Coxarthrosis is a disease of the hip joints caused by changes in the structure of the tissues they contain.The disease has another name: arthrosis of the hip joint or osteoarthritis.
Coxarthrosis is a complex degenerative disease caused by changes in the cartilaginous tissue of the joint.Cartilage tissue cannot be restored after the formation of the human skeleton is completed, so any damage to it will affect the future condition of the tissue.The state of the cartilage is also influenced by joint fluid, which performs the function of lubricating the tissues.Due to insufficient lubrication and increased friction, the articular cartilage becomes thinner and eventually wears away completely.The absence of cartilage causes an increased load on the surface of the bones, friction occurs between the bones and this leads to a change in their shape and position, leading to the appearance of pain.
Most often, people of advanced age suffer from coxarthrosis, since by this time the functions of the cartilaginous tissue have been lost.
Types of coxarthrosis
In medicine, primary and secondary coxarthrosis are distinguished.
In the primary case, the causes of the disease are unclear.
The development of secondary coxarthrosis is influenced by the following reasons:
- receiving various wounds and fractures;
- congenital defects in the hip joint (congenital hip dislocation);
- the presence of inflammatory processes in the hip area;
- rheumatoid arthritis (a connective tissue disease that destroys joint cartilage);
- aseptic necrosis of the femoral head (death of the femoral head).
Phases of coxarthrosis
In medical practice, there are 4 stages of coxarthrosis:
Phase 1
Characterized by the appearance of periodic pain in the joint.The pain occurs when you start to move after a state of rest, but disappears when you resume vigorous activity.In a calm state, pain does not appear.Joint mobility is not compromised.The x-ray shows small bony growths and slight narrowing of the joint space.
Phase 2
The appearance of pain during moderate physical activity, as well as at rest.The appearance of lameness during prolonged walking.The pain may appear in the knee or lower back.The x-ray shows: changes in the shape of the femoral head, irregular bone contour, thickening of the bone neck, significant growth of bone tissue, narrowing of the joint space by 2 times.
Phase 3
Constant pain occurs regardless of physical activity, both in an active and calm state.The pain can cause insomnia.Due to limited joint mobility, a person is forced to walk with support.X-ray reveals a significant increase in the width of the neck of the bone and a decrease in its length compared to normal and a deformation of the femoral head.The joint space is practically absent.Physical conditions are severely limited.The patient may be recognized as disabled.
Phase 4
The patient feels unbearable pain at rest.Any movement causes extreme pain, the patient is unable to move with support (crutches, cane).The only method to treat coxarthrosis is surgical.
Causes of coxarthrosis
The appearance of coxarthrosis is influenced by many reasons, but the most important is impaired blood circulation in the hip area.Due to improper blood circulation, the metabolism of the joints slows down, which leads to gradual atrophy of the leg muscles.
Other causes of coxarthrosis are:
- sedentary lifestyle;
- microtraumas that do not cause pain to the patient;
- endocrine disorders;
- changes in joint surfaces due to age;
- increased load on the joints (more often found in athletes);
- inflammatory and infectious processes in the joints;
- pathologies of the foot (flat feet) and spine (scoliosis);
- obesity (increased load on the joint due to excess weight) and other reasons.
Taking into account the state of health of the entire organism, the exact causes of the disease for a particular patient are determined.
Symptoms of coxarthrosis
Osteoarthritis affects men and women after the age of 40.Women experience more painful symptoms.
Signs of coxarthrosis are:
- pain in the hip joint (occurs periodically and is aching in nature);
- irregular and uncertain gait (lameness);
- the appearance of a creak in the joint;
- the mobility of the injured leg is limited (in the initial phase you feel heaviness and stiffness in movements, fatigue and general malaise);
- the appearance of thigh muscle atrophy (the volume and tone of the muscles change, causing knee pain).
Diagnosis of coxarthrosis
To determine the diagnosis of coxarthrosis, it is necessary to undergo diagnostic procedures:
- examination of the patient by a specialist;
- Performing general and biochemical blood tests (allows you to identify inflammatory processes and distinguish arthritis from arthrosis);
- X-rays (used to detect damage and changes in bone tissue);
- MRI of the joint (detects small changes in cartilage tissue).
Treatment of coxarthrosis
To treat the disease, specialists use medical procedures and medications.
Treatment methods for coxarthrosis include:
- therapeutic exercises and massages;
- physiotherapy;
- ozone therapy;
- cryotherapy;
- treatment with drugs;
- surgical treatment, etc.
In specialized clinics for each patient an individual treatment program for coxarthrosis is selected, taking into account his age, concomitant diseases and the stage of coxarthrosis.An individual approach contributes to the patient's recovery as quickly as possible.
Therapeutic gymnastics and massage
Gymnastics helps strengthen muscles and improve blood circulation.Morning exercises not only wake up the body after sleep, but also lift synovial fluid from the lower parts of the joint.Synovial fluid lubricates cartilage tissue with essential nutrients, which increases the cartilage's resistance to stress during the day.
However, for coxarthrosis, physical exercises should be selected wisely.Too sudden and vigorous movements can cause severe pain and damage the joint.It is recommended to go to the pool, as swimming helps strengthen muscles, relieves stress on joints and does not cause injuries.
Massage for coxarthrosis is a very effective and safe method.Improves blood circulation, strengthens muscles, relieves painful spasms, swelling and muscle tension.During the massage of the hip joint, lower back and back, the muscles relax, due to which the synovial fluid is distributed throughout the cartilage.
Physiotherapy
Physiotherapy combines various methods:
- electrotherapy;
- UHF therapy;
- ultrasound therapy;
- laser therapy;
- paraffin therapy, etc.
All these procedures are aimed at improving blood circulation, relieving spasms and inflammation, this is due to the fact that access to the hip joint is limited.
Treatment with drugs
There are many drugs that perform different functions in the treatment of coxarthrosis:
- Topical medications(ointments, compresses, lotions).Under the influence of advertising, most patients believe that treatment with various ointments and creams is the most effective way.However, this is a misconception because the healing properties of such drugs are not able to reach the hip joint due to its deep location.They only temporarily help improve blood circulation and relieve spasms.The causes of coxarthrosis are not eliminated, and the disease continues to gradually develop into a more complex stage.
- Non-steroidal anti-inflammatory drugs.They are used to eliminate inflammatory processes, relieve swelling and pain.As a result of long-term use of non-steroidal drugs, side effects appear that negatively affect the internal organs (gastritis).These drugs do not restore the cartilage tissue necessary for normal joint function.
- Muscle relaxants(drugs that relax muscles).Improves blood circulation and relieves muscle tension around the joint.The effect of the drugs is temporary, joint functions are not restored.
- Hormonal steroid drugs.Intra-articular hormone injections help with concomitant diseases, for example in case of inflammation of the femur tendons.They have side effects and a short-term therapeutic effect.
- Vasodilators.They are used to relax the smooth muscles of blood vessels, expand the lumen between them, relieve pain in small vessels and eliminate night pain.Vasodilators also improve joint circulation and help provide necessary nutrients to cartilage tissue.When used correctly, vasodilator drugs provide a significant therapeutic effect.However, the effectiveness of treatment is influenced by the individual tolerability of the drugs.
- Chondroprotectors(drugs that restore cartilage).They are the most effective modern drugs, as they affect the restoration of cartilage tissue and nourish it with the necessary substances.With regular use of chondroprotectors it is possible to stop the development of coxarthrosis.A positive result appears over time, and after the end of taking the drug, the process of cartilage restoration will continue.
Surgical treatment of coxarthrosis
Surgical intervention is resorted to in case of significant destruction of the cartilaginous tissue, impossibility of its restoration and immobility of the joints.In some cases, surgery is the only possible way to restore a person's ability to walk without pain.
Endoprosthesis is an operation to remove the affected joint and replace it with an artificial analogue, an endoprosthesis.The shape of the endoprosthesis resembles a real joint, performs all the functions of a joint and can withstand heavy loads during walking, running, etc.
Useful life of the endoprosthesis
Like everything, an endoprosthesis has its own lifespan.The wear of the endoprosthesis depends on the load and mobility.Excess weight significantly increases the load, and the life of the prosthesis will be approximately 10 years.With moderate loading and mobility, the endoprosthesis will last approximately 15 years.There are also models of prostheses whose lifespan is 20-25 years, but their main disadvantage is the high cost.
After the endoprosthesis wears out, a second operation must be performed to replace it.However, replacing the prosthesis is complicated by the fact that the hip bone thins over time and the problem of fixing the prosthesis arises.Therefore, in order to avoid repeated endoprosthetics, it is necessary to use conservative treatment methods for as long as possible.
It is worth mentioning the risks of hip replacement: the number of deaths after the operation is 1-2%.
Rehabilitation after endoprosthesis
Joint replacement surgery is quite complex and will take time to restore lost mobility.The recovery period includes methods that strengthen the body: massage, gymnastics and breathing exercises.The volume and complexity of loads should be increased gradually so that the body gets used to all the changes.
Eating healthy also speeds up the healing process.It is recommended to include foods rich in phosphorus and phospholipids in the diet, as their properties contribute to the restoration of cartilage tissue.
The rehabilitation period lasts approximately 6 months.The patient is in hospital under observation for 5-10 days.Then a series of rehabilitation measures aimed at strengthening the hip muscles are carried out.The patient will have to walk first with crutches, then with a cane and finally alone without any support.
At the end of the rehabilitation period, the patient regains his lost working capacity and the joy of an easy gait!
Prevention of coxarthrosis
To prevent coxarthrosis it is necessary:
- adhere to an active lifestyle (do morning exercises, take short walks);
- do not play sports at a professional level;
- maintain a balanced diet, as this helps avoid weight gain, which causes additional stress on the joints;
- take a course of chondroprotectors once every 1-2 years after the age of 40 (in case of family predisposition to coxarthrosis or joint lesions).