As you know, the largest joint in our body is the hip. It takes almost all the load while walking. But also, it is quite often exposed to conditions such as osteoarthritis or coxarthrosis. What is it and how is osteoarthritis of the hip treated? We will talk about this in our article.
What is coxarthrosis?
To understand the essence of coxarthrosis, the treatment of which is extremely problematic, you need to delve a little into the very structure of the hip joint. It itself has the shape of a "hinge", and its function is to connect with the pelvis of the femur. Fixing is done using a spherical head, which is embedded in the cavity of the hip bone. The surface of the head and the surface of the cavity are covered with cartilage. They perform shock-absorbing functions and protect against wear.
Thus, a violation of the structure of these cartilages becomes the cause of arthrosis, which contributes to the 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. Therefore, it is important here to know how to relieve pain in coxarthrosis of the hip joint, but we will talk about this later.
In advanced stages, the bone becomes so deformed that the patient loses the ability to walk. Summarizing all this, it is possible to formulate 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 arthrosis, coxarthrosis and arthrosis are practically the same thing. It's just that osteoarthritis is a broader definition, and the other two are one and the same, 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:
- Congenital pathologies. The most common are dysplasia (curvature) and congenital hip dislocation. 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, the cartilage loses its elasticity and elasticity and can become deformed.
- Violation of the hormonal background. Such a violation can easily cause inflammation of the tissues of the joint.
- Age. In 70% of cases, osteoarthritis occurs in people over 40 years old. It's about the natural aging of the body and maintaining, for the most part, a sedentary lifestyle as you age.
- Injuries. An injury to the joint leads to thinning of the cartilage or even its deformation, and this is an unavoidable pre-hip joint.
- Overweight. Sign - a lot of weight, which will constantly overload the hip joint. Such prolonged loads inevitably lead to wear of the cartilage, leading to 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. Thus, in the periarticular tissues, many residues accumulate after metabolism, which leads to the production of enzymes, but these, in turn, destroy the cartilage tissue.
- Hip diseases. Another fairly common cause of coxarthrosis. The fact is that incorrect or untimely treatment of any other hip disease (various infections or even necrosis of the femoral head) easily leads to the development of arthrosis.
Symptoms
Symptoms in the early stages of the disease are mild, so no one thinks about the treatment of arthrosis of the hip of the 1st degree. 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 at rest it weakens or disappears completely. Patients often do not pay attention to these symptoms, but the prevention of coxarthrosis will not help here.
At later stages, the disease already begins to fully annoy even at rest, and everyone thinks about which doctor treats coxarthrosis in order to contact him in time. In addition, the joint begins to inflame, its mobility is lost, and the cartilage collapses, forming bone spurs. The pain does not subside even with a long rest, the movement is rather constrained. Here you will need information on how to treat coxarthrosis grade 3, which you can find from us.
Then comes the complete disappearance of the cartilage and the bones begin to rub against each other. It becomes quite difficult to move around. As a result, inactivity, which leads to weakening or even atrophy of muscles, begins to deform arthrosis of the hip joint. Leg length can also change. There is obvious lameness. Here, conservative treatment of coxarthrosis of the 3rd degree will no longer help. The final stage is the complete loss of the ability to walk.
Diagnostic
In order to properly diagnose and treat osteoarthritis of the hip, 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. Diagnosis will begin with questioning the patient, i. e. what hurts, where exactly does it hurt, how often the pain is felt, etc. To assess the intensity of the pain, the doctor will perform several manipulations with the joint. It will flex, extend and rotate the lower limb. Additionally, 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 sedimentation rate of erythrocytes will be significantly increased, namely by 30 mm / h and more. An increase in globulins, seromucoids, immunoglobulins and C-reactive protein are also symptoms of coxarthrosis. To determine their level, a biochemical blood test is necessary. But while such tests are not enough to prescribe treatment for coxarthrosis of the hip joint.
A mandatory event is the x-ray. But here a significant drawback creeps in - only bones and bone seals are visible in the photo, cartilage and soft tissues are not visible. Thus, diagnosing an early stage will be quite difficult. In this case, computed tomography will help to draw a complete picture, and already on its basis it will be possible to tell how to treat arthrosis of the hip joint. But all these procedures will become useless if you suffer from doa or deforming arthrosis of the hip joint of the 4th degree. After all, the disease will be visible to the naked eye, and the prevention of arthrosis and treatment without surgery will no longer be useful.
Degrees and types
Based on the neglect and symptoms of the disease, 4 degrees of its manifestation can be distinguished.
| Diploma | The description |
|---|---|
| First | Osteoarthritis of the 1st degree hip joint is easy to overlook. Its symptoms are recurrent pain in the hip joint after prolonged physical exertion. The pain disappears as soon as the load stops. The X-ray will show only a slight narrowing of the inter-articular space. If you orient yourself in time, the disease can be easily avoided. |
| Second | Arthrosis of the hip 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 themselves even in a state of calm. There may be obvious lameness. Morning stiffness syndrome appears periodically in the morning. Further we will talk about how to treat coxarthrosis of the hip joint of the 2nd degree. |
| Third | The third stage is when the disease is already very advanced. There is almost no cartilage left. The X-ray image shows a strong filiform narrowing of the space between the joints. The pain at this stage is permanent and is eliminated only with the help of medication. At the same time, the patient is very constrained in his movements and to move around 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. |
| Fourth | The fourth stage is the most neglected and one cannot do without surgical intervention. Accompanied by severe pain in the joint area. The joint as such has almost disappeared, the bones begin to grow together. The symptoms are the same as in the third stage, but there is no possibility of movement of the pelvic joint. |
With the types of coxarthrosis, he seems to have understood. Now a few words about the types of this disease. So, the most popular are 2 classifications. The first is a classification based on the number of affected joints - 1 or 2. Everything is simple here, if 1, then they say coxarthrosis is unilateral. If the joints on both sides of the hip bone are affected, then they speak of bilateral arthrosis.
But there is another no less popular classification, which designates a disease according to the causes of its occurrence. There are 7 types here:
- The change in the joint and cartilage with a person's age is called involutive hip osteoarthritis.
- 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 hip osteoarthritis. A fairly common phenomenon, according to doctors, one in ten cases is the result of congenital subluxation of the femoral head or the so-called dysplasia.
- Complication after osteoarthritis or post-infectious coxarthrosis.
- Post-traumatic coxarthrosis. This is the consequence of an incorrect constant load on the joint, which leads to microtraumas, and these, in turn, slowly destroy the cartilage tissue.
- The next risk group includes people taking antidepressants and corticosteroids, as well as other people with hormonal disorders. This type is called dishormonal osteoarthritis.
- Well, if it is not possible to establish the cause of the disease, you are diagnosed with idiopathic coxarthrosis.
Treatment methods
There are many methods of treating osteoarthritis of the hip joint, but the disease cannot be completely cured. Any treatment can be divided into three stages.
- Prevention or prevention of diseases.
- Treatment of early stages (first and second).
- Treatment of advanced stages (third and fourth).
Conservative treatment
This includes the treatment of the first and second stages of the development of coxarthrosis. 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 seal will not be superfluous. This includes light loads, for example therapeutic exercises, swimming, cycling, etc. Such training will help not only to develop the joint, but also to keep it in good shape.
Equally important is the correction of weight, with its excess, as well as proper nutrition. You should also take care of constant and sufficient sleep and rest. Massages, both special and self-massage, will also help. In the second stage, with an increase in pain, it is necessary to take nonsteroidal anti-inflammatory drugs. Well, if the disease progresses and reaches grade 3, it can also be treated without surgery, but you do not need to disdain with a stick or crutches to relieve the additional load on the pelvis.
Operation
The attending physician may decide on surgical intervention already in the third stage in order to cure arthrosis of the hip joint. There are 4 types of operations performed:
- Arthroplasty - the modeling of the cartilage on the joint is carried out. With its help, you can almost completely restore the functionality of the joint.
- Osteotomy is a dissection of the bones, which is performed in such a way that the deformed areas are completely eliminated and the normal tissue is not deformed.
- Arthrodesis - the joint is fixed to the bone using special plates and screws. A more radical method of intervention. After that, the joint remains immobilized.
- The endoprosthesis is a complex operation of the hip joint. To be honest, this is not an operation on the joint, but its complete replacement with a prosthesis, which is performed based on the anatomical features of the patient. Thus, a complete or partial replacement is performed, which is why it is possible to cure coxarthrosis. The success rate is around 70%. What procedures take place before the operation and how to treat yourself 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 at all, but if treated in time at an early age, it can be cured. It's not true. Since coxarthrosis can only be cured in the event of arthroplasty, it is better to prevent it beforehand. This includes controlling excessive stress on the joint, maintaining an active lifestyle, controlling nutrition and weight. Normal sleep and rest are also important. You can opt for regular massages. Regular intake of chondroprotectors is recommended.