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 - to the appearance of acute pain syndrome, which cannot be removed by analgesics, and the complete loss of motor ability of the joint.
In this article, we will talk in detail about all the nuances related to the elimination of 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 a severe form, which can lead to a violation of the functional ability of the joint up to its absolute loss. In terms of the frequency of manifestations, coxarthrosis ranks second after deformed arthrosis of the knee joint.
Coxarthrosis of the hip joint is accompanied by degenerative cartilage damage, the appearance of pathological formations, bone resorption, inflammatory processes and other complications.
That is, this pathology is characterized by damage to the entire joint, which covers 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 in the hip joint. In the elderly, this pathology appears against the background of age-related changes;
- Secondary coxarthrosis. Appears as a result of any disease.
Causes of coxarthrosis
Development of pathology can be provoked by external, acquired and hereditary reasons.
In particular, coxarthrosis can be manifested against the background of congenital insufficiency of the hip joint, degenerative-dystrophic changes, trauma, inflammatory processes, necrosis of the marrow of the femoral head, metabolic disorders, genetic factors, age-related changes, obesity. Vascular disorders and work in difficult conditions.
It should be noted that almost all joint structures are subject to inflammation.
3 stages of development of hip joint coxarthrosis
During the development of the pathological process, the viscosity of the joint fluid increases, which leads to the appearance of microcracks and dehydration of the cartilage surface. This, in turn, helps reduce cramping and mobility. People feel such unpleasant symptoms during daily stress and physical exertion. The pressure on the lower limbs increases, the exhausted joint adapts to the forced state and begins to destroy the nearby structures.
Currently, there are 3 stages of disease development:
- Პirveli. Coxarthrosis of the hip joint at this stage has mild symptoms that are inconsistent and appear in the affected area. At the same time, motor activity is maintained and it is enough to take medication to relieve pain;
- second. When the patient is diagnosed with coxarthrosis of the hip joint at the 1st stage, the disease does not cause much discomfort, but when it comes to the 2nd stage of the disease, the symptoms become more pronounced. The pain becomes more intense and begins to spread to other parts of the body. the motor ability significantly deteriorates, which becomes especially noticeable after a long walk or increased physical effort;
- the third. If coxarthrosis of the 2nd degree of the hip joint is still curable, in the third stage the pathology becomes chronic. It is accompanied by constant pain and is transmitted to the lower part of the body. The patient loses the ability to move without crutches. In the absence of appropriate therapeutic measures, cartilage and muscle structures atrophy.
Types of coxarthrosis
The classification of hip joint pathology is based on one criterion - how the disease originated in the musculoskeletal system. There are two main risk factors that can lead to the onset of the disease - genetic and acquired due to age-related changes. The pathological process is also divided into several types, depending on the source of origin:
- Primary coxarthrosis. This pathology appears in the thigh area and is acquired. At the initial stage, it affects the synovial capsule, after which it moves to the tissues surrounding the joint. Risk factors include increased pressure on the pelvic bones, excessive physical activity, and the presence of inflammatory foci in the lower limbs and spinal column. Degenerative lesions are concentrated in tissues that have already undergone changes;
- Secondary coxarthrosis. This anomaly is hereditary. It manifests itself in the joints and the musculoskeletal system. The development of the pathological process can begin already in the womb, after a woman receives an injury, as well as against the background of necrosis of the bone marrow of the femoral head.
Types of coxarthrosis due to detection:
- post-infectious. It is detected in the presence of consequences after infectious diseases;
- Პost tram. Diagnosed in case of complications after limb injury;
- dyshormonal. occurs against the background of metabolic disorders or drug overdose;
- involute. Due to the aging of the body, it appears in people over 50 years old.
Diagnostic measures
If you suspect grade 1 or 2 coxarthrosis of the hip joint, you should have a full body examination before treatment. It is also important to consult an orthopedic doctor who will conduct an examination, give recommendations regarding laboratory tests and develop an effective treatment plan. As a rule, diagnostic measures are limited to the following procedures:
- Radiography. allows you to study the parameters of the gap between the cartilages, determine the presence of pathological formations, and also assess the condition of the femoral head;
- Ultrasonography. makes it possible to track the etiology of changes in bone structures 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 get more detailed information about the state of the joints and tissues near them;
- MRI. This method provides a detailed picture of the condition of all structures of the hip joint.
Treatment of coxarthrosis of the hip joint
If the patient is diagnosed with coxarthrosis of the hip joint 1 or 2 degrees, effective results can be obtained with conservative methods. Such therapy is assigned to the patient individually and includes several techniques that only give a positive effect together. So, if the patient is diagnosed with coxarthrosis of the hip joint 1 or 2 degrees and the corresponding symptoms are observed, the following measures can be recommended:
- use of medication;
- Physiotherapy procedures;
- shock wave therapy;
- Physiotherapy.
In order to achieve positive dynamics using conservative methods, the causes that caused coxarthrosis of the hip joint should be eliminated. First of all, you should reduce your body weight, which will reduce the load on the joint and minimize the likelihood of further development of the degenerative-dystrophic process.
In addition, you should exclude the use of tobacco products and increase physical activity, avoiding excessive efforts. To prevent the progression of the pathology, experts recommend the use of orthopedic devices (orthosis and bandages). They allow you to firmly fix the joint and provide the necessary support during physical activity.
Medicines
Medicines are also prescribed individually. As a rule, patients are advised to take the following medications:
- Nonsteroidal anti-inflammatory drugs. These drugs allow you to get a double effect: relieve pain and eliminate the inflammatory process;
- Preparations containing chondroitin, glucosamine and collagen. They allow you to activate the recovery processes in the cartilage;
- steroid hormones. Drugs with a strong anti-inflammatory effect. Used in situations where non-steroidal anti-inflammatory drugs are not significantly effective;
- Muscle relaxants. Medicines that relieve muscle tone, which is a necessary condition for relieving pain of increased intensity;
- Means normalization of blood circulationand improving tissue trophism near the joint;
- Vitamin B. Complexes containing this vitamin are prescribed to improve nerve transmission, which is of particular importance when the endings are compressed by affected structures.
Periarticular blockades are also recommended for severe pain. They are performed only under the supervision of professional specialists in a clinical setting. In this case, special solutions with steroid hormones and anesthetics are injected into the joint.
Exercise for coxarthrosis of the hip joint
Special exercises recommended for coxarthrosis of the hip joint are particularly effective in restoring motor function and reducing muscle spasm. Due to the optimally selected load, it is possible to remove pain and increase the amplitude of movements. In addition, a properly composed complex allows you to prevent atrophic processes in the muscles and relieve spasms if nerve endings are observed against the background of the disease.
Also, gymnastics during coxarthrosis of the hip joint helps improve blood flow to the affected area and allows you to speed up recovery processes.
When choosing exercises, the specialist should take into account the destruction of the hip joint and the physical condition of the patient.
Physiotherapy methods
Massage procedures and physiotherapy can provide special analgesic, anti-inflammatory and decongestant effects. They also help maintain muscle tone in the limbs, preventing atrophic processes.
The following procedures are performed in case of hip joint anomalies:
- UHF;
- laser exposure;
- ultrasound treatment;
- magnetotherapy;
- exposure to direct electric current with medication;
- paraffin therapy;
- Phonophoresis.
The above-mentioned treatment gives a positive effect only if the patient was diagnosed with coxarthrosis at the initial stage.
Shock wave therapy for coxarthrosis
In the first or second stage of coxarthrosis, shock wave treatment provides significant positive dynamics. For example, 10-15 courses of shock wave therapy procedures 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. In addition, it will be possible to reduce the number of SWT procedures.
However, the main positive aspect of impacting the damaged joint with shock waves is the ability to normalize blood circulation, which contributes to the accelerated delivery of important nutrients involved in regeneration processes to various structures of the hip joint.
Moreover, within the scope of shock wave therapy, it is possible to suppress pathological bone formations, which contributes to significant irritation of joint tissues and prevents regeneration.
Physiotherapists and neurologists with professional experience work in clinics. They are fluent in the work of the latest physiotherapeutic methods, which include the shock wave method. In addition, specialists have the ability to work with modern equipment. This ensures a guaranteed positive effect and allows you to shorten the treatment period.
surgery
Unfortunately, many patients delay the medical facility and consult a specialist only when irreversible processes begin in the hip joint.
For advanced third or fourth stages of the disease, the only effective method is surgery. It will restore motor skills and eliminate acute pain, that is, it will significantly improve the patient's quality of life.
As a rule, surgery is prescribed in the following situations:
- Painful sensations of increased intensity that cannot be removed with medication;
- lack of inter-articular space;
- Violation of the integrity of the femoral neck;
- Significant limitation of physical activity.
Considering the intensity of joint damage and bone tissue changes, patients may be prescribed the following types of interventions:
- Arthrodesis. An intervention that creates complete immobility of the joint. Special metal plates are used for this purpose;
- osteotomy. A surgical intervention consisting of an artificial fracture of the femur to align its axis. The resulting parts are placed in the most optimal position, which allows you to remove excess load from the affected joint;
- Arthroplasty. The only method through which it is possible to restore the entire functionality of the hip joint and achieve a complete recovery of the patient. After using this method of eliminating coxarthrosis, a person forgets about joint problems for 20-30 years.
Medical centers perform 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 excludes mistakes made during the intervention.
Complications of the disease
When the pathological process is in an advanced stage, joint movement is significantly restricted, a person loses the ability to walk and take care of himself, and pathological fusion of tissues is observed. Moreover, such an anomaly can have an adverse effect on walking, which is caused by the appearance of lameness and a decrease in the size of the limb.
Preventive actions
Patients with hip joint pain should be monitored by a specialist and use special orthopedic devices during work and physical activity. In addition, after the operation, it is necessary to undergo radiography 3 times a year to monitor the condition of the joint.