Arthrosis (osteoarthritis) of the hip joint is a chronic, progressive pathology in which degenerative-dystrophic processes occur in the area of the joints of the pelvic bones. To be more precise, there is a destruction of the hyaline cartilage that lines the femoral head and the acetabulum, the surfaces of the pelvic bones that are in contact with each other.
The second name of the pathology is coxarthrosis of the hip joints.
Osteoarthritis of the hip joints: features of the disease.
Most of the time, first-hand knowledge of coxarthrosis is for older people, mainly women, who are at risk of developing the pathology after the age of 45. Such a selective appearance of pathology comes from the details of the structure of the female pelvic bones, as well as from their direct participation in the process of childbirth. In men, osteoarthritis of the hip joints (coxarthrosis) occurs mainly from the age of 65.
The natural aging of the body plays an important role in the pathogenesis of coxarthrosis, when the most stressed joints of the bones begin to collapse.
Also, the disease can be triggered by a number of infectious, traumatic, non-inflammatory diseases, their combination. Initially, arthrosis manifests itself as pain and a decrease in the activity of movements in the pelvic area, but later its consequences become more serious - the affected limb is shortened.
Classification of diseases
Types of arthrosis of the hip joint depend on the features of its development and the cause of its occurrence. Often there is post-traumatic arthrosis of the hip joint - it appears after an injury. The classification also includes the following types of osteoarthritis:
- Dysplastic: due to dysplasia that arose in childhood but was not cured;
- Static - associated with an uneven load on the pelvic area, which occurs with pathologies of the foot, knee and ankle;
- Postinfectious: appears after various inflammatory diseases;
- Primary chronic - develops in older people due to aging of the body.
Any type of disease can be called "deforming arthrosis of the hip joint", because the pathology leads to a violation of the shape and appearance of the pelvic joint of the bones.
Also, the disease is divided into 3 grades depending on the severity of the changes, the symptoms of which are described below in the text.
Reasons for the development of arthrosis
Signs of coxarthrosis can appear even in the absence of obvious prerequisites, which is due to natural degenerative processes in the joint. It has a narrow gap, while bearing huge and constant loads, so it wears out sooner than others. Initially, blood circulation is disturbed in the tissues, due to which nutrients are delivered to the hyaline cartilage to a lesser extent. Metabolic processes are disturbed, cartilage dries out, cracks form in it. In addition, the articular surfaces quickly wear out and destroy - arthrosis of the hip joint progresses. Symptoms can appear even more quickly if the body is affected by a number of provoking factors:
- Any injury;
- Physical work, heavy sports;
- Diseases of the spine, including curvature;
- flatfoot;
- Arthritis against the background of an infectious process;
- Joint dysplasia transferred in childhood;
- Metabolic diseases;
- Overweight;
- Rheumatism and other autoimmune pathologies.
Against the background of the influence of such factors, the disease can develop much faster - after 30-40 years.
Symptoms of coxarthrosis
Signs of arthrosis of the hip joint largely depend on its degree. During the pathology three degrees (stages) are distinguished:
- First grade. There are pains during physical overload, after a long walk, running, in connection with which there are aching and dull sensations in the pelvic area (pass after a short rest). The pain does not radiate to other parts of the leg. Deforming arthrosis of the hip joint of the first degree does not cause changes in gait, the muscles work fully. At the end of the stage slight restrictions in the movement of the legs may appear;
- Second grade.Pain in arthrosis of the hip joint in this case becomes more pronounced. Pain appears with minimal exertion, discomfort is present at night after a day's work. There are pains at night, at rest. A crunch, a feeling of friction at the joint junction. If a person walks for a long time, rocking movements can be noticed in the gait. It becomes difficult to put on shoes, to take the foot to the side;
- Third degree.The work of the pelvic bones is seriously impaired (with primary arthrosis, both joints are affected, with other types - usually only one). The pain in the groin is constant, unbearable, it gives to the knee. The thigh muscles are atrophied. The leg becomes shorter, so the person uses crutches and a cane to get around.
Later, ankylosis occurs, in which movement becomes impossible at all.
Diagnosis of the disease
What is coxarthrosis of the hip joint, what is its degree and how to treat the disease? All problems should be resolved after diagnosis. Although the main method of making a diagnosis is radiography, the patient needs consultations with various specialists and specific tests. This will help find the cause of the disease and act accordingly. So, coxarthrosis can be triggered by osteochondrosis, flat feet, urological and gynecological infections, and its treatment will help stop the destruction of the bone joint.
As for making an accurate diagnosis and establishing the degree of osteoarthritis, all changes are perfectly visualized on one image: X-ray or computed tomography (MRI):
- The first degree is a slight narrowing of the gap, the appearance of marginal osteophytes;
- Second degree - narrowing of the joint space by 50% of the norm, the appearance of osteophytes on the outer and inner sides of the space, deformity of the femoral head, often the presence of inflammatory changes in the tissues near the articulation of the bones;
- The third degree is an acute deformity of the joint, the presence of large osteophytes, zones of sclerosis.
Treatment of osteoarthritis
Conservative treatment
Ointments, creams, tablets for arthrosis of the hip joint help only in the first stage of the disease. Medications can completely restore the cartilage and it is important to start therapy at an early stage. Usually NSAIDs, corticosteroids, chondroprotectors, drugs based on hyaluronic acid, muscle relaxants are used. They also practice massage, exercise therapy and therapeutic exercises.
At the second stage, it is necessary to connect physiotherapy and mechanical methods of influencing the joint. These include extractor hood, UHF, magnetotherapy, shock wave therapy, ultrasound, laser, inductothermy, electrophoresis. Folk remedies for osteoarthritis of the hip joint, such as local drugs, are only of secondary importance, and the main method of therapy should be drugs.
Be sure to apply a diet for coxarthrosis of the hip joint, it is required to normalize metabolism and improve cartilage nutrition.
Endoprosthesis for osteoarthritis
The third stage of the disease can only be treated surgically. The patient is recommended a joint replacement surgery or arthroplasty. The surgeon cuts off the head of the femoral bone, inserts a metal pin into the cut, on which the artificial head is attached. After the operation, prolonged rehabilitation and exercise therapy are carried out, but then the hip joint will function fully, and the doctor will be able to answer the patient in the affirmative to the question whether it is possible to squat with hip arthrosis . joint.
disease prevention
To prevent osteoarthritis of the hip joint, sports and a healthy lifestyle should prevail. It is impossible to overload the joints, but it is necessary to eliminate hypodynamia. Good for walking, swimming, skiing, elliptical trainer. It is also important to lose weight and eat well.
The prevention of osteoarthritis of the hip joint is also based on the early treatment of possible bruises, injuries that affect the pelvis and spine. In childhood, all congenital joint pathologies should also be eliminated.
Answers to popular questions.
- Who to contact with arthritis? The question of which doctor treats coxarthrosis of the hip joint does not have a definite answer. Of course, initially it is recommended to contact a surgeon, traumatologist or orthopedist, which depends on the capabilities of the clinic. In specialized centers, an arthrologist deals with problems of the pelvic joints, but it is not always possible to find such a limited specialist.
Depending on the cause of the disease, in the future, in parallel, you will have to order and undergo treatment under the supervision of a rheumatologist, a neurologist, an infectious disease specialist and several other doctors;
- Can arthritis be cured? This disease is chronic and it is impossible to completely eliminate it, especially since the main cause is aging. But if you see a doctor when there is arthrosis of the first degree of the hip joint, you can cure all existing changes, and then prevent rapid progression. In later stages, it is possible to stop and repair all existing pathological changes and live normally due to regular courses of therapy. Only arthroplasty can save the joint from arthrosis, but it also has a number of disadvantages, from the need for periodic replacement of the prosthesis to postoperative complications: pain, thrombosis, infection;
- When are local therapies sufficient and in which cases can a visit to the doctor be avoided? Any ointment can only slightly improve blood microcirculation in the joint area, and also relieve pain, but does not have a therapeutic effect. In addition, this union is very deep, which makes it difficult for the active substances to penetrate. Therefore, it is necessary to consult a doctor at any stage of the disease, regardless of the severity of the manifestations. Only at an early stage can the disease be stopped with "little blood" without surgery.
Osteoarthritis of the hip joint is a disabling pathology that leaves the person crippled, preventing him from walking.
The only way to prevent the development of such problems is to start conservative therapy at stages 1-2 of the disease, not forgetting to conduct regular and full courses.