One of the most severe pathologies of the musculoskeletal system is coxarthrosis of the hip joint. If a visit to a medical facility is delayed, the disease can progress - up to the appearance of acute pain syndrome, which cannot be removed with analgesics, and complete loss of motor ability of the joint.
In this article we will talk in detail about all the nuances associated with eliminating the consequences of this pathological process, its stages and preventive procedures.
What is coxarthrosis of the hip joint?
We are talking about a degenerative-dystrophic disease of the hip joint in severe form, which can provoke a violation of the functional ability of the joint, up to its absolute loss. In terms of the frequency of its manifestation, coxarthrosis is in second place after deforming arthrosis of the knee joint.
Coxarthrosis of the hip joint is accompanied by degenerative damage to the cartilage, the appearance of pathological growths, bone resorption, inflammatory processes and other complications.
That is, this pathology is characterized by damage to the entire joint, which includes cartilage tissue, synovial layer, subchondral bone plate, muscle structures, capsule and ligaments.
The following forms of the disease are also distinguished:
- Primary coxarthrosis. It is considered the most common disease of the hip joint. In older people, this pathology manifests itself against the background of age-related changes;
- Secondary coxarthrosis. Manifests itself as a result of any disease.
Causes of coxarthrosis
The development of pathology can be triggered by reasons of an external, acquired and hereditary nature.
In particular, coxarthrosis can manifest itself against the background of congenital inferiority of the hip joint, degenerative-dystrophic changes, trauma, inflammatory processes, bone marrow necrosis of the femoral head, metabolic disorders, genetic factors, age-related changes, obesity. , blood vessel disorders, and working in difficult conditions.
It should be noted that almost all joint structures are inflamed.
3 stages of development of coxarthrosis of the hip joint
During the development of the pathological process, the viscosity of the joint fluid increases, which leads to the appearance of microcracks and causes dehydration of the cartilage surface. This, in turn, contributes to the emergence of precariousness and limited mobility. A person feels unpleasant manifestations during daily stress and physical exertion. As pressure on the lower extremities increases, the exhausted joint adapts to the forced position and begins to crush nearby structures.
Currently, there are 3 stages of disease development:
- First. Coxarthrosis of the hip joint at this stage has inconsistent mild symptoms and appears in the affected area. At the same time, motor activity is maintained, and to relieve pain, it is enough to take medication;
- Second. When a patient is diagnosed with coxarthrosis of the hip joint at stage 1, the disease does not cause much discomfort, but when the disease reaches stage 2, the symptoms become more pronounced. The pain becomes more intense and starts to spread to other parts of the body. Motor abilities decrease significantly, which is especially noticeable after long walks or increased physical activity;
- Third. If grade 2 coxarthrosis of the hip joint can still be treated, in the third stage the pathology becomes chronic. This is accompanied by persistent pain and spreads to the lower body. The patient loses the ability to move without crutches. In the absence of appropriate therapeutic measures, atrophy of cartilage and muscle structures occurs.
Types of coxarthrosis
The classification of hip joint pathology is based on one criterion - how the disease appears in the musculoskeletal system. There are two main risk factors that can trigger the onset of this disease - genetic and acquired due to age-related changes. The pathological process is also divided into several types, depending on the source of its occurrence:
- Primary coxarthrosis. This pathology manifests itself in the hip area and is acquired. In the initial stages, it affects the synovial capsule, after which it enters the tissue area around the joint. Risk factors include increased pressure on the pelvic bones, excessive physical activity, and the presence of inflammatory foci in the lower extremities and spine. Degenerative lesions concentrate in tissue that has undergone changes;
- Secondary coxarthrosis. This anomaly is hereditary. It manifests itself in the joints and musculoskeletal system. The development of the pathological process can begin in utero after a woman receives an injury, as well as against the background of bone marrow necrosis of the femoral head.
Types of coxarthrosis based on occurrence:
- Post infection. Identified the presence of consequences after an infectious disease;
- Post-traumatic. Diagnosed if complications occur after limb injury;
- Not hormonal. Occurs against the background of metabolic disorders or drug overdose;
- Involutional. It appears in people over 50 years of age due to aging of the body.
Diagnostic measures
If you suspect coxarthrosis of the hip joint of the 1st or 2nd degree, before starting treatment, you should carry out a thorough examination of the body. It is also important to consult an orthopedic doctor, who will perform an examination, provide recommendations regarding laboratory tests and develop an effective treatment plan. Usually, diagnostic measures are limited to the following procedures:
- Radiography. Allows you to study the parameters of the gaps between the cartilages, diagnose the presence of pathological growths, and also assess the condition of the femoral head;
- Ultrasound. Makes it possible to trace the etiology of changes in the structure of bones and ligaments, as well as study the dynamics of the patient's condition and determine the degree of development of the anomaly;
- CT. Allows you to obtain more detailed information about the condition of the joint and the tissues located around it;
- MRI. This method provides a detailed picture of the condition of the entire structure of the hip joint.
Treatment of coxarthrosis of the hip joint
If the patient has been diagnosed with coxarthrosis of the hip joint grade 1 or 2, effective results can be obtained through conservative methods. Such therapy is prescribed to the patient individually and includes several techniques, which only in combination give a positive effect. So, if the patient is diagnosed with coxarthrosis of the hip joint 1 or 2 degrees, and appropriate symptoms are observed, the following measures may be recommended:
- Drug use;
- Physiotherapy procedures;
- Shock wave therapy;
- Physiotherapy.
To achieve positive dynamics using conservative methods, the causes that provoke coxarthrosis of the hip joint must be eliminated. First of all, you should reduce body weight, which will reduce the load on the joints and minimize the possibility of further development of degenerative-dystrophic processes.
Apart from that, you should eliminate the use of tobacco products and increase physical activity, avoiding excessive activity. To prevent the development of pathology, experts advise using orthopedic devices (orthoses and bandages). They allow you to firmly fix the joint and provide the necessary support during physical activity.
Drugs
Medicines are also prescribed individually. As a rule, patients are recommended to take the following medications:
- Non-steroidal anti-inflammatory drugs. These drugs allow you to get a double effect: eliminating pain and eliminating the inflammatory process;
- The preparation contains chondroitin, glucosamine and collagen. They allow you to activate restoration processes in cartilage;
- Steroid hormones. A drug with a strong anti-inflammatory effect. Used in situations where NSAIDs are not significantly effective;
- Muscle relaxants. Medicines that relieve muscle tone, which is a necessary condition for eliminating pain of increased intensity;
- Means normalizes blood circulationand increased trophism of tissues located near the joint;
- Vitamin B. Complexes containing this vitamin are prescribed to improve nerve transmission, which is especially important when the endings are compressed by the affected structures.
If pain of significant intensity occurs, it is also recommended to perform a periarticular blockade. They are carried out only under the supervision of a professional specialist in a clinical setting. In this case, a special solution with steroid hormones and anesthetic is injected into the joint.
Gymnastics for coxarthrosis of the hip joint
Particularly effective in restoring motor function and reducing muscle spasms are special exercises recommended for coxarthrosis of the hip joint. Thanks to optimally selected loads, it is possible to eliminate pain and increase the range of motion. In addition, a properly composed complex allows you to prevent atrophic processes in the muscles and relieve spasms if pinched nerve endings are observed against the background of the disease.
In addition, gymnastics for coxarthrosis of the hip joint helps to improve blood flow in the affected area and allows you to speed up the recovery process.
When choosing exercises, the specialist must take into account the damage to the hip joint and the patient's physical condition.
Physiotherapy methods
Massage and physiotherapy procedures can provide special analgesic, anti-inflammatory and decongestant effects. They also help maintain muscle tone in the limbs, preventing atrophic processes.
For hip joint disorders, the following procedures are performed:
- UHF;
- laser exposure;
- Ultrasound treatment;
- magnetotherapy;
- Exposure to direct electric current in combination with medications;
- Paraffin therapy;
- Phonophoresis.
The above treatment will only have a positive effect if the patient has been diagnosed with coxarthrosis in the primary stage.
Shock wave therapy for coxarthrosis
For coxarthrosis of the first or second stage, shock wave treatment provides significant positive dynamics. For example, undergoing 10-15 procedures of shock wave therapy can reduce the negative manifestations characteristic of stage 2 pathology to signs of the initial stage of the disease.
It is important to understand that only timely treatment sessions can provide the best recovery effect. At the same time, the number of SWT procedures can be reduced.
However, the main positive aspect when exposed to shock waves in the affected joint is the ability to normalize blood circulation, which facilitates the accelerated supply of important nutrients involved in regenerative processes to the various structures of the hip joint.
In addition, as part of the application of shock wave therapy, pathological bone growths can be destroyed, which contributes to significant irritation of the articular tissue and prevents regeneration.
Physiotherapists and neurologists with professional experience operate in the clinic. They are fluent in using the latest physiotherapy methods, including the shock wave method. In addition, specialists have the ability to work with modern equipment. This provides a guarantee of a positive effect and allows you to shorten the treatment period.
Operation
Unfortunately, many patients delay contacting a medical facility and see a specialist only when irreversible processes begin to occur in the hip joint.
For advanced third or fourth stage disease, the only effective method is surgery. This will restore motor abilities and eliminate acute pain, which significantly improves the patient's quality of life.
As a rule, surgery is prescribed in the following situations:
- Pain sensations of increased intensity that cannot be relieved by medication;
- Lack of inter-articular space;
- Violation of the integrity of the femoral neck;
- Significant restriction of physical activity.
Given the intensity of joint damage and changes in bone tissue, the patient may be prescribed the following types of interventions:
- Arthrodesis. Interventions that create complete immobility of the joint. For this purpose, special metal plates are used;
- Osteotomy. Surgical intervention consisting of an artificial fracture of the femur to straighten its shaft. The resulting part is placed in the most optimal position, which allows you to remove excess load from the affected joint;
- Arthroplasty. The only method that allows to restore the entire function of the hip joint and achieve complete recovery of the patient. After using this method of eliminating coxarthrosis, a person forgets about joint problems for 20-30 years.
The medical center performs surgical procedures in the area of the hip joint of any complexity. They are carried out by highly qualified specialists using modern tools and technologies, which eliminates any errors during the intervention.
Disease complications
When the pathological process is in an advanced stage, joint mobility is severely limited, a person loses the ability to walk and care for himself, and pathological tissue fusion is observed. In addition, such an anomaly can have an undesirable effect on gait, caused by the appearance of lameness and a decrease in the size of the limb.
Preventive measure
Patients with pain in the hip joint should be examined by a specialist and use special orthopedic devices when carrying out work and physical activity. In addition, post-operative radiography needs to be done 3 times a year to monitor the condition of the joint.