Coxarthrosis of the hip joint, a complex pathology of arthrosis, leads to serious changes in articulation.Unfortunately, adult disability with loss of ability to work is common.In fact, statistics on hip joint diseases account for almost half of all pathologies of the musculoskeletal system.I will give an example from the life of a case after surgical treatment and rare complications during recovery.
Coxarthrosis of the hip joint: a little about this disease
Osteoarthritis is a degenerative-dystrophic change that contributes to the complete destruction of cartilage with loss of joint function.
Coxarthrosis - here the hip joint is destroyed, practically, this is the same arthrosis.
In terms of its mechanism, the articulation of the hip with the pelvis is similar to a door hinge.The head of the femur is connected to the ischium like a hinge.Which has a special anatomical formation - the acetabulum.This structure ensures maximum joint mobility.Which does a full cycle of movement, or rather flexion, extension, rotation, etc.
Normally, the articular surface is smooth, there is enough fluid in it, which ensures smooth sliding.As the disease progresses, the lubricant becomes thicker and more viscous, which immediately affects the condition of the cartilage.Synovial fluid no longer performs its full function.Due to this, the shock absorbing pad becomes dry, cracked and rough.
- First of all.As a result of the lack of necessary sliding, bone friction increases, injuring them.
- Second.As it progresses, the deformation of the bone surface also joins the altered cartilage tissue.Therefore, the body tries to balance the increased load.
- Third.Increased load leads to complete atrophy of the femoral muscle and weakening of the ligaments.
Important: osteoarthritis of the hip joint is a progressive disease.The change can lead to a complete loss of a person's physical activity.Ultimately leading to disability.And really disrupts the normal way of life.The disease and its treatment are significant not only from the medical aspect, but also a huge social problem.
Causes of the development of coxarthrosis and its types
At least there is no real cause of coxarthrosis, which destroys the hip joint.There are only assumptions.Most cases of pathological development of the hip joint are associated with congenital dislocation of the hip and dysplasia (inferiority) of the joint.
Therefore, there are 2 types of coxarthrosis;
- primary (arising from an unknown etiology);
- secondary (related to injury, illness).
Primary osteoarthritis is characterized by a combination of factors:
- descent;
- the influence of biological, mechanical processes;
- overweight;
- metabolic disorders;
- There are also theories about pathological tissue recovery in response to damaging agents (inflammation, friction, infection).
Often this type of coxarthrosis is combined with damage to the spine and inflammatory phenomena of the knee joint (arthritis, arthrosis).
In the secondary version, the reason for the development is clearer.These include:
- Dysplastic disorders.In half of all cases of congenital pathology, grade 1 dysplastic coxarthrosis of the hip joint occurs.
- Hip dislocation (congenital).
- Life trauma.Pelvic fracture, femoral neck, dislocation, subluxation.
- Legg-Calvé-Perthes disease.Osteochondropathy of the femoral head with the development of necrosis.This disease occurs in children when the blood supply and nutrition of the joints are affected.
In addition, pathology can affect both formations at once or be unilateral.In addition to the direct cause of the event, there are predisposing factors that trigger the development of the disease.Often this disease occurs with increased load on the athlete's limbs.As well as people with difficult physical working conditions.Being overweight significantly increases the likelihood of arthrosis.
Provocative factors also include:
- Disorders of metabolic processes, joint nutrition, hormonal imbalance.
- Adynamia.
- Poor posture.Especially scoliosis, kyphosis, which leads to misalignment of the pelvic bones.
- Age after 40 years.It is estimated that after this date, every 10 patients are diagnosed with coxarthrosis of the hip joint, grade 1, 2. After 60, every third person is already observed.And when they reach the age of 70 or more, almost 80% of those who apply have this pathology.
There is no specific gene responsible for the transmission of pathological changes in the joints.However, hereditary factors can still be detected.A person can receive from relatives structural features of cartilage tissue, altered metabolism, and skeletal pathology.It is a combination of such genetic information that can trigger the appearance of hip arthrosis.
Classification
The main division of this disease is based on severity.There are 3 stages, which differ not only in symptoms, but also in changes on radiographs.These indicators are taken as the basis for making a diagnosis.
Degree |
Signs |
|---|---|
me |
|
II |
|
III |
|
This division is the most common.There is also a type of Kellgren classification.It includes 4 levels, plus zero degrees - equivalent to healthy joints.
symptoms
The basis of all diseases of the musculoskeletal system is pain.Coxarthrosis of the hip joint 1-2 degree has less pronounced symptoms compared to the terminal stage 3. At first, the pain manifests itself during exercise.Especially after a long walk or climbing stairs.Then, pain becomes a constant companion, significantly worsening the quality of life.
1st degree coxarthrosis
Unpleasant sensations are concentrated only in the joint area (the groin and back are almost not affected), rarely reflected in the hips or knees.The pain goes away with rest.
At this stage, no further manifestations are detected - the gait remains unchanged, there are no disturbances in movement.In the dysplastic variant, on the other hand, there is an increase in mobility due to changes in the connective tissue;often in the early stages of the disease, due to increased flexibility, patients become interested in gymnastics and yoga.Problems with movement only occur at level 3.
For symptoms of stage 1 coxarthrosis of the hip joint, treatment can be carried out without surgery.Rational therapy allows you to eliminate unpleasant symptoms, stop the development.
2nd stage of the disease
Pain, although not constant, manifests itself during rest.Irradiation becomes noticeable - hips, groin, knees.Stiffness is observed - limited movement in lifting, trying to abduct to the side, difficulty in circular movements of the legs (pain especially often increases).Lameness becomes noticeable, which appears after intense walking or running.
When moving, characteristic arthrosis irritation is heard - rough, dry.
3 degree osteoarthritis
The pain becomes persistent and does not go away after rest and sleep.Unpleasant sensations do not leave the patient even at night.There are problems with walking;to facilitate movement, you need to use crutches.The defect is persistent.
At this stage, limb muscle atrophy occurs, and the leg itself shortens.This change forces the patient to bend to the affected side, further increasing the load on the joint.Mobility limitations are observed in almost all directions.
Changes in bilateral coxarthrosis of the hip joint change the patient's gait, which is why all formations involved in the walking process suffer.Lower back pain appears, posture is disturbed, and the position of the pelvic axis changes.
Diagnostics
An important role in determining the disease is an examination by an orthopedic surgeon, as well as a comprehensive analysis of complaints.It is worth assessing the patient's activities - the ability to climb stairs, comfort while wearing boots and socks, walking activities, use of crutches.
It is recommended to check the general condition - blood test, urine test, biochemistry, ECG, determination of HIV and syphilis markers.
Coxarthrosis of the hip joint stage 1 has the most subtle symptoms.That is why it is worth conducting an X-ray examination to visualize changes in the joint space.This method allows not only to identify diseases.And also often know the cause of the incident - dysplasia, Perthes disease.
Often, knee pain is more pronounced with coxarthrosis grade 1 deformation of the hip joint, so it should be distinguished from gonarthrosis.Differential diagnosis also includes examination of the spine to rule out radicular syndrome (it gives pain that radiates to the hips and knees).
In doubtful cases, MRI (allows you to examine soft tissues in detail) and CT (to check bone formation) are used.
Treatment
This disease cannot be completely cured, but modern medicine can restore the lost ability to move, allowing you to live a full life.
The use of physiotherapy and drugs is effective for grades 1-2 of the disease.In the terminal stage, only surgery helps.In other cases, surgery is performed if conservative therapy methods used do not bring relief.
1st degree treatment
Unfortunately, it is impossible to completely eliminate pathology.In grade 1, treatment aims to stabilize the condition.
During therapy, some general recommendations must be followed:
- Normalization of physical activity - recommended to reduce excessive stress (long hikes, running, jumping).
- Use shoes with good shock absorbing soles and special insoles.
- Weight loss.
- Physical therapy is mandatory.
Important: many patients absolutely refuse gymnastics and any exercise because of pain.This is often associated with the fear of increased pain and the possibility of worsening the situation.Practice proves that this opinion is wrong - regular exercise therapy helps strengthen muscles, protect them from atrophy, reduce pain and improve joint function.
Diet for grade 1 coxarthrosis of the hip joint is not prescribed;moderate diet prescribed for weight loss.It is also useful to add products with gelatin, canned fish with bones, and dairy products to your diet.
Conservative
Nonsteroidal anti-inflammatory drugs are used as a medical method.Due to the large number of side effects, it is recommended to take the drug for severe pain.You can combine its use with gastroprotectors.
Persistent pain is relieved by intra-articular steroid injections, and pain-relieving blocks are also possible.
For support the following are set:
- Relaxes muscles - relieves tension, reduces pain in the legs.
- Chondroprotectors - improve the recovery of cartilage tissue.
- Vasodilator (nicotinic acid) - helps relieve vascular spasm and also improves tissue microcirculation.
Heating compresses are also used in combination (you can also use traditional treatment methods).They do not have a therapeutic effect, but they help relieve muscle spasms.
Be sure to use physiotherapy - UHF, magnetotherapy, induction current, massage.
Hip replacement surgery
To restore freedom of movement in stage 3 and relieve severe pain, the patient is ready for planned endoprosthetic surgery.This is a special operation to replace destroyed formations with artificial ones.The intervention fully restores the patient's motor abilities.Helping you fully return to your normal lifestyle.
Depending on the level of the process, the prosthesis can be either unipolar (only the worn head of the femur is replaced) or bipolar (the surface of the acetabulum is also changed).After the operation, rehabilitation is mandatory to return the patient to an active life as soon as possible.
For patients over 60 years of age, the recovery period is set even before the surgical treatment, so that the recovery process takes place in a shorter period.The lifespan of an artificial joint is about 20 years, but it is important to follow the recommendations:
- Exceptions are running, long walking, jumping.
- Avoid heavy lifting.
- Avoid excessive exposure to forced static positions (this is especially true for people who have a permanent job).
Life events
My friend's husband needs surgical treatment for endoprosthetics.He was not diagnosed with coxarthrosis, but the lumbar hernia was successfully removed.The situation did not improve, the examination continued, and finally, after finding out what was wrong, they sent me for surgery under the quota.
After the replacement, everything grew back safely, but the second hip joint also required surgical intervention.A year later, the quota for the operation again, which was successful.And then, from the first minute after anesthesia, recovery and strict adherence to the doctor's recommendations are required.
And what about our friends?Already on the way home after the hospital, I began to put pressure on the prosthetic joint (sitting for a long time, stepping on my feet).I forgot how careful I was the first time.As a result, ligaments and muscles that have not had time to adapt to the implant cannot hold it and it falls out.
Of course, they put it in, put a cast on it, and then everything seems to work.But he complained that he could not move his leg to the side, it hurt, and he felt uncomfortable when walking.Although he does exercises and various exercises to develop both joints, it is also work and the desire to move freely.
Prevention
We have discussed the symptoms and treatment of coxarthrosis in the hip joint, as well as their stages.
- Only daily physical exercise will help you avoid serious complications and live to a ripe old age without crutches.In Soviet times, serious work was carried out to prevent diseases of the musculoskeletal system and strengthen the immune system.Nowadays it is difficult to restore the lost experience, it is clear with the mind, but too lazy to do it.
- Being overweight weakens the joints to the point of embarrassment;endoprosthetics are better, but do not lose extra pounds.My friend is sure of this, without trying to cut back on sweet and starchy foods.Proper nutrition is very important.
- I think lifting weights is no less bad for the whole frame.
- Bad habits (alcohol, smoking) remove calcium, magnesium and other beneficial substances from the body.
Just dig it, it's all interconnected.
Take care of yourself and your joints by exercising every day!