Coxarthrosis is a disease of the hip joints caused by changes in the structure of their tissues.The disease has another name - osteoarthritis 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 completed, so any damage to it affects the condition of the tissue in the future.The condition of the cartilage is also affected by joint fluid, which performs the function of tissue lubrication.Due to insufficient lubrication and increased friction, the joint cartilage thins and eventually wears out completely.The absence of cartilage causes an increase in the load on the surface of the bones, friction occurs between the bones, which leads to a change in their shape and position, leading to the appearance of pain.
Most often, older people suffer from coxarthrosis, because by this time the functions of cartilage tissue have been lost.
Types of coxarthrosis
In medicine, a distinction is made between primary and secondary coxarthrosis.
In the main case, the causes of the disease are unclear.
The development of secondary coxarthrosis is influenced by the following reasons:
- suffer various injuries and fractures;
- congenital malformations of 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:
Step 1
Characterized by the appearance of periodic pain in the joint.The pain occurs when you begin to move after a resting state, but disappears when resuming vigorous activity.In a calm state, pain does not appear.Joint mobility is not impaired.The x-ray shows minor bony growths and slight narrowing of the joint space.
Step 2
The appearance 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, irregular bone contour, thickening of the bone neck, significant growth of bone tissue, narrowing of the joint space by 2 times.
Step 3
Constant pain occurs regardless of physical activity, both in an active and calm state.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, as well as deformation of the femoral head.Joint space is virtually absent.Physical fitness is severely limited.The patient may be recognized as disabled.
Step 4
The patient feels unbearable pain at rest.Any movement causes extreme pain, the patient is unable to move with support (crutches, cane).The only method of treating coxarthrosis is surgical.
Causes of coxarthrosis
The appearance of coxarthrosis is influenced by many reasons, the most important of which is impaired blood circulation in the hip region.Due to poor blood circulation, the metabolism in the joints slows down, which leads to progressive atrophy of the leg muscles.
Other causes of coxarthrosis are:
- sedentary lifestyle;
- microtraumas that do not cause pain in the patient;
- endocrine disorders;
- changes in joint surfaces due to age;
- increased load on the joints (most often seen in athletes);
- inflammatory and infectious processes in the joints;
- pathologies of the foot (flat feet) and spine (scoliosis);
- 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 in a particular patient are determined.
Symptoms of coxarthrosis
Cosarthritis affects men and women over the age of 40.Women experience more painful symptoms.
The signs of coxarthrosis are:
- pain in the hip joint (occurs periodically and is painful in nature);
- uneven and uncertain gait (lameness);
- the appearance of a crunch in the joint;
- mobility of the injured leg is limited (at the initial stage, heaviness and stiffness in movements, fatigue and general discomfort are felt);
- the appearance of muscle atrophy of the thigh (the volume and tone of the muscles change, causing pain in the knee area).
Diagnosis of coxarthrosis
To determine the diagnosis of coxarthrosis, it is necessary to undergo diagnostic procedures:
- examination of the patient by a specialist;
- Carrying out general and biochemical blood tests (allows you to identify inflammatory processes and distinguish arthritis from osteoarthritis);
- x-ray (used to detect damage and changes in bone tissue);
- magnetic resonance imaging of the joint (detects minor changes in cartilage tissue).
Treatment of coxarthrosis
To treat the disease, specialists use medical procedures and medications.
Methods for treating coxarthrosis include:
- therapeutic exercises and massages;
- physiotherapy;
- ozone therapy;
- cryotherapy;
- treatment with medications;
- surgical treatment, etc.
In specialized clinics, an individual treatment program for coxarthrosis is selected for each patient, taking into account his age, concomitant diseases and stage of coxarthrosis.An individual approach contributes to the patient's recovery as quickly as possible.
Therapeutic gymnastics and massage
Gymnastics helps strengthen muscles and improve blood circulation.Morning exercises not only wake up the body after sleep, but also raise the synovial fluid from the lower parts of the joint.Synovial fluid lubricates 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.Movements that are too sudden and vigorous can cause intense pain and injure the joint.It is recommended to go to the pool, as swimming helps strengthen muscles, relieves stress 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.When massaging the hip joint, lower back and back, the muscles relax, due to which 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 are aimed at improving blood circulation, relieving spasms and inflammation, this is due to the fact that access to the hip joint is limited.
Treatment with medications
There are many drugs that perform various functions in the treatment of coxarthrosis:
- Topical medications(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 these drugs cannot reach the hip joint due to its deep location.They only help to temporarily improve blood circulation and relieve spasms.The causes of coxarthrosis have not been eliminated, and the disease continues to gradually progress to a more complex stage.
- Non-steroidal anti-inflammatories.They are used to eliminate inflammatory processes, relieve swelling and pain.As a result of long-term use of non-steroidal drugs, side effects appear that negatively affect the internal organs (gastritis).These medications do not restore the cartilage tissue necessary for normal joint function.
- Muscle relaxers(medications that relax muscles).Improves blood circulation and relieves muscle tension around the joint.The effect of drugs is temporary, joint functions are not restored.
- Hormonal steroid drugs.Intra-articular hormonal injections help with concomitant diseases, for example, with inflammation of the femur 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 provide necessary nutrients to cartilage tissue.When used correctly, vasodilator drugs provide a significant therapeutic effect.However, the effectiveness of treatment depends on the individual tolerability of the drugs.
- Chondroprotectors(drugs that restore cartilage).These are the most effective modern drugs, as they affect the restoration of cartilage tissue and nourish it with the necessary substances.With 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 process of cartilage restoration will continue.
Surgical treatment of coxarthrosis
Surgical intervention is resorted to in cases of significant destruction of cartilaginous tissue, the impossibility of its restoration 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 aimed at removing the affected joint and replacing it with an artificial analogue, an endoprosthesis.The shape of the stent resembles a real joint, it performs all the functions of a joint and can withstand heavy loads when walking, running, etc.
Lifespan of stents
Like anything, a stent has its own lifespan.Stent wearing depends on load and mobility.Excess weight significantly increases the load and the lifespan of the prosthesis will be approximately 10 years.With moderate load and mobility, the stent will last approximately 15 years.There are also prosthesis models with a lifespan of 20 to 25 years, but their main disadvantage is their high cost.
After the stent wears out, it is necessary to carry out 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 fixing the prosthesis arises.Therefore, in order to avoid repeated endoprostheses, 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 surgery is 1-2%.
Rehabilitation after endoprostheses
Joint replacement surgery is quite complex and will take time to restore lost mobility.The recovery period includes methods that strengthen the body: massages, gymnastics and breathing exercises.The volume and complexity of loads 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 restoration of cartilage tissue.
The rehabilitation period lasts approximately 6 months.The patient is hospitalized under observation for 5 to 10 days.Next, a set of rehabilitation measures is carried out aimed at strengthening the hip muscles.The patient will first have to walk with crutches, then with a cane and finally alone, without any support.
At the end of the rehabilitation period, the patient regains his lost capacity for work and the joy of an easy gait!
Prevention of coxarthrosis
To prevent coxarthrosis, you must:
- adhere to an active lifestyle (do morning exercises, take short walks);
- do not play sports professionally;
- maintain a balanced diet, as this helps avoid weight gain, which causes additional stress on the joints;
- follow a course of chondroprotectors once every 1 to 2 years after the age of 40 (in case of family predisposition to coxarthrosis or joint damage).