Coxarthritis or arthropathy of the hip joint is a degenerative-dystrophic disease that leads to loss of elasticity and destruction of cartilage tissue, premature wear of the homonymous joint.Arthritis is considered an age-related problem, which is confirmed by global statistics: after 40 years, every second person is diagnosed, and closer to 70, pathology is detected in 80% of cases.Structural changes in the hip area occur 2.5 times more often in women than in men.
Causes of the disease
The hip joint is formed by the acetabulum, which includes the head of the femur.The greater trochanter attaches to the articular head, which is surrounded by a synovial bursa with a thick mucous mass.It is the synovial membrane that nourishes the cartilages of the hip and ensures their easy sliding together, without noise and pain.The age-related decrease in the production of synovial fluid and the change in its viscosity are the main causes of osteoarthritis of the hip joint.
Coxarthrosis of the mobile joints in the hip area occurs when:
- Perthes disease.
- Hip dysplasia.
- Reactive or infectious coccitis.
- Metabolic disorders.Diabetes mellitus and gout can cause joint disease.
- Coarsening of the joints.The disease is characterized by the formation of loose intra-articular bodies that damage the hyaline cartilage.
- Mechanical injuries.This includes fracture or dislocation of the hip (including congenital), rupture of the joint capsule and frequent microtrauma of the joints.
People who are overweight and have bad habits are at risk.In professional runners or weightlifters, connective tissue wears down quickly, and athletes are not immune to displaced articular cartilage and hip muscle tears.Hip arthropathy itself is not hereditary, but the structural characteristics of bone tissue or slow metabolism are genetically determined.
Course of the disease
First of all, arthropathy affects the large joints of the bones of the pelvis and knee joints (knee joint).they are the ones who carry a huge load when moving.During the period of exacerbation, acute arthropathy occurs, then palpation of the tissue of the joint and hip is accompanied by pain.In case of incomplete or incorrect fusion of the femur after an injury, a neo-joint or false joint is formed, filled not with callus, but with connective tissue.
There are joints of the hip joint of the 1st, 2nd and 3rd degree, each stage of the disease has its own characteristics:
- 1st degree arthropathy develops slowly, without affecting the mobility of joint structures, muscle tone is normal.In the initial stage of coxarthrosis, the disease can only be detected by X-rays.
- Osteoarthritis of the hip joint of the second degree is accompanied by severe pain in the hip area, sometimes a cracking sound is heard in the joint.With arthropathy, it is difficult to rotate the hip and move it to the side, the joint space narrows and the tone of the hip muscles weakens.A contraction begins to form.
- With coxarthrosis of the 3rd degree, the pain syndrome is intense.Due to atrophy of the muscles of the hip area and expansion of the neck of the femur, the leg is shortened.When walking, the patient uses support.Due to articulation, the joint space can disappear completely, so they talk about bony ankylosis.
In clinical practice, doctors regularly deal with an involutional type of coxarthrosis (common in the elderly) and postinfectious arthropathy of the hip joint.Patients receiving corticosteroids and antidepressants are at risk of dyshormonal coxarthrosis.This type of arthritis also affects the joints of menopausal women.With arthropathy-arthritis, the inflammatory rather than the degenerative process predominates in the hip joint.
If the etiology of the disease has not been documented, we speak of primary or idiopathic coxarthrosis.Usually the disease affects the joints of people who have crossed the 50-year mark.Secondary arthropathy develops at a young age.as a rule, arthropathy of the left or right hip joint (unilateral coxarthrosis) is diagnosed.
Symptoms
The symptoms of arthrosis of the hip joint do not initially bother the patient, only occasional prolonged loads on the affected area or uncomfortable movement remind 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 the joint and weather conditions.
- Increased body temperature.Joint stiffness and swelling are seen with joint-arthritis of one or two hip joints.
- Weakening and subsequent atrophy of the muscles of the hip area.
- A distinct cracking sound at the joints.Possible sign of coxarthrosis, but not mandatory.
- Lameness.Due to the destruction of the hip bone with arthropathy, an uncertain "duck" gait is formed.
Those suffering from coxarthrosis often experience pain that radiates to the patella, so an inexperienced doctor, after listening to the patient's complaints, can make an incorrect diagnosis and delay the recovery process for many months.
Diagnostics
Arthropathy 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 arthropathy include:
- General and biochemical blood test.
- Plain x-ray of the hip area.
- Ultrasound and MRI.
If infectious arthropathy of the hip joint is suspected, the volume of synovial fluid is determined and its cellular composition is examined.To rule out the presence of auto-aggressive antibodies in the body, the patient is sent for RF analysis in the blood serum.
How is hip arthropathy treated?
Treatment for arthropathy of the hip joint is selected taking into account the stage of coxarthrosis, the age of the patient and the accompanying diagnoses.Arthropathy of degrees 1 and 2 can be treated using an integrated approach: taking pharmaceutical drugs in combination with physiotherapy methods, massage and a special diet.
After the acute period of coxarthrosis is over, cardio training is allowed without running and jumping to treat the hip joint.
After the end of the acute period of coxarthrosis, mild gymnastic exercises with a limited range of motion, cardio training without running and jumping are selected for the treatment of the hip joint.At the final stage, the treatment of arthrosis of the hip joint takes place in a sanatorium-resort environment.
Pharmaceutical treatment
Conservative treatment of the disease aims to relieve pain in the hip area and maintain the functionality of the joints.The main goal is complete recovery or stable remission of the coxarthrosis.
Arthritis treatment is not complete without the following:
- NSAIDs.Non-steroidal drugs relieve pain and inflammation in the mobile joint, but the tablets have nothing to do with the restoration of the hyaline cartilage structure in the coxal joint.
- Vasodilators.Medicines ensure the supply of nutrients to the joints affected by arthritis and eliminate congestion in the hip area.
- Carboprotectors.Saturate the tissues of the joints with water, improving its lubricating properties.It stops the destruction of the joint structures in the hip area.Glucosamine and chondroitin sulfate are part of many chondroprotectants.
- Anti-arthritis gels and ointments.They have heating, irritating or distracting effects.Medicines successfully treat arthropathy of the hip joints.
- 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 mentioned treatments for arthropathy.Therapeutic dressings cannot be applied to the hip area if the lymphatic system is affected and there is a fever (infectious coxarthrosis).
Physiotherapy
Despite the deep location of the hip joints, physical therapy methods bring relief from coxarthrosis.Popular physical therapy procedures include electrophoresis, laser therapy, and paraffin heating applications.Acupuncture improves the innervation of cartilage tissue and the functioning of internal organs.Phonophoresis with hydrocortisone for joints combines the advantages of ultrasound and medicinal effects in the hip area.
Diet and nutrition
A special diet for coxarthrosis consists of foods that are low in fat and high in vitamins B, C, E, as well as calcium, potassium and magnesium.It is good to start each new day with a glass of freshly squeezed juice.Give preference to boiled and steamed.
The daily menu for arthropathy should consist of:
- Dairy products.
- Fresh vegetables and fruits.
- Low-fat varieties of fish and meat.
- Whole wheat bread.
- Porridge cooked in water.
From your diet, exclude salty and spicy foods, night snacks, pastries, smoked and carbonated drinks.When treating coxarthrosis, you should not buy ready-made foods from supermarkets or semi-processed products.
Endoprosthetic
Replacing the affected joint with an artificial one is indicated in the last stage of coxarthrosis.Before the operation, the patient must undergo general blood and urine tests, an ultrasound of the hip area and an EKG.
Main steps of the process:
- The surgeon cuts the femoral head and inserts a pin inside to connect to the titanium femoral head implant.
- A portion of the pelvic bone surface is removed and a layer of polymer is attached in its place, which is attached to the titanium head.
The best way to fix dentures is with bone cement.If arthropathy affects the joints at a young age, cementless fixation methods are sometimes used.
Massage
The massage relieves muscle spasms, strengthens the ligamentous apparatus in case of coxarthrosis.During the procedure, the patient with arthropathy must take a comfortable position and relax.First we rub the back (10 minutes), then we massage the sacro-gluteal area.Using circular movements of bent fingers, we knead the problematic thigh in the direction of the flow of lymph - from bottom to top.To slow down the development of arthropathy, the procedure is carried out 3 times a day.
Exercises and exercise therapy
The level of loading on the hip joints during arthropathy is determined by the physical therapist.It is recommended to do physical therapy in a room specially equipped for this purpose.Swimming in the pool or skiing will speed up the recovery of coxarthrosis joints.
The popularity of the method of combating arthropathy, which was presented by practicing rheumatologist P. V. Evdokimenko, is growing.Evdokimenko's gymnastics consists of 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 leg at the knee and extend your right leg, then hold it in the raised position for about 30 seconds, the muscles will begin to contract.For the coxal joint, the work is performed in 5 approaches on each leg.
Folk remedies
Traditional methods of treating coxarthrosis are based on basic concepts about the properties of medicinal herbs.Before the development of the pharmaceutical industry, eucalyptus oils, cloves and fresh aloe juice were rubbed into painful joints for joints.Celandine ointments relax the muscles and tendons of the hip.
Effective alternative medicine recipes:
- Grind 200 g of the roots of the white leg and fill it with pork fat (300–400 g).Put on low heat, after 5-7 minutes the medicine for coxarthrosis is ready.Rub the cold mass on the affected joint at night for 2 weeks.
- Beat the egg white with 1 tbsp.large.flour.For arthropathy, the medicinal mixture should be applied to the hip area before going to bed.Don't forget to wrap the sore joint with greaseproof paper and a woolen scarf.
Shilajit has a strong restorative effect and improves the mobility of the hip joints.For arthritis and arthritis, 5 g of mumiyo is dissolved in 10-20 ml of water and 45 g of heated petroleum jelly is poured into it.The product is rubbed into the skin of the thigh with gentle movements.
Prevention
Prevention of arthropathy of the hip joint includes giving up bad habits, sedentary lifestyle, extra pounds load the hip area, exceeding the normal limits of joint strength.Follow the daily routine and PN principles for coxarthrosis, watch your posture.An annual examination of the joints, starting at the age of 30, will help prevent the development of irreversible changes in the body of a patient with arthropathy.
Among the pathologies of the musculoskeletal system, arthropathy of the hip joint occupies a leading position.The disease reduces the patient's quality of life and is the main cause of disability at a young age.Even if you could not protect yourself from coxarthrosis, do not despair - act!