Coxarthrosis is a disease of the hip joint caused by changes in the tissue structure within it.This disease has other names - arthrosis of the hip joint, or osteoarthritis.
Coxarthrosis is a complex degenerative disease caused by changes in joint cartilage tissue.Cartilage tissue cannot be restored after the completion of the formation of the human skeleton, so any damage will affect the condition of the tissue later in life.The condition of the cartilage is also influenced by joint fluid which functions to lubricate the tissue.Due to insufficient lubrication and increased friction, the articular cartilage becomes thinner and eventually erodes completely.The absence of cartilage causes increased load on the surface of the bones, friction occurs between the bones, this causes changes in shape and position, causing pain.
Most often, people in old age suffer from coxarthrosis, because by this time the function of cartilage tissue has been lost.
Types of coxarthrosis
In medicine, primary and secondary coxarthrosis are distinguished.
In primary cases, the cause of this disease is not clear.
The development of secondary coxarthrosis is influenced by the following reasons:
- receive various injuries and fractures;
- congenital defects of the hip joint (congenital hip dislocation);
- the presence of an inflammatory process in the hip area;
- rheumatoid arthritis (a connective tissue disease that damages 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
Characterized by the appearance of periodic pain in the joints.Pain occurs when you start moving after resting, but disappears when you resume vigorous activity.In a calm state, pain does not appear.Joint mobility is not impaired.X-rays show slight bone growth and slight narrowing of the joint spaces.
Stage 2
The occurrence of pain during moderate physical activity, as well as at rest.Lameness appears when walking long distances.Pain may appear in the knees or lower back.X-ray results showed: changes in the shape of the femoral head, uneven bone contours, thickening of the cervical vertebrae, significant growth of bone tissue, narrowing of the joint space by 2 times.
Stage 3
Persistent pain occurs regardless of physical activity, whether active or calm.The pain can cause insomnia.Due to limited joint mobility, a person is forced to walk with support.X-ray shows a significant increase in the width of the bone neck and a decrease in its length compared to normal, and deformation of the femoral head.There are practically no shared spaces.Physical conditions are very limited.The patient may be recognized as having a disability.
Stage 4
The patient experiences unbearable pain at rest.Any movement causes excruciating pain, the patient cannot move with assistance (crutches, sticks).The only method of treating coxarthrosis is surgery.
Causes of coxarthrosis
The appearance of coxarthrosis is influenced by many things, but the most important thing is blood circulation disorders in the hip area.Due to improper blood circulation, metabolism in the joints slows down, and this leads to gradual atrophy of the leg muscles.
Other causes of coxarthrosis are:
- sedentary lifestyle;
- microtrauma that does 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;
- pathology of the feet (flat feet) and spine (scoliosis);
- obesity (increased load on the joints due to excess weight) and other reasons.
Taking into account the state of health of the whole organism, the exact cause of the disease in a particular patient is determined.
Symptoms of coxarthrosis
Cosarthrosis affects both men and women after the age of 40.Women experience more painful symptoms.
Signs of coxarthrosis are:
- pain in the hip joint (occurs periodically and is painful);
- uneven and erratic gait (limping);
- the appearance of cracks in the joints;
- limited mobility of the injured leg (in the initial stages, heaviness and stiffness in movements, fatigue and general malaise);
- the appearance of thigh muscle atrophy (change in muscle volume and tone, causing pain in the knee).
Diagnosis of coxarthrosis
To establish a diagnosis of coxarthrosis, it is necessary to carry out diagnostic procedures:
- examination of patients by specialist doctors;
- Carrying out general and biochemical blood tests (allows us to identify inflammatory processes and differentiate arthritis from arthrosis);
- x-ray (used to detect damage and changes in bone tissue);
- magnetic resonance imaging of joints (detects small changes in cartilage tissue).
Treatment of coxarthrosis
To treat this disease, specialists use medical procedures and medications.
Coxarthrosis treatment methods include:
- therapeutic exercises and massage;
- physiotherapy;
- ozone therapy;
- cryotherapy;
- treatment with drugs;
- 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 fastest possible recovery of the patient.
Therapeutic gymnastics and massage
Gymnastics helps strengthen muscles and improve blood circulation.Morning exercises not only wake up the body after sleep, but also increase the synovial fluid of the lower joints.Synovial fluid lubricates cartilage tissue with essential nutrients, which increases the cartilage's resistance to stress throughout the day.
However, for coxarthrosis, physical exercises must be chosen wisely.Movements that are too sudden and forceful can cause severe pain and injure the joints.It is recommended to go to the swimming pool, as swimming helps strengthen muscles, reduces stress on joints and does not cause injury.
Massage for coxarthrosis is a very effective and safe method.It improves blood circulation, strengthens muscles, relieves painful spasms, swelling and muscle tension.During massage of the hip joints, lower back and back, the muscles relax, so that 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, eliminating spasms and inflammation, this is due to limited access to the hip joint.
Treatment with drugs
There are many drugs that perform various functions in the treatment of coxarthrosis:
- Topical medication(ointments, compresses, lotions).Under the influence of advertising, most patients think that treatment with various ointments and creams is the most effective way.However, this assumption is wrong because the healing properties of the drug are not able to reach the hip joint due to its deep location.They only help to temporarily improve blood circulation and relieve spasms.The causes of coxarthrosis are not eliminated, and the disease continues to develop into more complex stages.
- Non-steroidal anti-inflammatory drugs.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 have a negative impact on internal organs (gastritis).This drug does not restore the cartilage tissue necessary for normal joint function.
- Muscle relaxants(a drug that relaxes muscles).Improves blood circulation and relieves muscle tension around the joints.The effect of the drug is temporary, joint function is not restored.
- Hormonal steroid drugs.Intra-articular hormonal injections help with concomitant diseases, for example in cases of inflammation of the tendons of the femur.They have side effects and short-term therapeutic effects.
- Vasodilators.They are used to relax the smooth muscles of blood vessels, expand the lumen between them, relieve pain in small blood vessels, and eliminate night pain.Vasodilators also improve articular circulation and help deliver nutrients needed by cartilage tissue.When used correctly, vasodilator drugs provide a significant therapeutic effect.However, the effectiveness of treatment is influenced by individual tolerance to the drug.
- Chondroprotector(a drug that restores cartilage).They are the most effective modern drugs, as they affect the restoration of cartilage tissue and nourish it with necessary substances.With regular use of chondroprotectors, the development of coxarthrosis can be stopped.Positive results appear over time, and after the end of drug use, the process of cartilage recovery will continue.
Surgical treatment of coxarthrosis
Surgical intervention is performed in case of significant damage to cartilage tissue, impossibility of restoration and immobility of the joint.In some cases, surgery is the only possible way to restore a person's ability to walk without pain.
Endoprosthetics 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 the joint and can withstand heavy loads when walking, running, etc.
Endoprosthesis service life
Like any other object, an endoprosthesis has its own service life.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 loads and mobility, the endoprosthesis will last about 15 years.There are also models of prostheses whose service life is 20-25 years, but their main drawback is their high cost.
Once the endoprosthesis is worn, a second surgery will need to be performed to replace it.However, prosthesis replacement is complicated by the fact that the hip bones become thinner over time and problems arise in fixing the prosthesis.Therefore, in order to avoid repeated endoprosthetics, it is necessary to use conservative treatment methods as long as possible.
It is worth mentioning the risks of hip replacement - the number of deaths after surgery is 1-2%.
Rehabilitation after endoprosthetics
Joint replacement surgery is quite complicated and takes time to restore lost mobility.The recovery period includes body strengthening methods: massage, gymnastics and breathing exercises.The volume and complexity of the load should be increased gradually so that the body gets used to any changes.
Healthy eating 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 in the hospital under observation for 5 to 10 days.Then a series of rehabilitation measures are carried out aimed at strengthening the hip muscles.First, the patient has to walk with crutches, then with a cane, and finally walk on his own without any help.
At the end of the rehabilitation period, the patient regains his lost ability to work and enjoys an easy gait!
Prevention of coxarthrosis
To prevent coxarthrosis it is necessary:
- 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;
- take chondroprotectors once every 1-2 years after 40 years (in case of family predisposition to coxarthrosis or joint injury).