Coxarthrosis is a disease of the hip joint caused by changes in the structure of the tissues in it.The disease also has other names - hip arthritis, or osteoarthritis.
Coxarthrosis is a complex degenerative disease caused by changes in the cartilage tissue of the joints.Cartilage tissue cannot be restored after completion of the formation of the human skeleton, therefore, any damage to it affects the condition of the tissue in the future.The condition of the cartilage is also influenced by synovial fluid, which functions to lubricate the tissues.Due to insufficient lubrication and increased friction, joint cartilage becomes thinner and eventually wears away completely.The absence of cartilage increases the load on the bone surface, friction between the bones occurs, and this leads to a change in their shape and position, which leads to the appearance of pain.
Usually, people in old age suffer from coxarthrosis, because at this time the functions of cartilage tissue are lost.
Types of coxarthrosis
In medicine, primary and secondary coxarthrosis are distinguished.
In primary cases, the cause of the disease is unclear.
The development of secondary coxarthrosis is influenced by the following reasons:
- received various injuries and fractures;
- birth defects of 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).
Stages of coxarthrosis
In medical practice, there are 4 stages of coxarthrosis:
Stage 1
Characterized by the appearance of periodic pain in the joints.The pain occurs when you begin to move after a state of rest but disappears when vigorous activity resumes.In a calm state, pain does not appear.Joint mobility is not impaired.X-rays show small bony growths and mild narrowing of the joint space.
Stage 2
The appearance of pain during moderate physical activity, as well as at rest.Lameness appears during prolonged walking.Pain may appear in the knees or lower back.X-ray films showed: the shape of the femoral head changed, the bone contour was irregular, the bone neck thickened, bone tissue developed significantly, and the joint space narrowed 2 times.
Stage 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-rays showed a significant increase in the width of the bone neck and a decrease in its length compared to normal, as well as deformity of the femoral head.Common space is practically non-existent.Physical condition is severely limited.Patients may be recognized as disabled.
Stage 4
The patient feels unbearable pain when resting.Any movement causes extreme pain, the patient cannot move with support (crutches, canes).The only way to treat coxarthrosis is surgery.
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, metabolism in the joints slows down, leading to gradual atrophy of the leg muscles.
Other causes of coxarthrosis are:
- sedentary lifestyle;
- microtraumas do not cause pain to the patient;
- endocrine disorders;
- age-related changes in joint surfaces;
- increased load on joints (most common in athletes);
- inflammatory and infectious processes in the joints;
- pathologies of the feet (flat feet) and spine (scoliosis);
- obesity (increased load on joints due to being overweight) and other reasons.
Taking into account the health condition of the entire body, the exact cause of the disease for a particular patient will be determined.
Symptoms of coxarthrosis
Cosarthrosis affects men and women after age 40.Women experience more painful symptoms.
Signs of coxarthrosis are:
- pain in the hip joint (occurs periodically and has an aching nature);
- uneven, uncertain gait (limping);
- the appearance of crepitations in the joints;
- mobility of the injured leg is limited (in the early stages, a feeling of heaviness and stiffness when moving, fatigue and general discomfort);
- the appearance of thigh muscle atrophy (muscle volume and tone change, causing pain in the knee).
Diagnosis of coxarthrosis
To confirm the diagnosis of coxarthrosis, it is necessary to undergo diagnostic procedures:
- Patient examination by a specialist;
- Carry out general and biochemical blood tests (allows us to identify inflammatory processes and distinguish arthritis from joint disease);
- X-ray (used to detect damage and changes in bone tissue);
- magnetic resonance imaging of the joint (detects small changes in cartilage tissue).
Treatment of coxarthrosis
To treat the disease, specialists use medical procedures and medications.
Treatments for coxarthrosis include:
- therapeutic exercises and massage;
- physical therapy;
- ozone therapy;
- cryotherapy;
- drug treatment;
- surgical treatment, etc
In specialized clinics, an individual coxarthrosis treatment program is selected for each patient, taking into account age, comorbidities and stage of coxarthrosis.An individual approach contributes to the patient's recovery as quickly as possible.
Exercise therapy and massage
Exercise helps strengthen muscles and improve blood circulation.Morning exercise not only wakes up the body after sleep, but also increases synovial fluid from the lower part of the joints.Synovial fluid lubricates cartilage tissue with essential nutrients, helping to increase the cartilage's ability to withstand stress throughout the day.
However, for coxarthrosis, physical exercises should be chosen wisely.Movement that is too sudden and forceful can cause severe pain and damage the joint.You should go to the swimming pool because swimming helps strengthen muscles, reduces stress on joints and does not cause injury.
Massage to treat coxarthrosis is a very effective and safe method.It improves blood circulation, strengthens muscles, relieves spasms, swelling and muscle tension.During massage of the hip joints, lower back and back, the muscles are relaxed, thanks to which synovial fluid is distributed throughout the cartilage.
Physical therapy
Physical therapy combines many different methods:
- electrotherapy;
- UHF therapy;
- ultrasound therapy;
- laser therapy;
- paraffin therapy, etc.
All these procedures are aimed at improving blood circulation, reducing spasms and inflammation, this is due to limited access to the hip joint.
Treatment with medication
There are many drugs that perform different functions in the treatment of coxarthrosis:
- Topical medicine(ointments, compresses, topicals).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 these drugs cannot reach the hip joint due to their deep location.They only help improve blood circulation temporarily and reduce spasms.The cause of coxarthrosis is not eliminated and the disease continues to gradually progress to a more complicated stage.
- Nonsteroidal anti-inflammatory drugs.They are used to eliminate inflammatory processes, reduce swelling and pain.Due to long-term use of non-steroidal drugs, side effects appear that negatively affect internal organs (gastritis).These drugs do not restore cartilage tissue needed for normal joint function.
- Muscle relaxants(muscle relaxant).Improves blood circulation and reduces muscle tension around joints.The effects of the drug are only temporary, joint function is not restored.
- Hormonal steroid drugs.Hormone injections into the joint help treat concurrent diseases, such as femoral tendonitis.They have side effects and short-term therapeutic effects.
- 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 deliver essential nutrients to cartilage tissue.When used properly, vasodilators provide significant therapeutic effects.However, treatment effectiveness is influenced by individual drug tolerance.
- Chondroprotectors(cartilage restoration medicine).They are the most effective modern drugs because they affect the restoration of cartilage tissue and nourish it with the necessary substances.With regular use of chondroprotectors, it is possible to prevent the development of coxarthrosis.Positive results will appear over time, and after stopping taking the drug, the process of cartilage recovery will continue.
Surgical treatment of coxarthrosis
Surgical intervention is used in cases of significant, irreversible destruction of cartilage tissue and immobility of the joint.In some cases, surgery is the only possible way to restore a person's ability to walk without pain.
Arthroscopy is a surgery aimed at removing the affected joint and replacing it with a similar, arthroscopic joint.The shape of the prosthesis resembles a real joint, it performs all the functions of the joint and can withstand heavy loads when walking, running, etc.
Endoscopy lifespan
Like anything, endoscopic prostheses have their own lifespan.Prosthetic wear depends on load and mobility.Excess weight significantly increases the load, and the life of the prosthesis will be about 10 years.With moderate load and mobility, the prosthesis will last about 15 years.There are also models of prosthetic limbs with a service life of 20-25 years, but the main disadvantage is the high price.
After the prosthesis wears out, a second operation is required to replace it.However, prosthetic replacement is complicated because the hip bone becomes thinner over time and problems with prosthetic fixation arise.Therefore, to avoid having to perform multiple endoscopy, it is necessary to use conservative treatment methods for as long as possible.
It is worth mentioning the risks of hip replacement - the mortality rate after surgery is 1-2%.
Rehabilitation after endoscopy
Joint replacement surgery is quite complicated and will take time to restore lost mobility.The recovery phase includes methods of strengthening the body: massage, gymnastics and breathing exercises.The volume and complexity of the exercises should be gradually increased 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 recovery of cartilage tissue.
Recovery time lasts about 6 months.Patients stay in the hospital for observation for 5 to 10 days.Then, a series of rehabilitation measures are performed to strengthen the hip muscles.First, the patient will have to move with crutches, then with a cane and finally walk on his own without any support.
At the end of the rehabilitation period, the patient regains the lost ability to work and the pleasure of walking with ease!
Prevention of coxarthrosis
To prevent coxarthrosis, it is necessary to:
- adhere to an active lifestyle (morning exercise, short walks);
- not participating in sports professionally;
- maintain a balanced diet, as this helps avoid weight gain, which puts additional stress on the joints;
- take a course of treatment with chondroprotective drugs every 1-2 years after 40 years (in case of family predisposition to coxarthrosis or joint injuries).