As you know, the largest joint in our body is the hip. It takes over almost the entire load while walking. But it is also often exposed to diseases such as arthrosis or coxarthrosis. What is it and how is arthrosis of the hip joint treated? We will talk about this in our article.
What is coxarthrosis?
To understand the essence of coxarthrosis, the treatment of which is extremely problematic, you need to delve a little deeper into the structure of the hip joint. It is itself shaped like a "hinge" and its function is to connect it with the pelvis of the femur. It is fixed using a spherical head, which is embedded in the cavity of the hip bone. Both the surface of the head and the surface of the cavity are covered with cartilage. They perform shock-absorbing functions and protect theagainst wear.
So, the violation of the structure of these cartilages is the cause of arthrosis, which contributes to its development. That is, the flexible and durable cartilage dries out and hardens under the influence of some internal or external factor, and its surface becomes rough instead of smooth. Such a structure interferes with normal function and leads to the slow and painful destruction of the hip joint. Therefore, it is important here to know how to relieve pain in coxarthrosis of the hip joint, but more on that later.
In an advanced stage, the bone deforms so much that the patient loses the ability to walk. Summarizing all this, it is possible to define such a disease as arthrosis of the hip joint - the destruction of the complete or partial integrity of the surface of the joints. It is also important to understand that the concepts of arthrosis, coxarthrosis and osteoarthritis are practically the same. It's just that arthrosis is a broader definition, and the other two are one and the same and refer only to the hip joint.
The reasons for the manifestation
According to doctors, there can be many reasons for the appearance of coxarthrosis, but we will consider only the most common ones:
- Congenital pathologies. The most common are dysplasia (curvature) and congenital dislocation of the hip. They almost always cause grade 1 dysplastic coxarthrosis of the hip.
- hereditary tendency. In this case, this disease is quite common in your family.
- Passive lifestyle. In case of inactivity, the cartilage loses its flexibility and elasticity and may deform.
- Violation of the hormonal background. Such a violation can easily cause inflammation in the tissues of the joint.
- Circle. In 70% of cases, arthrosis occurs in people over 40 years of age. This is the natural aging of the body and maintaining a mostly sedentary lifestyle as we age.
- Injuries. Injury to the joint leads to thinning or even deformation of the cartilage, and this is an inevitable hip joint.
- Overweight. Sign - a lot of weight, which constantly overloads the hip joint. Such a long-term load inevitably leads to wear of the cartilage, as a result - to the destruction of the hip joint.
- Big loads. Athletes fall into this risk category.
- Simple circulatory disorder. For one reason or another, blood circulation in the human body can fail. So, in the periarticular tissues, a lot of residues accumulate after metabolism, and this leads to the production of enzymes, but these, in turn, destroy the cartilage tissue.
- Diseases of the hip joint. Another fairly common cause of coxarthrosis. The fact is that improper or premature treatment of any other disease of the hip (various infections or even necrosis of the femoral head) easily leads to the development of osteoarthritis.
Symptoms
In the early stages of the disease, the symptoms are mild, so no one thinks about treating 1st degree osteoarthritis of the hip joint. Symptoms include stiffness and discomfort in the hip joint in the morning, right after waking up. Discomfort or pain increases with physical exertion, and during rest it weakens or disappears completely. Patients often do not pay attention to such symptoms, but prevention of coxarthrosis does not help here.
At a more advanced stage, the disease begins to completely annoy, even during rest, and everyone thinks about which doctor treats coxarthrosis, to contact him in time. In addition, the joint becomes inflamed, mobility is lost, and the cartilage collapses, forming bone spurs. The pain does not subside even with prolonged rest, and movement is quite limited. Here you will need information about the treatment of grade 3 coxarthrosis, which you will find with us.
Then comes the complete disappearance of the cartilage and the bones begin to rub against each other. It becomes quite difficult to move. As a result, inactivity, which leads to muscle weakness or even atrophy, causes deformity of the hip joint. The length of the legs can also vary. The lameness is obvious. Here, conservative treatment of grade 3 coxarthrosis no longer helps. The last stage is the complete loss of the ability to walk.
Diagnostics
In order to correctly diagnose and treat arthrosis of the hip joint, you should consult a doctor. So which doctor treats arthrosis of the hip joint without surgery? You should contact a rheumatologist or orthopedic traumatologist. The diagnosis begins with questioning the patient, that is, what hurts, exactly where it hurts, how often the pain is felt, etc. In order to assess the intensity of the pain, the doctor performs a number of manipulations with the joint. Flexes, extends and rotates the lower limb. In addition, the patient may be asked to walk to assess the external configuration of the joint.
However, a clinical blood test can confirm the diagnosis more precisely. Here, the sedimentation rate of erythrocytes increases significantly, namely from 30 mm / h and more. An increase in the level of globulins, seromucoids, immunoglobulins and C-reactive protein are also symptoms of coxarthrosis. To determine their level, a biochemical blood test is required. But while such tests are not enough to treat coxarthrosis of the hip joint.
Radiography is a mandatory event. But here a significant minus slips through - only the bones and bone fillings are visible in the picture, the cartilages and soft tissues are not visible. Thus, diagnosing the early stage will be quite difficult. In this case, computerized tomography helps to create a complete picture, and already based on this, it is possible to tell how to treat arthrosis of the hip joint. But all these procedures become unnecessary if you have 4th degree doa or deforming arthrosis of the hip joint. After all, the disease will be visible to the naked eye, and prevention of arthrosis and treatment without surgery will no longer be useful.
Degrees and types
Based on the neglect of the disease and its symptoms, 4 degrees of manifestation can be distinguished.
| Degree | Description |
|---|---|
| First | Grade 1 osteoarthritis of the hip joint is easy to ignore. Its symptoms are hip joint pain that returns after prolonged physical exertion. The pain goes away as soon as the load is stopped. The X-ray shows only a slight narrowing of the interarticular space. If you find out in time, the disease can be easily prevented. |
| Second | degree hip osteoarthritis - the symptoms of which begin to appear, this is the beginning of the destruction of cartilage tissue. The pain intensifies and radiates to the thigh and groin. They manifest even in a calm state. It can be obvious lameness. Morning stiffness syndrome regularly appears in the morning. We will talk about further treatment of coxarthrosis of the 2nd degree hip joint. |
| Third | The third stage is when the disease is already very advanced. Almost no cartilage left. The radiographic image shows a strong thread-like narrowing of the gap between the joints. The pain at this stage is constant and can only be relieved with the help of medication. At the same time, the patient is very limited in his movement and needs crutches or a cane to lean on. Atrophy of soft tissues begins, swelling appears in the joint area. This raises the question of how to treat grade 3 osteoarthritis of the hip: conservative methods or surgical intervention. |
| Fourth | The fourth stage is the most neglected and cannot do without surgical intervention. It is accompanied by severe pain in the joint area. The joint as such has almost disappeared, the bones grow together. The symptoms are the same as in the third stage, but there is no possibility of movement of the pelvic joint. |
For the types of coxarthrosis, they seem to have understood. Now a few words about the types of the disease. So the most popular 2 classifications. The first is a classification based on the number of affected joints - 1 or 2. Everything is simple here, if it is 1, then they say that coxarthrosis is unilateral. If the joints on both sides of the hip bone are affected, it is called bilateral arthrosis.
But there is another, no less popular classification, which designates the disease based on the causes of its occurrence. There are 7 types here:
- Age-related changes in the joint and cartilage are called involutive coxarthrosis.
- Coxarthrosis caused by a complication of Perthes disease. As a result, necrosis of the spongy tissue covering the head of the femur.
- A congenital malformation of the joint or joints is called dysplastic coxarthrosis. According to doctors, this is a fairly common case, one in ten cases is the result of congenital subluxation of the femoral head or so-called dysplasia.
- Complications after coxarthrosis after arthritis or infection.
- Post-traumatic coxarthrosis. This is the result of improper constant loading of the joint, which leads to microtraumas, which in turn slowly destroy the cartilage tissue.
- The next risk group includes those taking antidepressants and corticosteroids, as well as those suffering from hormonal disorders. This type is called dyshormonal arthrosis.
- Well, if the cause of the disease cannot be determined, then idiopathic coxarthrosis is diagnosed.
Treatment methods
There are many methods for treating arthrosis of the hip joint, but the disease cannot be completely cured. Each treatment can be divided into three stages.
- Disease prevention or prevention.
- Treatment of early stages (first and second).
- Treatment of advanced stages (third and fourth).
Conservative treatment
This includes the treatment of the first and second stages of the development of coxarthrosis. As already mentioned, the disease cannot be cured, you can simply eliminate everything that leads to a constant increased load on the joint. A moderate load that develops the joint will not be superfluous. This includes light exercise such as therapeutic exercises, swimming, cycling, etc. Such training not only helps in the development of the joint, but also helps in good form.
Equally important is the correction of weight, with its excess, as well as proper nutrition. You should also ensure that you are getting enough sleep and rest at all times. Special massages and self-massages also help. In the second stage, as the pain increases, non-steroidal anti-inflammatory drugs should be taken. Well, if the disease progresses and reaches stage 3, it can be treated without surgery, but you don't have to disdain a stick or crutches to relieve the pelvis.
Surgery
Already in the third stage, the attending physician can decide on surgical intervention in order to cure hip arthrosis. 4 types of operations are performed:
- Arthroplasty - joint cartilage is modeled. With its help, you can almost completely restore the functionality of the joint.
- An osteotomy is a bone dissection performed in such a way that the deformed areas are completely removed without deforming the normal tissue.
- Arthrodesis - the joint is attached to the bone using special plates and screws. A more radical method of intervention. After that, the joint remains immobilized.
- Endoprosthesis is a complex hip joint surgery. To be honest, this is not an operation of the joint, but its complete replacement with a prosthesis, which is made taking into account the patient's anatomical characteristics. In this way, a full or partial replacement is performed, which is why it is possible to cure coxarthrosis. The success rate is about 70%. What procedures take place before the operation and how you can heal yourself from a psychological point of view after the operation, we will tell you in the next article.
Prevention
Many people think that arthrosis in the elderly is not treated at all, but if it is treated in time, it can be cured. This is not true. Since coxarthrosis can only be cured by joint surgery, it is better to warn in advance. This includes controlling overuse of the joints, maintaining an active lifestyle, and controlling nutrition and weight. Normal sleep and rest are also important. You can go for regular massage treatments. Regular intake of chondroprotectors is recommended.