Coxarthrosis or hip arthritis is a degenerative-dystrophic disease that leads to loss of elasticity and destruction of cartilage tissue, premature wear of the joint of the same name.Osteoarthritis is considered an age-related problem, which is confirmed by world statistics: after 40 years, every second person is diagnosed, and closer to 70 years of age, pathology is detected in 80% of cases.Structural changes in the hip area occur 2.5 times more often in women than in men.
Cause of the disease
The hip joint is formed by the acetabulum, which includes the head of the femur.The greater trochanter is attached to the head of the joint, surrounded by a synovial capsule that has a thick mucus-like mass.It is the synovial membrane that nourishes the hip cartilages and ensures they slide easily against each other without noise or pain.Age-related reduction in synovial fluid production and changes in its viscosity are the main causes of hip osteoarthritis.
Coxarthrosis of mobile joints in the hip area occurs when:
- Perthes disease.
- Hip dysplasia.
- Reactive or infectious coxitis.
- Metabolic disorders.Diabetes and gout can cause joint disease.
- Chondromatosis of the joints.The disease is characterized by the formation of loose intra-articular masses that damage the hyaline cartilage.
- Mechanical trauma.This includes fractures or dislocations of the hip (including congenital), tears of the joint capsule, and frequent microtraumas to the joints.
People who are overweight and have bad habits are at risk of getting the disease.In professional runners or weightlifters, connective tissue wears out quickly and athletes inevitably experience displacement of the articular cartilage and tears of the hip muscles.Hip osteoarthritis itself is not hereditary, but structural features of bone tissue or slow metabolism are genetically determined.
Process of the disease
First of all, arthritis affects the large joints of the pelvis and knee joints (gonorrhea);it is they who have to bear the huge load when moving.In the stage of exacerbation, acute arthritis occurs, then palpation of the joints and hip tissues is accompanied by pain.In cases where the femur fuses incompletely or incorrectly after injury, a new joint or prosthesis is formed, not with scar tissue but filled with connective tissue.
There are grade 1, 2 and 3 hip osteoarthritis, each stage has its own characteristics:
- Grade 1 osteoarthritis develops slowly, does not affect the mobility of joint structures, and muscle tone is normal.In the early stages of coxarthrosis, the disease can only be detected by X-rays.
- Grade 2 hip osteoarthritis is accompanied by severe pain in the hip area, sometimes a cracking sound is heard in the joint.With arthritis, it is difficult to rotate the hip and move sideways, the joint space narrows, and the tone of the hip muscles weakens.A contraction begins to form.
- With grade 3 coxarthrosis, pain syndrome is pronounced.Due to hip muscle atrophy and femoral neck expansion, the legs become shorter.When walking, patients use support objects.Due to arthritis, the joint space can completely disappear, in this case people talk about ankylosing spondylitis.
In clinical practice, physicians frequently encounter complicated coxarthrosis (typical in the elderly) and postinfectious hip arthropathy.Patients taking corticosteroids and antidepressants are at risk for the hormonal disorder coxarthrosis;This type of joint disease also affects the joints of women during menopause.With arthritis, the inflammatory process predominates rather than degeneration in the hip joint.
If the cause of the disease is not established, we are talking about primary or idiopathic coxarthrosis.Usually the disease affects the joints of people who have passed the 50-year mark.Secondary arthritis develops at a young age;As a rule, the diagnosis is arthritis of the left or right hip joint (unilateral coxarthrosis).
Symptom
Symptoms of hip osteoarthritis do not bother the patient at first, only occasionally prolonged load on the affected area or difficulty in movement reminds of the problem.
Coxarthrosis of the hip joint manifests itself:
- Pain in the hip area.The intensity and nature of joint pain depends on the stage of arthritis and weather conditions.
- Body temperature increases.Chills and joint swelling are observed with arthritis in one or two hip joints.
- Subsequent weakening and atrophy of the hip muscles.
- A distinct crunching sound in the joints.A possible sign of coxarthrosis, but not required.
- Lameness.Due to the destruction of the hip bone and osteoarthritis, an uncertain, "duck" gait develops.
People with coxarthrosis often feel pain radiating down to the kneecap, so an inexperienced doctor after hearing the patient's complaints may misdiagnose and delay recovery for months.
Diagnose
Arthritis is diagnosed by a rheumatologist, traumatologist, or orthopedist.After interviewing the patient, the doctor conducts an external examination of the hip area, studies the mobility of the legs and evaluates the gait of the patient with coxarthrosis.
The most effective methods for diagnosing joint diseases include:
- General blood and biochemical tests.
- Routine x-ray of the hip area.
- Ultrasound and MRI examination.
If hip infection is suspected, the volume of synovial fluid will be determined and its cellular composition will be examined.To exclude the presence of autoantibodies in the body, the patient was sent for serum RF analysis.
How is hip arthritis treated?
The method of treatment of hip arthrosis is selected taking into account the stage of coxarthrosis, the patient's age and concomitant diagnoses.Grade 1 and 2 osteoarthritis can be cured with a comprehensive method: using pharmaceuticals combined with physical therapy, massage and a special diet.
After the end of the acute coxarthrosis stage, cardiovascular training without running and jumping is allowed for the treatment of the hip joint.
After the end of the acute coxarthrosis phase, gentle exercises with limited range of motion, cardiovascular training without running and jumping are chosen to treat the hip joint.In the final stages, treatment for hip arthritis takes place in a nursing home setting.
Drug treatment
Conservative treatment of the disease is aimed at reducing pain in the hip area and maintaining joint function.The main goal is complete recovery or stable remission of coxarthrosis.
Arthritis treatment cannot be completed without the following:
- NSAIDs.Nonsteroidal drugs relieve pain and inflammation in mobile joints, but pills have nothing to do with restoring the structure of hyaline cartilage in coxarthrosis.
- Vasodilators.The medicine ensures the supply of nutrients to arthritic joints and eliminates congestion in the hip area.
- Chondroprotectors.Saturates joint tissues with water, improving its lubricating properties.Prevents destruction of joint structures in the hip area.Glucosamine and chondroitin sulfate are part of many cartilage protectants.
- Anti-arthritis gels and ointments.They have a warming, irritating or distracting effect.The drug successfully treats hip osteoarthritis.
- It is recommended to inject steroid drugs into the joint cavity to eliminate pain in the acute phase of coxarthrosis.
Compresses with medical bile increase the effectiveness of the listed methods of treating joint diseases.A therapeutic bandage cannot be applied to the hip area if the lymphatic system is affected and fever is present (infectious coxarthrosis).
Physical therapy
Despite the deep location of the hip joint, physical therapy methods help alleviate coxarthrosis.Common physical therapy methods include electrophoresis, laser therapy, and warming paraffin applications.Acupuncture improves the preservation of cartilage tissue and the functioning of internal organs.Phonophoresis with hydrocortisone for joint disease combines the advantages of ultrasound and the therapeutic effect on the hip area.
Diet and nutrition
A special diet for coxarthrosis includes foods low in fat and high in vitamins B, C, E, as well as calcium, potassium and magnesium.It is advisable that every new day begins with a glass of freshly squeezed juice.Prioritize boiled and steamed dishes.
The daily menu for arthritis should include:
- Dairy products.
- Fresh vegetables and fruits.
- Low-fat fish and meat.
- Whole grain bread.
- Porridge cooked in water.
From your diet, exclude salty and spicy foods, night foods, baked goods, smoked foods and carbonated drinks.When treating coxarthrosis, you should not buy ready-made foods in the supermarket or semi-finished products.
Endoscopy
Replacement of the affected joint with an artificial joint is indicated in the final stages of coxarthrosis.Before surgery, the patient must undergo general blood and urine tests, hip ultrasound and electrocardiogram.
Main stages of the procedure:
- The surgeon will cut the head of the femur and insert a pin inside to connect to the titanium femoral head implant.
- Part of the surface of the pelvis is removed and replaced with a polymer bed connected to a titanium head.
The best way to fix dentures is with bone cement.If arthritis affects the joint at a young age, cementless fastening methods are sometimes used.
Massage
Massage relieves muscle spasms, strengthens the ligamentous apparatus in case of coxarthrosis.During the procedure, patients with arthritis should have a comfortable and relaxed position.First we massage the back (10 minutes), then massage the sacrum-buttocks area.Using circular movements of curved fingers, we knead the problem thigh in the direction of lymph flow - from bottom to top.To slow down the development of arthritis, the procedure is performed 3 times a day.
Exercises and exercise therapy
The degree of load on the hip joint during arthritis is determined by a physiotherapist.It is recommended to carry out physiotherapy in a room specially equipped for this purpose.Swimming in a pool or skiing will speed up the recovery of joints with coxarthrosis.
The popularity of the method of fighting arthrosis presented by rheumatologist P. V. Evdokimenko is increasing.Evdokimenko's gymnastics includes static exercises to strengthen the hip muscles, stretching with minimal pressure on the affected area.For example, if you lie on your left side, bend your left knee and extend your right leg, then hold in the elevated position for about 30 seconds, the muscles will begin to contract.For coxarthrosis, the task is performed in 5 approaches on each leg.
Folk remedies
Traditional methods of treating coxarthrosis are based on basic concepts of medicinal properties.Before the development of the pharmaceutical industry, eucalyptus oil, cloves and fresh aloe vera juice were rubbed into painful joints to cure arthritis.Celandine ointment helps relax hip muscles and tendons.
Effective alternative medicine formula:
- Grind 200 g of white root and pour in lard (300–400 g).Place on low heat, after 5-7 minutes the treatment for coxarthrosis is ready.Rub the cooled mass into the affected joint at night for 2 weeks.
- Beat egg white with 1 tbsp.I.flour.For arthritis, the medicinal mixture should be applied to the hip area before going to bed.Don't forget to wrap the sore joint with parchment paper and a woolen towel.
Shilajit has a powerful restorative effect and improves hip joint mobility.For arthritis and arthritis, 5 g of mumiyo is dissolved in 10–20 ml of water and 45 g of heated Vaseline is poured into it.The product is rubbed into the skin of the thighs with gentle movements.
prevent
Prevention of hip osteoarthritis includes giving up bad habits, a sedentary lifestyle, adding weight to the hip area, exceeding the physiological limits of joint strength.Follow your daily routine and PN guidelines for coxarthrosis, paying attention to your posture.Annual joint examination, starting from the age of 30, will help prevent the development of irreversible changes in the body of patients with joint diseases.
Among the diseases of the musculoskeletal system, hip arthritis occupies a leading position.This disease reduces the patient's quality of life and is the main cause of disability in young people.Even if you cannot protect yourself from coxarthrosis, don't despair – take action!