As you know, the largest joint in our body is the hip. It takes on almost the entire load while walking. But also, he is quite often exposed to such ailments as arthrosis or coxarthrosis. What is it and how is osteoarthritis of the hip joint treated? We will talk about this 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 into the very structure of the hip joint. It itself has the form of a "hinge", and its function is to connect with the pelvis of the femur. Fastening occurs with the help of a spherical head, which is embedded in the cavity on the hip bone. Both the surface of the head and the surface of the cavity are covered with cartilage. They perform shock-absorbing functions and protect against wear.
So, a violation of the structure of these cartilages becomes the cause of arthrosis that contributes to the development. That is, 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 more on that later.
At advanced stages, the bone is deformed so much 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 arthrosis, coxarthrosis and osteoarthritis are practically the same thing. It's just that arthrosis 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 quite a few reasons for the appearance of coxarthrosis, but we will consider only the most common:
- 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. This is when this disease is quite common in your family.
- Passive lifestyle. With inactivity, the 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.
- Age. In 70% of cases, arthrosis occurs in people over 40 years of age. It's all about the natural aging of the body and maintaining, for the most part, a sedentary lifestyle with age.
- Injuries. Injury to the joint leads to thinning of the cartilage or even to its deformation, and this is an inevitable 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, 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 residues accumulate after metabolism, and this leads to the production of enzymes, but they, in turn, destroy cartilage tissue.
- Diseases of the hip. Another fairly common cause of coxarthrosis. The thing is that incorrect or untimely 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 the treatment of osteoarthritis of the hip joint of the 1st degree. Symptoms include stiffness and discomfort in the hip joint in the morning, immediately after waking up. Discomfort or pain increases with physical exertion, and weakens or disappears during rest. Patients often do not pay attention to such symptoms, but the prevention of coxarthrosis will not help here.
At more advanced stages, the disease already begins to annoy in full, even during rest, and everyone thinks about which doctor treats coxarthrosis in order to contact him in time. Further, the joint begins to become inflamed, 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 grade 3 coxarthrosis, which you can find with us.
Then comes the complete disappearance of 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 the muscles, begins deforming osteoarthritis of the hip joint. The length of the legs may also change. There is obvious lameness. Here, conservative treatment of coxarthrosis of the 3rd degree will no longer help. The last stage is the complete loss of the ability to walk.
Diagnostics
In order to correctly diagnose and treat osteoarthritis of the hip joint, you need to consult a doctor. So which doctor treats arthrosis of the hip joint without surgery? You need to contact a rheumatologist or orthopedic traumatologist. Diagnosis will begin with a questioning of the patient, that is, what hurts, where exactly it hurts, how often the pain is felt, etc. To assess the strength of the pain, the doctor will perform several manipulations with the joint. It 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, namely from 30 mm / h and more. An increase in globulins, seromucoid, immunoglobulins and c-reactive protein are also symptoms of coxarthrosis. To determine their level, a biochemical blood test is needed. But while such tests are not enough to prescribe treatment for coxarthrosis of the hip joint.
A mandatory event is radiography. But here a significant minus slips through - only bones and bone seals are visible in the picture, 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 say how to treat arthrosis of the hip joint. But all these procedures will become unnecessary if you have 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.
| Degree | Description |
|---|---|
| First | Osteoarthritis of the hip joint of the 1st degree is easy to miss. Its symptoms are recurrent pain in the hip joint after prolonged physical exertion. The pain goes away as soon as the load stops. X-ray will show only slight narrowing of the interarticular space. If you orient yourself in time, then 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 themselves even in a state of calm. There may be obvious lameness. Morning stiffness syndrome periodically appears in the morning. We will talk about how to treat coxarthrosis of the hip joint of the 2nd degree further. |
| Third | The third stage is when the disease is already very advanced. There is almost no cartilage left. The radiographic picture shows a strong threadlike narrowing of the gap between the joints. Pain at this stage are permanent and are eliminated only with the help of medications. At the same time, the patient is very constrained in his movements and in order to move he needs crutches or a cane, on which he can lean. Atrophy of soft tissues begins, edema 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 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 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 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, then they speak of bilateral arthrosis.
But there is another no less popular classification, which denotes a disease based on the causes of its occurrence. There are 7 types here:
- The change in the joint and cartilage with a person's age is the so-called involutive coxarthrosis.
- Coxarthrosis caused by a complication of Perthes disease. As a result, necrosis of the spongy tissue that covers the head of the femoral bone.
- Congenital maldevelopment of a joint or joints is called dysplastic coxarthrosis. A fairly common occurrence, according to doctors, every tenth case is the result of congenital subluxation of the femoral head or the so-called dysplasia.
- Complication after arthritis or post-infectious coxarthrosis.
- Posttraumatic coxarthrosis. It is a consequence of an incorrect constant load on the joint, which leads to microtraumas, and those, in turn, slowly destroy the cartilage tissue.
- The next risk group includes people taking antidepressants and corticosteroid drugs, as well as others suffering from any hormonal disorders. This type is called dishormonal arthrosis.
- Well, if it is not possible to establish the cause of the disease, then you are diagnosed with idiopathic coxarthrosis.
Treatment Methods
There are many methods of treatment for arthrosis of the hip joint, but the disease cannot be completely cured. All treatment can be divided into three stages.
- Disease prevention or prevention.
- 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 increased load on the joint. Moderate loads that will develop the joint will not be superfluous. This includes light loads, for example, therapeutic exercises, swimming, cycling, etc. Such training will help not only develop the joint, but also keep it in good shape.
Equally important is the correction of weight, with its excess, as well as proper nutrition. You also need to take care of constant 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 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 disdain with a stick or crutches to relieve the extra load on the pelvis.
Surgery
The attending physician may decide on a surgical intervention already in the third stage in order to cure arthrosis of the hip joint. There are 4 types of operations performed:
- Arthroplasty - modeling of 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 carried out in such a way as to completely eliminate the deformed areas and not deform the normal tissue.
- Arthrodesis - the joint is fastened to the bone with the help of special plates and screws. A more radical method of intervention. After it, the joint remains immobilized.
- Endoprosthetics is a complex operation on the hip joint. To be honest, this is not an operation on the joint, but its complete replacement with a prosthesis, which is made in view of the anatomical features of the patient. Thus, a complete or partial replacement is carried out, which is why it is possible to cure coxarthrosis. The success rate is about 70%. What procedures take place before the operation, and how to cure yourself from a psychological point of view after the operation, we will tell in the next article.
Prevention
Many people think that arthrosis in the elderly is not treated at all, but if it is addressed in time at an early age, then 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 warn him in advance. 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 go for regular massage treatments. Regular intake of chondroprotectors is recommended.