Coxarthrosis is a disease of the hip joints caused by changes in the tissue structure in them.The disease has another name - arthropathy 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 formation of the human skeleton is complete, 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 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 a change in their shape and position, resulting in pain.
Most often, people in old age suffer from coxarthrosis, since by then the functions of the cartilage tissue have been lost.
Types of coxarthrosis
In medicine, primary and secondary coxarthrosis are distinguished.
In the primary case, the causes of the disease are unclear.
The development of secondary coxarthrosis is affected by the following reasons:
- receiving various injuries and fractures.
- congenital defects in 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
It is characterized by the appearance of periodic pain in the joint.The pain occurs when you begin to move after a state of rest, but subsides during the process of resuming vigorous activity.In a calm state, pain does not appear.Joint mobility is not affected.X-ray shows small bony growths and slight narrowing of the joint space.
Stage 2
The appearance of pain during moderate physical activity, as well as at rest.Appearance of lameness during prolonged walking.The pain may occur 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 active and at rest.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 compared to the norm and deformation of the femoral head.The joint space is practically absent.Physical fitness is severely limited.The patient may be identified as disabled.
Stage 4
The patient feels unbearable pain at rest.Any movement causes severe pain, the patient cannot move with support (crutches, cane).The only treatment method for coxarthrosis is surgery.
Causes of coxarthrosis
The appearance of coxarthrosis is affected by many reasons, but the most important is the disruption of 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.
- foot (flatfoot) and spine (scoliosis) pathologies.
- obesity (increased load on the joint due to excess weight) and other reasons.
Taking into account the state of health of the entire organism, the exact causes of the disease are determined for a particular patient.
Symptoms of coxarthrosis
Osteoarthritis affects men and women after the age of 40.Women experience more painful symptoms.
The signs of coxarthrosis are:
- pain in the hip joint (appears periodically and aches in nature);
- uneven, unsteady gait (limp);
- the appearance of a critical moment in the joint.
- the mobility of the injured leg is limited (at the initial stage, he feels heaviness and stiffness in movements, fatigue and general malaise).
- the appearance of atrophy of the muscles of the thigh (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.
- Conducting general and biochemical blood tests (allows us to identify inflammatory processes and distinguish arthritis from arthropathy).
- X-ray (used to detect damage and changes in bone tissue).
- MRI of the joint (detects small changes in cartilage tissue).
Treatment of coxarthrosis
To treat the disease, specialists use medical procedures and drugs.
Treatment methods for coxarthrosis include:
- therapeutic exercises and massages.
- physiotherapy;
- ozone therapy;
- cryotherapy;
- drug treatment;
- surgical treatment etc.
In specialized clinics, an individual treatment program for coxarthrosis is selected for each patient, taking into account their age, accompanying diseases and the stage of coxarthrosis.The individual approach contributes to the patient's recovery as quickly as possible.
Therapeutic exercise and massage
Exercise 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 the cartilage tissue with essential nutrients, which increase the cartilage's resistance to stress throughout the day.
However, for coxarthrosis, physical exercises should be chosen wisely.Very sudden and vigorous movements can cause severe pain and injure the joint.It is recommended to go to the pool, as swimming helps strengthen the muscles, relieves pressure on the joint and does not cause injury.
Massage for coxarthrosis is a very effective and safe method.Improves blood circulation, strengthens muscles, relieves painful spasms, swelling and muscle tension.During a massage of the hip joint, back and back, the muscles relax, due to which the synovial fluid is distributed throughout the cartilage.
Physiotherapy
Physiotherapy combines several methods:
- electrotherapy;
- UHF therapy?
- ultrasound therapy;
- laser therapy;
- paraffin therapy, 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.
Drug treatment
There are many drugs that perform various functions in the treatment of coxarthrosis:
- Topical drugs(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 cannot reach the hip joint due to its deep location.They only help temporarily to improve blood circulation and relieve spasms.The causes of coxarthrosis are not eliminated and the disease continues to gradually progress to a more complicated stage.
- Non-steroidal anti-inflammatory drugs.They are used to eliminate inflammatory processes, relieve swelling and pain.As a result of the long-term use of non-steroidal drugs, side effects occur that negatively affect the internal organs (gastritis).These drugs do not restore the cartilage tissue that is necessary for normal joint function.
- Muscle relaxants(medicines that relax muscles).Improve blood circulation and relieve muscle tension around the joint.The effect of the drugs is temporary, joint functions are not restored.
- Hormonal steroid drugs.Intra-articular hormonal injections help with accompanying diseases, for example, in case of inflammation of the femoral tendons.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 joint 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 tolerability of the drugs.
- Carboprotectors(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 the 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 cartilage restoration process will continue.
Surgical treatment of coxarthrosis
Surgery is resorted to in case of significant destruction of the cartilage tissue, inability to restore it and immobility of the joints.In some cases, surgery is the only possible way to restore a person's ability to walk without pain.
Endoprosthesis 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, performs all the functions of a joint and can withstand heavy loads during walking, running, etc.
Endoprosthesis life span
Like anything, an endoprosthesis has its own lifespan.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 denture models whose service life is 20-25 years, but their main disadvantage is their high cost.
After the wear of the endoprosthesis, it is necessary to perform a second 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 fixation of the prosthesis arises.Therefore, to avoid repeated endoprosthesis, it is necessary to use conservative treatment methods for as long as possible.
It is worth mentioning the risks of hip replacement - the number of deaths after the operation is 1-2%.
Rehabilitation after endoprosthetics
Joint replacement surgery is quite complicated and it will take time to restore the 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.
A healthy diet 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 restoration of cartilage tissue.
The recovery period lasts about 6 months.The patient is in the hospital under observation for 5 to 10 days.A set of rehabilitation measures is then carried out with the aim of strengthening the hip muscles.First, the patient will have to walk with crutches, then with a cane, and finally by himself 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:
- lead an active lifestyle (do morning exercises, take short walks);
- do not play sports professionally.
- Maintain a balanced diet as this helps prevent weight gain, which puts extra stress on the joints.
- take a course of chondroprotectors once every 1-2 years after 40 years (in cases of family predisposition to coxarthrosis or joint injuries).