As you know, the largest joint in our body is the hip. When walking, he takes over almost the entire load. However, it is also frequently exposed to complaints such 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 structure of the hip joint. It itself has the form of a "hinge", and its function is to connect to the pelvis of the femur. Fixation is carried out with the help of a ball head embedded in the cavity on the hip bone. Both the surface of the head and theThe surface of the cavity is covered with cartilage, which performs shock-absorbing functions and protects against wear.
So, a violation of the structure of these cartilages becomes the cause of osteoarthritis, which contributes to its development. That is, due to some internal or external factors, elastic and durable cartilage becomes dry, hardens, and its surface becomes rough instead of smooth. Such a structure disrupts normal functioning and leads to slow and painful destruction of the hip joint. Therefore, here it is important to know how to relieve pain in coxarthrosis of the hip joint, but more on this later.
In the advanced stage, the bone is so deformed that the patient loses the ability to walk. Summing up, such a disease can be defined as osteoarthritis of the hip joint - the destruction of the full or partial integrity of the articular surface. It is also important to understand that the terms arthrosis, coxarthrosis and osteoarthritis are practically the same. It's just that osteoarthritis is a broader definition and the other two are one and the same and only apply to the hip joint.
causes of manifestation
According to doctors, there can be some 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. During inactivity, the cartilage loses its elasticity and resilience and can deform.
- Violation of the hormonal background. Such an injury can easily lead to inflammation of the joint tissues.
- Age. Osteoarthritis occurs in people over 40 years of age in 70% of cases. It's all about the body's natural aging and maintaining a largely sedentary lifestyle as we age.
- injuries. Injury to the joint leads to thinning of the cartilage or even its deformation, and this is an inevitable prehip joint.
- overweight. Sign - a lot of weight, which constantly overloads the hip joint. Such sustained loads inevitably lead to wear and tear of the cartilage and thus to the destruction of the hip joint.
- Big loads. Athletes belong to this risk category.
- A simple circulatory disorder. For one reason or another, blood circulation in the human body can fail. So, after the metabolism, many residues accumulate in the periarticular tissues, which lead to the production of enzymes, but which in turn destroy cartilage tissue.
- diseases of the hip. Another fairly common cause of coxarthrosis. The thing is that incorrect or untimely treatment of other diseases of the hip (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 treating 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 is aggravated by physical exertion and diminishes or disappears completely during rest. Patients often do not pay attention to such symptoms, but the prevention of coxarthrosis does not help here.
In more advanced stages, even at rest, the disease already begins to annoy in full and everyone thinks about which doctor treats coxarthrosis in order to contact him in time. In addition, the joint begins to become inflamed, its mobility is lost, and the cartilage breaks down, forming bone spurs. The pain does not subside even with prolonged rest, movement is rather limited. Here you need information on the treatment of coxarthrosis grade 3, which you can find with us.
Then the cartilage completely disappears and the bones begin to rub against each other. It becomes quite difficult to move. As a result, inactivity, which leads to weakening or even atrophy of muscles, deformation of osteoarthritis of the hip joint begins. The length of the legs can also change. There is obvious lameness. The conservative treatment of a third-degree coxarthrosis no longer helps here. The last stage is the complete loss of the ability to walk.
diagnosis
In order to properly diagnose and treat osteoarthritis of the hip joint, 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 begins with a survey 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 performs several manipulations with the joint. It will flex, straighten 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. The erythrocyte sedimentation speed is significantly increased, 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 required. However, such tests are not enough to prescribe treatment for coxarthrosis of the hip joint.
A mandatory event is radiography. But here a clear minus slips through - only bones and bone seals are visible in the picture, cartilage and soft tissues are not visible. Therefore, 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 can be said how to treat arthrosis of the hip joint. However, all of these procedures become unnecessary if you have stage 4 hip arthritis or deforming arthritis. After all, the disease will be visible to the naked eye, and prevention of osteoarthritis and treatment without surgery will no longer make sense.
degrees and types
Based on the neglect and symptoms of the disease, 4 degrees of its manifestation can be distinguished.
| Degree | description |
|---|---|
| First | Stage 1 osteoarthritis of the hip is easy to overlook. Its symptoms are recurring pain in the hip joint after prolonged physical exertion. The pain disappears as soon as the stress stops. The x-ray shows only a slight narrowing of the interarticular space. If you orientate yourself in time, the disease can be easily prevented. |
| Second | Osteoarthritis of the hip joint of the 2nd degree - the symptoms of which appear, this is the beginning of the destruction of cartilage tissue. The pain intensifies and radiates to the thigh and groin. They even begin to manifest in a state of calm. There may be obvious lameness. Morning stiffness syndrome occurs regularly in the morning. We will talk further about how to treat coxarthrosis of the hip joint of the 2nd degree. |
| third | In the third stage, the disease is already well advanced. There is almost no cartilage left. The X-ray shows a strong threadlike narrowing of the joint space. Pain at this stage is permanent and is eliminated only with the help of medication. At the same time, the patient is very limited in his movements and needs crutches or a walking stick to lean on. Atrophy of soft tissues begins, swelling appears in the joint area. This raises the question of how third degree arthrosis of the hip joint can be treated: conservative methods or surgery. |
| 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 are beginning 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 forms of a coxarthrosis one seems to have understood oneself. 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, this is referred to as bilateral arthrosis.
However, there is another no less popular classification, which designates a disease based on the causes of its occurrence. There are 7 types here:
- The age-related change in the joint and cartilage is the so-called involutive coxarthrosis.
- Coxarthrosis caused by a complication of Perthes disease. As a result, necrosis of the spongy tissue covering the head of the femoral bone.
- The congenital malformation of one or more joints is called dysplastic coxarthrosis. A fairly common occurrence, according to doctors, every tenth case is the result of a congenital subluxation of the femoral head or what is known as dysplasia.
- Complication after arthritis or post-infectious coxarthrosis.
- Post-traumatic coxarthrosis. It is the result of improper long-term stress on the joint, which leads to microtraumas, which in turn slowly destroy the cartilage tissue.
- The next risk group includes people taking antidepressants and corticosteroids, as well as others suffering from hormonal imbalances. This type is called dishormonal arthrosis.
- Well, if it is not possible to establish the cause of the disease, you will be diagnosed with idiopathic coxarthrosis.
treatment methods
There are many treatments for osteoarthritis of the hip joint, but there is no complete cure for the disease. All treatments can be divided into three phases.
- Disease Prevention or Prevention.
- Treatment of the 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, there is no cure for the disease, you can just get rid of everything that leads to a constantly increased load on the joint. Moderate loads developing the joint will not be superfluous. These include 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 must also ensure adequate sleep and rest at all times. Massages, both special and self-massage, also help. In the second stage, with increasing 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 don't have to give up using a cane or crutches to relieve the extra load on the pelvis.
surgery
The doctor treating you can decide on surgical intervention as early as the third stage in order to heal arthrosis of the hip joint. 4 types of operations are performed:
- Arthroplasty - Cartilage modeling is performed on the joint. With its help, you can almost completely restore the functionality of the joint.
- Osteotomy is a dissection of the bones performed in such a way that the deformed areas are completely removed and the normal tissue is not deformed.
- Arthrodesis - the joint is attached to the bone with the help of special plates and screws. A more radical intervention method. After that, 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 made taking into account the patient's anatomy. Thus, full or partial replacement is performed, which is why healing of coxarthrosis is possible. The success rate is around 70%. In the next article we will tell you what interventions take place before the operation and how you can heal yourself after the operation from a psychological point of view.
prevention
Many people think that osteoarthritis is not treated at all in old age, but if it is addressed early and in a timely manner, then it can be cured. It's not like this. Since healing of coxarthrosis is possible only with endoprosthetics, it is better to warn him beforehand. These include controlling excessive stress on the joint, maintaining an active lifestyle, controlling diet and weight. Normal sleep and rest are also important. You can go for regular massage treatments. Regular intake of chondroprotectors is recommended.