One of the most serious pathologies of the musculoskeletal system is coxarthrosis of the hip joint. If the visit to a medical facility is delayed, the disease may progress - up to the appearance of an acute pain syndrome, which cannot be relieved with analgesics, and the complete loss of motor ability in the joint.
In this article we will talk in detail about all the nuances related to eliminating the consequences of this pathological process, its stages and preventive procedures.
What is hip joint coxarthrosis?
We are talking about a severe degenerative dystrophic disease of the hip joint, which can cause a violation of the functional capacity of the joint, up to its absolute loss. In terms of frequency of manifestation, coxarthrosis ranks second after deforming arthrosis of the knee joint.
Coxarthrosis of the hip joint is accompanied by degenerative damage to the cartilage, the appearance of pathological growths, bone resorption, inflammatory processes and other complications.
In other words, this pathology is characterized by damage to the entire joint, which includes the cartilaginous tissue, the synovial layer, the subchondral bone plate, the muscular structures, the capsule and the ligaments.
The following forms of the disease are also distinguished:
- Primary Coxarthrosis. It is considered the most common disease in the hip joint. In the elderly, this pathology manifests itself against the background of age-related changes;
- Secondary Coxarthrosis. It manifests itself as a result of any disease.
Causes of Coxarthrosis
The development of pathology can be provoked by reasons of an external, acquired and hereditary nature.
In particular, Coxarthrosis can manifest itself against the background of congenital inferiority of the hip joint, degenerative-dystrophic changes, trauma, inflammatory processes, bone marrow necrosis of the femoral head, metabolic disorders, genetic factors, age-related changes, obesity, vascular abnormalities and work in difficult conditions.
It should be noted that almost all joint structures are subject to inflammation.
3 stages of development of hip joint coxarthrosis
During the development of the pathological process, the viscosity of the articular fluid increases, which causes microcracks to appear and leads to dehydration of the cartilage surface. This, in turn, contributes to the appearance of crunching and limited mobility. A person feels these unpleasant manifestations during daily stress and physical activity. As pressure on the lower extremities increases, the exhausted joint adapts to the forced position and begins to destroy nearby structures.
Currently, there are 3 stages of disease development:
- First. Coxarthrosis of the hip joint at this stage has mild symptoms that are inconsistent and appear in the affected area. At the same time, motor activity is preserved, and to relieve pain it is enough to take medications;
- Second. When a patient is diagnosed with coxarthrosis of the hip joint at stage 1, the disease does not cause much discomfort, but when it comes to stage 2 of the disease, the symptoms become more pronounced. The pain becomes more intense and begins to radiate to other parts of the body. Motor capacity deteriorates significantly, which becomes especially noticeable after prolonged walking or increased physical exertion;
- Third. If hip joint coxarthrosis of the 2nd degree is still treatable, then in the third stage the pathology becomes chronic. It is accompanied by constant pain and is transmitted to the lower part of the body. The patient loses the ability to move without crutches. In the absence of adequate therapeutic measures, atrophy of cartilaginous and muscular structures occurs.
Types of Coxarthrosis
The classification of hip joint pathology is based on one criterion - how the disease arose in the musculoskeletal system. There are two main risk factors that can trigger the onset of the disease - genetic and acquired due to age-related changes. The pathological process is also divided into several types, depending on the origin of the occurrence:
- Primary Coxarthrosis. This pathology manifests itself in the hip region and is acquired. At the initial stage, it affects the synovial capsule, after which it passes to the area of tissues surrounding the joint. Risk factors include increased pressure in the pelvic bones, excessive physical activity and the presence of inflammatory foci in the lower extremities and spine. Degenerative lesions are concentrated in tissues that have already undergone changes;
- Secondary Coxarthrosis. This anomaly is hereditary. It manifests itself in the joints and musculoskeletal system. The development of the pathological process can begin already in utero, after a woman has suffered an injury, as well as against the background of necrosis of the bone marrow of the femoral head.
Types of Coxarthrosis due to occurrence:
- Post-infectious. Identified in the presence of consequences after infectious diseases;
- Post traumatic. Diagnosed in case of complications after limb injury;
- Dishormonal. It occurs against the background of metabolic disorders or drug overdose;
- Involutional. It appears in people over 50 years old due to the aging of the body.
Diagnostic measures
If you suspect grade 1 or 2 coxarthrosis of the hip joint, before starting treatment, you must carry out a complete examination of the body. It is also important to consult an orthopedic doctor, who will perform examinations, give recommendations on laboratory tests and draw up an effective treatment plan. Typically, diagnostic measures are limited to the following procedures:
- Radiography. It allows you to study the parameters of the gap between the cartilages, diagnose the presence of pathological growths, and also assess the condition of the femoral head;
- Ultrasound. It allows you to monitor the etiology of changes in bone and ligament structures, as well as study the dynamics of the patient's condition and determine the degree of development of the anomaly;
- TC. Allows you to obtain more detailed information about the state of joints and tissues located nearby;
- MRI. This method provides a detailed picture of the condition of all structures in the hip joint.
Treatment of hip joint coxarthrosis
If the patient has been diagnosed with 1 or 2 degree hip joint coxarthrosis, it is possible to achieve effective results using conservative methods. This therapy is prescribed to the patient individually and covers several techniques, which only together provide a positive effect. So, if a patient is diagnosed with hip joint coxarthrosis of 1 or 2 degrees, and corresponding symptoms are observed, the following measures can be recommended:
- Use of medications;
- Physiotherapeutic procedures;
- Shock wave therapy;
- Physiotherapy.
To obtain positive dynamics using conservative methods, the causes that provoked the occurrence of coxarthrosis of the hip joint must be eliminated. First of all, body weight should be reduced, which will reduce the load on the joint and minimize the likelihood of further development of the degenerative-dystrophic process.
Furthermore, the use of tobacco products must be eliminated and physical activity must be increased, avoiding excessive exertion. To prevent the progression of the pathology, experts advise the use of orthopedic devices (ortheses and bandages). They allow you to firmly fix the joint and provide the necessary support during physical activity.
Medicines
Medicines are also prescribed individually. As a rule, patients are recommended to take the following medications:
- Nonsteroidal anti-inflammatory drugs. These medicines allow you to achieve a double effect: relieve pain and eliminate the inflammatory process;
- Preparations containing chondroitin, glucosamine and collagen. They allow you to activate restoration processes in cartilage;
- Steroid hormones. Medicines with a strong anti-inflammatory effect. Used in situations where NSAIDs are not significantly effective;
- Muscle relaxants. Medicines that relieve muscle tone, a necessary condition for relieving more intense pain;
- Means that normalize blood circulationand improving the trophism of tissues located close to the joint;
- Vitamin B. Complexes containing this vitamin are prescribed to improve nerve transmission, which is of particular importance when the endings are compressed by the affected structures.
In case of significant pain, periarticular blocks are also recommended. They are carried out only under the supervision of specialist professionals in a clinical environment. In this case, special solutions with steroid hormones and anesthetics are injected into the joint.
Gymnastics for coxarthrosis of the hip joint
Particularly effective in restoring motor function and reducing muscle spasm are the special exercises recommended for coxarthrosis of the hip joint. Due to the optimally selected load, it is possible to relieve pain and increase the range of movements. In addition, a properly composed complex allows you to prevent atrophic processes in muscles and relieve spasms if pinched nerve endings are observed against the background of the disease.
In addition, gymnastics for coxarthrosis of the hip joint helps to improve blood flow in the affected area and allows you to speed up the recovery processes.
When choosing exercises, the specialist must take into account the destruction of the hip joint and the physical condition of the patient.
Physiotherapeutic methods
Massage and physiotherapy procedures can provide a special analgesic, anti-inflammatory and decongestant effect. They also help maintain muscle tone in the limbs, preventing atrophic processes.
For anomalies of the hip joint, the following procedures are performed:
- UHF;
- Laser exposure;
- Ultrasound treatment;
- Magnetotherapy;
- Exposure to direct electrical current in combination with medications;
- Paraffin therapy;
- Phonophoresis.
The above treatment will have a positive effect only if the patient has been diagnosed with coxarthrosis in the primary stages.
Shockwave Therapy for Coxarthrosis
For first- or second-stage coxarthrosis, shock wave treatment provides significant positive dynamics. For example, a course of 10-15 shock wave therapy procedures can reduce the negative manifestations characteristic of stage 2 pathology to signs of the initial stage of the disease.
It is important to understand that only timely treatment sessions can provide the best recovery effect. At the same time, it will be possible to reduce the number of SWT procedures.
However, the main positive aspect when impacting the affected joint with shock waves is the ability to normalize blood circulation, which facilitates the accelerated supply of important nutrients involved in regenerative processes to various structures of the hip joint.
In addition, as part of the implementation of shock wave therapy, it is possible to crush pathological bone growths, which contribute to significant irritation of articular tissues and prevent regeneration.
Physiotherapists and neurologists with professional experience work in the clinics. They are fluent in working with the latest physiotherapeutic methods, which include the shock wave method. Furthermore, specialists have the ability to work with modern equipment. This provides a guaranteed positive effect and allows you to shorten the treatment period.
Surgery
Unfortunately, many patients delay contacting a medical center and turn to a specialist only when irreversible processes begin to occur in the hip joint.
For the third or fourth advanced stage of the disease, the only effective method is surgery. It will restore motor capacity and eliminate acute pain, that is, significantly improve the patient's quality of life.
As a rule, surgery is prescribed in the following situations:
- Painful sensations of increased intensity that cannot be relieved with medication;
- Lack of interarticular space;
- Violation of the integrity of the femoral neck;
- Significant limitation of physical activity.
Considering the intensity of joint damage and changes in bone tissue, patients can receive the following types of interventions:
- Arthrodesis. An intervention that creates complete immobility of the joint. For this purpose, special metal plates are used;
- Osteotomy. Surgical intervention that consists of artificially fracturing the femur to straighten its axis. The resulting parts are placed in the optimal position, which makes it possible to remove excessive load from the affected joint;
- Arthroplasty. The only method through which it is possible to restore full functionality of the hip joint and achieve complete recovery for the patient. After using this method of eliminating coxarthrosis, a person forgets about joint problems for 20-30 years.
Medical centers carry out surgical procedures in the hip joint region of any complexity. They are carried out by highly qualified specialists, using modern tools and technologies, which eliminates errors during the intervention.
Complications of the disease
When the pathological process is at an advanced stage, joint mobility is significantly limited, the person loses the ability to walk and take care of themselves, and pathological fusion of tissues is observed. Furthermore, such an anomaly can have an undesirable effect on gait, which is caused by the appearance of lameness and a decrease in the size of the limb.
Preventive actions
Patients with pain in the hip joint should be observed by a specialist and use special orthopedic devices when carrying out work and physical activities. In addition, after surgery, it is necessary to take x-rays 3 times a year to monitor the condition of the joint.