Coxarthrosis is a disease of the hip joints caused by changes in the tissue structure in them.The disease has another name - arthrosis 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 renewed after the completion of the formation of the human skeleton, 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 lubricating the tissue.Due to insufficient lubrication and increased friction, the articular cartilage becomes thinner and eventually wears out completely.The absence of cartilage causes an increase in the load on the surface of the bones, there is friction between the bones, and this leads to a change in their shape and position, which leads to the appearance of pain.
Most often, people in old age suffer from coxarthrosis, because by that time the functions of cartilage tissue have been lost.
Types of coxarthrosis
In medicine, primary and secondary coxarthrosis are distinguished.
In the primary case, the causes of the disease are unclear.
The development of secondary coxarthrosis is influenced by the following reasons:
- receiving various injuries and fractures;
- congenital defects in the hip joint (congenital dislocation of the hip);
- the presence of inflammatory processes in the hip area;
- rheumatoid arthritis (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:
Phase 1
It is characterized by periodic joint pain.The pain occurs when you start to move after a state of rest, but disappears in the process of resuming vigorous activity.In a calm state, pain does not appear.The mobility of the joints is not disturbed.The X-ray shows smaller bony growths and a slight narrowing of the joint space.
Phase 2
The appearance of pain during moderate physical activity, as well as at rest.Appearance of lameness during prolonged walking.Pain may occur in the knee or lower back.The x-ray shows: changes in the shape of the femur head, uneven bone contour, thickening of the bone neck, significant growth of bone tissue, narrowing of the joint space by 2 times.
Phase 3
Constant pain occurs regardless of physical activity, both in an active and at rest state.Pain can cause insomnia.Due to the limited mobility of the joints, the 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 and deformation of the head of the femur.The joint space is practically absent.The physical condition is very limited.The patient may be recognized as disabled.
Phase 4
The patient feels unbearable pain at rest.Every movement causes severe pain, the patient cannot move with support (crutches, cane).The only way to treat coxarthrosis is surgery.
Causes of coxarthrosis
The appearance of coxarthrosis is influenced by numerous reasons, the most important of which is impaired blood circulation in the hip area.Due to improper circulation, the metabolism in the joints slows down, which leads to gradual atrophy of the leg muscles.
Other causes of coxarthrosis are:
- sedentary lifestyle;
- microtraumas that do 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 joints;
- pathologies of the feet (flat feet) and spinal column (scoliosis);
- obesity (increased joint load due to excess weight) and other reasons.
Taking into account the health condition of the whole organism, the exact causes of the disease for a particular patient are determined.
Symptoms of coxarthrosis
Osteoarthritis affects men and women after 40 years.Women experience more painful symptoms.
Signs of coxarthrosis are:
- pain in the hip joint (appears periodically and is painful in nature);
- uneven, unsteady gait (limping);
- appearance of cracking in the joint;
- the mobility of the injured leg is limited (in the initial phase one feels heaviness and stiffness in movements, fatigue and general weakness);
- occurrence of thigh muscle atrophy (muscle volume and tone change, which causes knee pain).
Diagnosis of coxarthrosis
In order to determine the diagnosis of coxarthrosis, it is necessary to undergo diagnostic procedures:
- examination of the patient by a specialist;
- Conducting general and biochemical blood tests (allows us to identify inflammatory processes and distinguish arthritis from arthrosis);
- X-ray (used to detect damage and changes in bone tissue);
- magnetic resonance of the joint (reveals minor changes in cartilage tissue).
Treatment of coxarthrosis
To treat diseases, experts use medical procedures and drugs.
Treatment methods for coxarthrosis include:
- therapeutic exercises and massage;
- physiotherapy;
- ozonotherapy;
- cryotherapy;
- drug treatment;
- surgical treatment etc.
In specialized clinics, an individual coxarthrosis treatment program is selected for each patient, taking into account their age, accompanying diseases and the stage of coxarthrosis.An individual approach contributes to the patient's recovery as quickly as possible.
Therapeutic gymnastics and massage
Gymnastics helps to 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 the cartilage tissue with essential nutrients, which increase the cartilage's resistance to stress during the day.
However, for coxarthrosis, physical exercises should be chosen wisely.Too sudden and forceful movements can cause severe pain and injure the joint.It is recommended to go to the pool, because swimming strengthens the muscles, relieves stress on the joint 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, the lower back and the back, the muscles relax, due to which the synovial fluid is distributed over the cartilage.
Physiotherapy
Physiotherapy combines different methods:
- electrotherapy;
- UHF therapy;
- ultrasound therapy;
- laser therapy;
- paraffin therapy, etc.
All these procedures are aimed at improving blood circulation, relieving spasms and inflammation, and this is due to the fact that access to the hip joint is limited.
Drug treatment
There are many drugs that perform different functions in the treatment of coxarthrosis:
- Local remedies(ointments, poultices, lotions).Under the influence of advertisements, 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 such drugs cannot reach the hip joint due to its deep location.They only temporarily help improve blood circulation and relieve spasms.The causes of coxarthrosis are not eliminated, and the disease continues to gradually develop into a more complex phase.
- Nonsteroidal anti-inflammatory drugs.They are used to remove inflammatory processes, relieve swelling and pain.As a result of long-term use of non-steroidal drugs, side effects occur that negatively affect the internal organs (gastritis).These drugs do not restore the cartilage tissue necessary for normal joint function.
- Muscle relaxants(muscle relaxants).It improves blood circulation and relieves muscle tension around the joint.The effect of the drugs is temporary, the functions of the joints are not restored.
- Hormonal steroid drugs.Intra-articular hormone injections help with accompanying diseases, for example, in case of femoral tendonitis.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 circulation in the joints and help deliver the nutrients needed by the cartilage tissue.When used correctly, vasodilator drugs provide a significant therapeutic effect.However, the effectiveness of the treatment is affected by the individual tolerability of the drugs.
- Chondroprotectors(drugs that restore cartilage).They are the most effective modern drugs, because they affect the restoration of cartilage tissue and feed 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 cartilage restoration process will continue.
Surgical treatment of coxarthrosis
Surgical intervention is resorted to in case of significant destruction of the cartilage tissue, 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.
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, it performs all joint functions and can withstand heavy loads during walking, running, etc.
The lifetime of the endoprosthesis
Like anything, endoprosthesis has a lifespan.Endoprosthesis wear depends on load and mobility.Excessive weight significantly increases the load, and the service life of the prosthesis will be about 10 years.With moderate loading 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 disadvantage is the high price.
After wearing out the endoprosthesis, it is necessary to perform another operation to replace it.However, replacement of the prosthesis is complicated by the fact that the bone becomes thinner over time and the problem of fixing the prosthesis arises.Therefore, in order to avoid the repetition of 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 complex and it will take time to regain lost mobility.The recovery period includes methods that strengthen the body: massage, gymnastics and breathing exercises.The volume and complexity of the load should be gradually increased so that the body gets used to all the changes.
A healthy diet also speeds up the healing process.It is recommended to include foods rich in phosphorus and phospholipids in the diet, because their properties contribute to the restoration of cartilage tissue.
The rehabilitation period lasts about 6 months.The patient is in the hospital for observation for 5 to 10 days.Then a series of rehabilitation measures aimed at strengthening the hip muscles is carried out.First the patient will 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 ability to work and the joy of easy walking!
Prevention of coxarthrosis
To prevent coxarthrosis, you need:
- adhere to an active lifestyle (do morning exercises, go for short walks);
- they do not play sports professionally;
- maintain a balanced diet, as this helps to avoid gaining weight, which causes additional stress on the joints;
- take a course of chondroprotector once every 1-2 years after 40 years (in cases of family predisposition to coxarthrosis or joint injuries).