood test can more accurately confirm the diagnosis. Here, the erythrocyte sedimentation rate will be significantly increased, ie by 30 mm/h and more. An increase in globulins, seromucoids, immunoglobulins and c-reactive protein are also symptoms of coxarthrosis. To determine its level, a biochemical blood test is required. But while these tests are not enough to prescribe treatment for coxarthrosis of the hip joint.
A mandatory event is radiography. But here a significant minus passes - only bones and bone seals are visible in the image, cartilage and soft tissue are not visible. So diagnosing an early stage will be quite difficult. In this case, CT will help to draw a complete picture, and already on the basis of it, it will be possible to tell how to treat arthrosis of the hip joint. But all these procedures will become unnecessary if you have osteoarthritis or deforming osteoarthritis of the 4th degree hip joint. After all, the disease will be visible to the naked eye, and the prevention of osteoarthritis and treatment without surgery will no longer be useful.
grades and types
Based on neglect and symptoms of the disease, 4 degrees of its manifestation can be distinguished.
| Grade | Description |
|---|---|
| First | 1st degree hip joint osteoarthritis is easy to ignore. Its symptoms are recurrent pain in the hip joint after prolonged physical exertion. The pain disappears as soon as the load stops. The radiograph will show only a slight narrowing of the interarticular space. If you orient yourself in time, the disease can be easily prevented. |
| Second | Osteoarthritis of the hip joint of the 2nd degree - the symptoms of which begin to appear, this is the beginning of the destruction of cartilage tissue. The pain intensifies and radiates to the thigh and groin. They begin to manifest even in a state of calm. There may be obvious lameness. Morning stiffness syndrome appears periodically in the morning. We will talk more about how to treat 2nd degree hip joint coxarthrosis. |
| Third | The third stage is when the disease is already very advanced. There is almost no cartilage. The radiographic image shows a strong filiform narrowing of the space between the joints. The pains at this stage are permanent and are only eliminated with the help of medication. At the same time, the patient is very limited in his movements and, in order to move, he needs crutches or a cane on which he can lean. Soft tissue atrophy begins, swelling appears in the joint area. This raises the question of how to treat grade 3 osteoarthritis of the hip joint: conservative methods or surgical intervention. |
| bedroom | The fourth stage is the most neglected and surgical intervention cannot be dispensed with. Accompanied by severe pain in the joint area. The joint as such is almost gone, the bones begin to grow together. The symptoms are the same as in the third stage, but there is no possibility of any movement of the pelvic joint. |
With types of a coxarthrosis it seems to have understood. Now a few words about the types of this disease. So the most popular are 2 ratings. The first is a rating based on how many joints are affected - 1 or 2. Everything is simple here, if 1, then they say that coxarthrosis is unilateral. If the joints on both sides of the hip bone are affected, they speak of bilateral arthrosis.
But there is another no less popular classification, which denotes a disease on the basis of the causes of its occurrence. There are 7 types here:
- The change in joint and cartilage with a person's age is called involutive coxarthrosis.
- Coxarthrosis caused by a complication of Perthes disease. As a result, necrosis of the spongy tissue covering the head of the femoral bone.
- Congenital maldevelopment of a joint or joints is called dysplastic coxarthrosis. A very common occurrence, according to doctors, every ten cases is the result of congenital subluxation of the head of the femur or the so-called dysplasia.
- Complication after post-infectious arthritis or coxarthrosis.
- Post-traumatic coxarthrosis. It is a consequence of an incorrect constant load on the joint, which leads to microtraumas, which, in turn, slowly destroy the cartilaginous tissue.
- The next risk group includes people who take antidepressants and corticosteroid medications, as well as others who suffer from hormonal disorders. This type is called dyshormonal osteoarthritis.
- Well, if the cause of the disease cannot be established, then you are diagnosed with idiopathic coxarthrosis.
treatment methods
There are many treatment methods for osteoarthritis of the hip joint, but the condition cannot be completely cured. The entire treatment can be divided into three stages.
- Disease prevention or prevention.
- Treatment of the initial stages (first and second).
- Treatment of advanced stages (third and fourth).
Conservative treatment
This includes treating the first and second stages of coxarthrosis development. As already mentioned, the disease cannot be cured, you can simply eliminate everything that leads to a constant increase in the load on the joint. Moderate loads that will develop the joint will not be superfluous. This includes light loads, e. g. therapeutic exercise, swimming, cycling, etc. Such training will help not only to develop the joint, but also to keep it in good shape.
Equally important is weight correction, with excess weight, as well as proper nutrition. You also need to take care of constant enough sleep and rest. Massages, both special and self-massage, will also help. In the second stage, with increasing pain, it is necessary to take non-steroidal anti-inflammatory drugs. Well, if the disease progresses and reaches grade 3, it can also be treated without surgery, but you don't need to shrug it off with a cane or crutches to lighten the extra load on the pelvis.
Surgery
The attending physician may decide on a surgical intervention already in the third phase to cure the osteoarthritis of the hip joint. There are 4 types of operations performed:
- Arthroplasty - modeling of the cartilage in the joint is performed. With its help, you can almost completely restore the functionality of the joint.
- Osteotomy is a dissection of bones, which is performed in order to completely eliminate deformed areas and not deform normal tissue.
- Arthrodesis - the joint is fixed to the bone with the help of special plates and screws. A more radical method of intervention. After that, the joint remains immobilized.
- Endoprosthesis is a complex operation on the hip joint. To be honest, it is not an operation on the joint, but its complete replacement with a prosthesis, which is performed according to the anatomical characteristics of the patient. Thus, a total or partial replacement is performed, which is why it is possible to cure coxarthrosis. The success rate is approximately 70%. What procedures take place before the operation and how to heal from a psychological point of view after the operation, we will tell in the next article.
Prevention
Many people think that osteoarthritis in the elderly is not treated, but if it is treated in time at an early age, it can be cured. This is not true. Since it is possible to cure coxarthrosis only in the case of arthroplasty, it is better to let you know in advance. This includes managing excessive stress on the joint, maintaining an active lifestyle, managing nutrition and weight. Normal sleep and rest are also important. You can go for regular massage treatments. Regular intake of chondroprotectors is recommended.