Coxarthrosis is a disease of the hip joints caused by a change in the structure of the tissues 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 articular cartilage tissue.Cartilage tissue cannot be restored after the completion of the development 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 influenced by the synovial fluid, which performs the function of lubricating the tissues.Due to insufficient lubrication and increased friction, the articular cartilage becomes thinner and eventually wears out completely.The lack of cartilage on the surface of the bones increases the load, friction occurs between the bones, which leads to a change in their shape and position, which leads to the appearance of pain.
Most often, elderly people suffer from coxarthrosis, since by this time the functions of the cartilage tissue have been lost.
Types of coxarthrosis
In medicine, a distinction is made between primary and secondary coxarthrosis.
In the primary case, the causes of the disease are unclear.
The development of secondary coxarthrosis is influenced by the following causes:
- reception of various injuries and fractures;
- congenital abnormalities of the hip joint (congenital hip dislocation);
- the presence of inflammatory processes in the hip area;
- rheumatoid arthritis (a connective tissue disease that destroys joint cartilage);
- aseptic necrosis of the femoral head (death of the femoral head).
Stages of coxarthrosis
In medical practice, coxarthrosis has 4 stages:
Section 1
It is characterized by the appearance of periodic pain in the joint.The pain occurs when you begin to move after a period of rest, but disappears when you resume vigorous activity.In a relaxed state, the pain does not appear.Joint mobility is not impaired.The x-ray shows smaller bone growths and a slight narrowing of the joint space.
Section 2
Occurrence of pain during moderate physical activity and at rest.Appearance of lameness during prolonged walking.Pain may occur in the knee or lower back.The X-ray shows: deformation of the femoral head, uneven bone contour, thickening of the bone neck, significant growth of bone tissue, 2-fold narrowing of the joint space.
Section 3
Constant pain occurs regardless of physical activity, both when active and at rest.Pain can cause insomnia.Due to limited joint mobility, people are forced to walk supported.The radiograph shows a significant increase in the width of the neck of the bone and a decrease in its length compared to the norm, as well as deformation of the femoral head.The joint gap is practically absent.Physical condition is severely limited.The patient may be considered disabled.
Section 4
The patient feels unbearable pain at rest.Any movement causes extreme 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 many reasons, but the most important is damage to blood circulation in the hip area.Due to improper blood circulation, the metabolism in the joints slows down, which leads to gradual atrophy of the leg muscles.
Other causes of coxarthrosis include:
- sedentary lifestyle;
- microtraumas that do not cause pain in the patient;
- endocrine disorders;
- age-related changes in joint surfaces;
- increased load on the joints (most often occurs in athletes);
- inflammatory and infectious processes in the joints;
- pathologies of the feet (flat feet) and spine (scoliosis);
- obesity (increased load on the joint due to excess weight) and other reasons.
Taking into account the health status of the whole organism, they determine the exact causes of the disease in a particular patient.
Symptoms of coxarthrosis
Cosarthrosis affects men and women after 40 years.Women experience more painful symptoms.
The symptoms of coxarthrosis are as follows:
- pain in the hip joint (periodic and painful);
- uneven, unsteady gait (limping);
- the appearance of crunch in the joint;
- the mobility of the injured leg is limited (at the initial stage, the difficulty and stiffness of movements, fatigue and general malaise are felt);
- the appearance of hamstring atrophy (the volume and tone of the muscles changes, causing pain in the knee).
Diagnosis of coxarthrosis
To determine the diagnosis of coxarthrosis, diagnostic procedures must be performed:
- examination of the patient by a specialist;
- Carrying out general and biochemical blood tests (allows identification of inflammatory processes and differentiation of arthritis and arthrosis);
- X-ray (used to detect damage and changes in bone tissue);
- magnetic resonance imaging of the joint (detects minor changes in the cartilage tissue).
Treatment of coxarthrosis
Specialists use medical procedures and drugs to treat the disease.
Treatment methods for coxarthrosis include:
- therapeutic exercises and massage;
- physiotherapy;
- ozone therapy;
- cryotherapy;
- medication;
- surgical treatment etc.
In specialized clinics, an individual treatment program for coxarthrosis is selected for each patient, taking into account age, concomitant diseases and the stage of coxarthrosis.An individual approach contributes to the patient's fastest possible recovery.
Physiotherapy and massage
Gymnastics strengthens muscles and improves blood circulation.Morning exercises not only wake up the body after sleep, but also raise synovial fluid from the lower parts of the joint.The synovial fluid lubricates the cartilage tissue with essential nutrients, which increases the cartilage's resistance to stress during the day.
However, in the case of coxarthrosis, physical exercises should be chosen wisely.Movements that are too sudden and forceful can cause severe pain and damage to the joint.We recommend going to the pool, as swimming strengthens muscles, relieves joint stress and does not cause injury.
Coxarthrosis massage is a very effective and safe method.It improves blood circulation, strengthens muscles, relieves painful cramps, swelling and muscle tension.During the massage of the hip joint, lower back and back, the muscles relax, thanks to which the synovial fluid is distributed in 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, 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:
- Topical medications(ointments, poultices, lotions).As a result of advertising, most patients believe that treatment with various ointments and creams is the most effective.However, this is a misconception, because the healing properties of such drugs cannot reach the hip joint due to its depth.They only temporarily improve blood circulation and relieve cramps.The causes of coxarthrosis are not eliminated, and the disease gradually develops into an increasingly complex stage.
- Nonsteroidal anti-inflammatory drugs.It is used to eliminate 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 needed for normal joint function.
- Muscle relaxants(medicines that relax muscles).It improves blood circulation and relieves muscle tension around the joint.The effect of the drugs is temporary, the joint functions are not restored.
- Hormonal steroid drugs.Intra-articular hormone injections help with accompanying diseases, such as femoral tendonitis.They have side effects and a short-term therapeutic effect.
- vasodilators.It is 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 joint circulation 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(medicines for cartilage repair).These are the most effective modern drugs, as they affect the restoration of cartilage tissue and feed it with the necessary substances.Regular use of chondroprotectors can stop the development of coxarthrosis.Over time, a positive result will appear, and after the drug is stopped, the process of cartilage restoration will continue.
Surgical treatment of coxarthrosis
Surgical intervention is used in case of significant destruction of the cartilage tissue, impossibility of restoration and immobility of the joints.In some cases, surgery is the only possible way for a person to be able to walk without pain.
Endoprosthesis is an operation during which the affected joint is removed and replaced with an artificial analogue, an endoprosthesis.The shape of the endoprosthesis resembles a real joint, it fulfills all the functions of the joint and withstands walking, running, etc.
Lifespan of the endoprosthesis
Like all things, an endoprosthesis has its lifespan.Endoprosthesis wear depends on loading and mobility.Excess weight significantly increases the load, and the life of the prosthesis will be about 10 years.With moderate loading and mobility, the endoprosthesis lasts about 15 years.There are also prosthetic models with a service life of 20-25 years, but their main disadvantage is the high cost.
After the endoprosthesis wears out, a second operation must be performed to replace it.However, replacement of the prosthesis is complicated by the fact that the hip bone thins over time and the problem of fixing the prosthesis arises.Therefore, in order to avoid repeated endoprostheses, conservative treatment methods should be used for as long as possible.
It is worth mentioning the risks of hip replacement - the number of deaths after surgery is 1-2%.
Rehabilitation after endoprosthesis
Joint replacement surgery is quite complex and it takes time to restore lost mobility.The recovery period includes body strengthening methods: massage, gymnastics and breathing exercises.The amount and complexity of the loads should be gradually increased so that the body gets used to all the changes.
A healthy diet also speeds up the healing process.We recommend that you include foods rich in phosphorus and phospholipids in your diet, as their properties contribute to the restoration of cartilage tissue.
The rehabilitation period lasts about 6 months.The patient is under observation in the hospital for 5-10 days.A series of rehabilitation measures are then performed to strengthen the hip muscles.First, the patient must walk with crutches, then with a cane, and finally independently, 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
In order to prevent coxarthrosis, the following is necessary:
- stick to an active lifestyle (doing morning exercises, short walks);
- do not engage in sports professionally;
- follow a balanced diet, as this helps to avoid weight gain, which causes additional stress on the joints;
- After 40 years, take a chondroprotector course every 1-2 years (if you have a family tendency to coxarthrosis or joint injuries).