Osteoarthritis is a degenerative disease of the cartilage tissue that can affect the joints of the vertebrae and all the bones of the skeleton.The hip joint (HJ) is the largest and most stressed bony joint.Therefore, coxarthrosis (deforming arthrosis of the hip joint) is a very common cause of disability among patients over 50 years of age.
Coxarthrosis (arthrosis of the hip joint): symptoms
Reasons
The causes of coxarthrosis are various.This pathology can lead to:
- Age-related dystrophic changes in cartilage.
- Constant physical activity among athletes and carrying heavy loads for several years.
- Congenital dysplasia.
- TJ injuries.
- Necrosis of the femoral head (Perthes disease).
The head of the femur, covered with elastic cartilage, is located in the acetabulum of the pelvic bones.
There are unilateral lesions (when the disease affects one joint) and bilateral lesions - when both articular surfaces of the hip are affected.
Symptoms of arthrosis of the hip joint
At the time of diagnosis, the following symptoms of hip arthritis are observed:
- Thinning of the cartilage, it becomes dry and rough.
- Thickening of the underlying bone, its growth to the sides.
- Fibrotization and inflammation of the joint capsule.
- The appearance of inflammatory exudate in the capsule.
- Stiffness of the joint, appearance of contractures.
Externally, these changes are manifested by the following symptoms:
- Joint pain, radiating to the groin, hip and knee.
- The initial (morning) painful symptom that disappears after warming up.
- A stiff, uncertain, limping gait.
- Shortening the leg on the affected side (the reason for this is contracture).
- Weakening and atrophy of the femoral muscle.
- A creaking in the joint.
Stages of the disease
Based on the signs and symptoms, three stages of the disease can be distinguished:
First
- Discomfort and pain, which usually ease with rest.
- Absence of external symptoms - lameness, stiffness, atrophy.
Such signs do not particularly alarm patients, and few people pay attention to episodic pain, much less begin to treat it.
But just at the initial stage, arthrosis of the hip joint is still a reversible disease.
Second degree
- Painful symptoms become more intense and may persist even at rest.
- The functional characteristics of the hip joint decrease:
- restrictions on hip abduction and internal rotation appear
- lameness is observed
- The x-rays show:
- marginal osteophytes;
- deformation of the head and change of its contour;
- reduction of joint space.
Third phase
- The pain becomes constant and even the most excruciating night pain begins.
- The patient is forced to rely on a cane.
- There is a strong limitation of movement and atrophy of the gluteal, thigh and calf muscles.
- Noticeable shortening of the leg and lameness are noted.
- Due to overgrown osteophytes, the joint space practically disappears, fusion and complete loss of function of the hip joint occurs.
It happens that the first attack occurs at a fairly young age - in the early forties.A person most likely forgets about it and remembers it already at the age of 50-60, when the deformations of the joint become significant, affecting the quality of life.
Diagnostics
X-rays and functional diagnostics are performed.The orthopedist not only deciphers the picture, but rotates, bends the femur in all directions and studies the symptoms that arise when walking.
However, more and more often, if a patient is suspected of having coxarthrosis of the hip joint, leading specialists are turning to diagnosis using magnetic resonance imaging (MRI).The explanation for this is the absolute safety and high information content of the procedure.It is the MRI examination that allows early detection of the smallest changes in the hip joint, which contributes to the development of the most effective therapeutic tactics.
Treatment of coxarthrosis of the hip joint
Treatment is carried out according to the principle “the sooner the better”.
Early coxarthrosis can be treated with:
- Chondroprotectors.
- Light physiotherapy: swimming, aerobics, walking and cycling.
- Adjustment of the allowable physical loads on the joint.
- Weight correction (downward).
- Physiotherapy treatment
- Extraction procedures.
- Massage sessions.
- Compresses on the pain area.
Painful symptoms can be relieved with NSAIDs.
Annual sanatorium treatment is also very effective.
Intra-articular injections of pain-relieving corticosteroids can be used to treat more severe pain in later stages.
Treatment of advanced coxarthrosis is very difficult due to the complete obliteration of the hip joint.Chondroprotectors in this case are absolutely useless.
All kinds of external remedies in the form of ointments and gels can relieve muscle spasms and pain, but, of course, they will not affect the condition of the diseased immobilized joint in any way.Therefore, it is necessary to take a sensible approach to all types of advertising that ensures that, smearing the sore spot with ointment, you can soon forget about the disease.
Hip replacement
The only option for complete restoration of the hip joint in the third stage of coxarthrosis is surgery - endoprosthesis (athroplasty) of the hip joint.
The endoprosthesis consists of two components: a head and a cup.
This operation is not simple:
- After surgery, a long period of rehabilitation is required.
- Healing of the joint is painful (the pain may persist for a year).
- You will have to walk for some time with the help of a walker or using a cane for support.