As you know, the largest joint in our body is the hip. Takes almost all the load while walking. But also, it is quite often exposed to conditions such as arthropathy or coxarthrosis. What is hip osteoarthritis and how is it 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 very structure of the hip joint. It is in the form of a "hinge" and its function is to connect to the pelvis of the femur. Fixation is done with the help of a spherical head, which is embedded in the cavity in 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 against wear.
Thus, a violation of the structure of these cartilages becomes the cause of arthropathy that contributes to the development. That is, the elastic and durable cartilage, due to some internal or external factors, dries up, hardens and its surface becomes rough instead of smooth. Such a structure interferes with normal function and leads to slow and painful destruction of the hip joint. Therefore, it is important here to know how to relieve pain in the coxal joint of the hip joint, but more on that later.
In advanced stages, the bone deforms so much that the patient loses the ability to walk. Summarizing all this, it is possible to form a definition of such a disease as arthropathy of the hip joint - the destruction of the complete or partial integrity of the joint surface. It is also important to understand that the concepts of arthropathy, coxarthrosis and osteoarthritis are practically the same thing. It's just that arthropathy is a broader definition and the other two are one and the same and only apply to the hip joint.
Reasons for event
According to doctors, there can be several reasons for the appearance of coxarthrosis, but we will consider only the most common:
- 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 predisposition. This happens when this disease is quite common in your family.
- Passive lifestyle. With inactivity, cartilage loses its elasticity and elasticity and can deform.
- Violation of the hormonal background. Such a violation can easily cause inflammation of the joint tissues.
- Age. In 70% of cases, arthropathy occurs in people over 40 years of age. It all has to do with the natural aging of the body and maintaining a mostly sedentary lifestyle as we age.
- Injuries. Injury to the joint leads to thinning of the cartilage or even its deformation, and this is an inevitable pre-ischial joint.
- Overweight. Sign - too much weight, which will constantly overload the hip joint. Such prolonged loads inevitably lead to cartilage wear, as a result - the destruction of the hip joint.
- Big loads. Athletes are in this risk category.
- A simple circulatory disorder. For one reason or another, blood circulation in the human body can fail. Thus, in the peri-articular 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. Another fairly common cause of coxarthrosis. The point is that incorrect or untimely treatment of any other diseases of the hip (various infections or even necrosis of the femoral head) easily leads to the development of osteoarthritis.
Symptoms
Symptoms in the initial stages of the disease are mild, so no one thinks about the treatment of osteoarthritis of the hip joint of the 1st degree. Symptoms include stiffness and discomfort in the hip joint in the morning, right after waking up. Discomfort or pain is aggravated by physical exertion and during rest weakens or disappears completely. Patients often do not pay attention to such symptoms, but the prevention of coxarthrosis will not help here.
In more advanced stages, the disease already begins to bother completely, even at rest, and everyone thinks about which doctor treats coxarthrosis to contact him in time. Further, the joint begins to become inflamed, its mobility is lost and the cartilage breaks down forming bone spurs. The pain does not go away even with a lot of rest, the movement is rather limited. Here you will need information on how to treat 3rd degree coxarthrosis, which you can 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 around. As a result, inactivity, which leads to weakening or even atrophy of the muscles, deforming osteoarthritis of the hip joint begins. The length of the legs can also be changed. There is obvious lameness. Here, conservative treatment of 3rd degree coxarthrosis will no longer help. The last stage is the complete loss of the ability to walk.
Diagnostics
For the correct diagnosis and treatment of osteoarthritis of the hip joint, you must consult a doctor. So which doctor treats hip arthropathy without surgery? You should contact a rheumatologist or orthopedic traumatologist. The diagnosis will begin with a question of the patient, that is, what hurts, where exactly it hurts, how often the pain is felt, etc. To assess the strength of the pain, the doctor will perform several manipulations with the joint. It will flex, extend and rotate the lower extremity. In addition, the patient may be asked to walk to assess the external conformation of the joint.
However, a clinical blood test can more accurately confirm the diagnosis. Here, the sedimentation rate of erythrocytes will increase significantly, that is, from 30 mm / h and more. Elevation of globulins, serum, 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 prescribe treatment for coxarthrosis of the hip joint.
A mandatory event is X-ray. But here a significant minus escapes - only bones and bone seals are visible in the picture, cartilage and soft tissues are not visible. Thus, diagnosis at an early stage will be quite difficult. In this case, computed tomography will help you draw a complete picture, and already on its basis it will be possible to say how to treat arthropathy of the hip joint. But all these procedures will become unnecessary if you have doa or deforming arthropathy of the hip joint 4th degree. After all, the disease will be visible to the naked eye, and prevention of arthropathy and treatment without surgery will no longer be useful.
Degrees and types
Based on the neglect and the symptoms of the disease, there are 4 degrees of its manifestation.
| Degree | Description |
|---|---|
| First | Grade 1 osteoarthritis of the hip joint is easy to overlook. Its symptoms are recurrent pain in the hip joint after prolonged physical exertion. The pain subsides as soon as the load is stopped. X-ray will show only slight narrowing of the inter-articular space. If you orient yourself in time, then the disease can be easily prevented. |
| Second | Osteoarthritis of the hip joint of the 2nd degree - 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 begin to manifest even in a state of rest. There may be obvious lameness. Morning stiffness syndrome occurs periodically in the morning. We will talk about how to treat 2nd degree coxarthrosis of the hip joint further. |
| Third | The third stage is when the disease is already very advanced. There is hardly any cartilage left. The radiographic image shows a strong filamentous narrowing of the space between the joints. The pain at this stage is permanent and can only be eliminated with the help of medication. At the same time, the patient is very limited in his movements and in order to move he needs crutches or a cane, on which he can lean. Soft tissue atrophy begins, swelling appears in the joint area. This raises the question of how to treat grade 3 osteoarthritis of the hip joint: conservative methods or surgery. |
| Fourth | The fourth stage is the most neglected and one cannot do without surgery. It is accompanied by severe pain in the joint area. The joint as such has almost disappeared, the bones begin to grow together. The symptoms are the same as in the third stage, but there is no possibility of any movement of the pelvic joint. |
With the formulas of a coxarthrosis they seem to have been understood. Now, a few words about the types of this disease. So, the most popular are 2 classifications. The first is a classification based on how many joints are affected - 1 or 2. Everything is simple here, if 1, then they say that the coxarthrosis is one-sided. If the joints on both sides of the hip bone are affected, then they talk about bilateral arthropathy.
But there is another no less popular classification, which indicates a disease based on the causes of its occurrence. There are 7 types here:
- The change of the joint and the cartilage with the age of the person is the so-called involutional coxarthrosis.
- Coxarthrosis caused by a complication of Perthes disease. As a result, necrosis of the spongy tissue covering the head of the femur.
- Congenital maldevelopment of a joint or joints is called dysplastic coxarthrosis. A fairly common phenomenon, according to doctors, every tenth case is the result of congenital subluxation of the femoral head or the so-called dysplasia.
- Complication after arthritis or post-infectious coxarthrosis.
- Posttraumatic coxarthrosis. It is a consequence of an incorrect constant load on the joint, which leads to microtraumas, which in turn slowly destroy the cartilage tissue.
- The next risk group includes people taking antidepressants and corticosteroid drugs, as well as other people suffering from hormonal disorders. This type is called dyshormonal arthropathy.
- Well, if it is not possible to determine the cause of the disease, then you are diagnosed with idiopathic coxarthrosis.
Methods of Treatment
There are many treatment methods for arthropathy of the hip joint, but the disease cannot be completely cured. The entire treatment can be divided into three stages.
- Disease prevention or prevention.
- Treatment of first stages (first and second).
- Treatment of advanced stages (third and fourth).
Conservative therapy
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. Moderate loads that will develop the joint will not be superfluous. This includes light loads, for example, therapeutic exercises, swimming, cycling, etc. Such training will help not only to develop the joint, but also to keep it in good condition.
Equally important is the correction of weight, with its excess, as well as proper nutrition. You must also make sure you get enough sleep and rest all the time. Massage, both specialist and self-massage, will also help. In the second stage, with an increase in pain, it is necessary to take non-steroidal anti-inflammatory drugs. Well, if the disease progresses and reaches grade 3, it can also be treated without surgery, but you do not need to disdain a stick or crutches to relieve the extra load on the pelvis.
Surgery
The attending physician may decide on surgery already in the third stage in order to treat arthropathy of the hip joint. There are 4 types of operations performed:
- Arthroplasty is performed - cartilage modeling in the joint. With its help, you can almost completely restore the functionality of the joint.
- Osteotomy is a dissection of bones, which is carried out in such a way that the deformed areas completely disappear and the normal tissue is not deformed.
- Arthroplasty - the joint is fixed to the bone with the help of special plates and screws. A more radical method of intervention. After that, the joint remains immobilized.
- Endoprosthesis is a complex operation in the hip joint. To be honest, this is not an operation on the joint, but a complete replacement of it with a prosthesis, which is done based on the anatomical characteristics of the patient. Thus, a complete or partial replacement is carried out, which is why coxarthrosis can be treated. The success rate is about 70%. What procedures are done before the operation and how to heal yourself from a psychological point of view after the operation, we will tell in the next article.
Prevention
Many people believe that arthritis in the elderly is not treated at all, but if it is treated early at a young age, then it can be cured. This is not real. Since it is possible to treat coxarthrosis only in the case of arthroplasty, it is better to warn him in advance. This includes controlling excessive stress on the joint, maintaining an active lifestyle, controlling diet and weight. Regular sleep and rest are also important. You can have regular massage treatments. Regular intake of chondroprotectors is recommended.