As you know, the largest joint in our body is the hip. Takes almost all the load while walking. In addition, he is often exposed to diseases such as arthrosis or coxarthrosis. What is it and how is osteoarthritis of the hip 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, it is necessary to study the structure of the hip joint a little. It itself has the shape of a "hinge" and its function is to connect the femur with the pelvis. Fixation takes place with the help of a spherical head placed in the space above 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, the disruption of the structure of these cartilages becomes the cause of arthrosis, which contributes to the development. In other words, the elastic and durable cartilage dries up, hardens due to the influence of some internal or external factors, the surface becomes rough instead of smooth. Such a structure interferes with normal functioning and causes slow and painful destruction of the hip joint. Therefore, here it is important to know how to relieve pain in coxarthrosis of the hip joint, but more on that later.
In advanced stages, the bone is so deformed that the patient loses the ability to walk. Summarizing all this, it is possible to form the definition of a disease such as arthrosis of the hip joint - a complete or partial violation of the 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 thing. Simply put, arthrosis is a broader definition, while the other two are one and the same, and they apply only to the hip joint.
Causes of manifestation
According to doctors, there may be several 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 predisposition. This is when the disease is quite common in your family.
- Passive lifestyle. With immobility, cartilage loses elasticity and flexibility and can become deformed.
- Disturbance of the hormonal background. Such a violation can easily cause inflammation of joint tissues.
- Age. In 70% of cases, arthrosis occurs in people over 40 years old. This is due to the natural aging of the body and, in most cases, maintaining a sedentary lifestyle with age.
- Injuries. Joint injury leads to thinning or even deformation of the cartilage, and this is an inevitable pre-hip joint.
- Excess weight. Zodiac - a lot of weight that will constantly load the hip joint. Such long-term loads inevitably lead to wear of the cartilage, as a result - the destruction of the hip joint.
- Big loads. Athletes are included in this risk category.
- Simple circulatory disorder. For one reason or another, blood circulation in the human body can be disturbed. Thus, in the periarticular tissues, a lot of residues accumulate after metabolism, which leads to the production of enzymes, but they, in turn, destroy the cartilage tissue.
- Hip diseases. Another fairly common cause of coxarthrosis. The fact is that any other diseases of the hip (various infections or even necrosis of the femoral head) are not treated correctly or in time, which easily leads to the development of osteoarthritis.
Symptoms
In the initial stages of the disease, the symptoms are mild, so no one thinks about the treatment of arthrosis of the hip joint of the 1st degree. Symptoms include stiffness and discomfort in the hip joint immediately after waking up in the morning. Discomfort or pain intensifies with physical exertion and weakens or disappears completely during rest. Patients often do not pay attention to such symptoms, but the prevention of coxarthrosis will not help here.
In the more advanced stages, the disease begins to be completely annoying, even at rest, and everyone wonders which doctor treats coxarthrosis in order to contact him in time. In addition, the joint begins to become inflamed, its mobility is lost, and the cartilage collapses, forming bone spurs. The pain does not subside even with a long rest, movement is quite limited. Here you need information on how to treat coxarthrosis of the 3rd degree, you can find it with us.
Then comes the complete disappearance of 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, begins deforming osteoarthritis of the hip joint. The length of the legs can also vary. There is obvious lameness. Here, conservative treatment of grade 3 coxarthrosis will no longer help. The last stage is the complete loss of the ability to walk.
Diagnostics
To properly diagnose and treat osteoarthritis of the hip joint, you need to see a doctor. So, which doctor treats arthrosis of the hip joint without surgery? You should contact a rheumatologist or orthopedic traumatologist. Diagnosis will begin with questioning the patient, that is, what hurts, exactly where 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 ambulate to assess joint external configuration.
However, a clinical blood test can confirm the diagnosis more accurately. Here, the rate of sedimentation of erythrocytes will increase significantly, that is, 30 mm / h and more. An increase in globulins, seromucoids, immunoglobulins and c-reactive proteins are also signs of coxarthrosis. A biochemical blood test is needed to determine their level. However, such tests are not enough to determine the treatment of coxarthrosis of the hip joint.
A mandatory event is radiography. But here a significant negative slips in - only bones and bone seals are visible in the picture, cartilage and soft tissues are not visible. Thus, it will be quite difficult to diagnose at an early stage. In this case, computed tomography will help to draw a complete picture, and based on it, it will be possible to tell how to treat arthrosis of the hip joint. But if there is doa or deforming arthrosis of the hip joint of the 4th degree, all these procedures will be unnecessary. After all, the disease will be visible to the naked eye, and the prevention and treatment of arthrosis without surgical intervention will no longer be useful.
Degrees and types
Based on the indifference and symptoms of the disease, 4 degrees of its manifestation can be distinguished.
| Degree | Description |
|---|---|
| First | Grade 1 osteoarthritis of the hip is easy to overlook. Its symptoms are recurrent pain in the hip joint after prolonged physical exertion. As soon as the load stops, the pain disappears. X-ray will show only a slight narrowing of the interarticular space. If you guide yourself in time, the disease can be easily prevented. |
| Second | Osteoarthritis of the hip joint of the 2nd degree - symptoms begin to appear, this is the beginning of the destruction of cartilage tissue. The pain intensifies and spreads to the thigh and groin. They begin to manifest themselves even in a calm state. There may be obvious lameness. Morning stiffness syndrome occasionally appears in the morning. Later, we will talk about how to treat coxarthrosis of the hip joint of the 2nd degree. |
| the third | The third stage is when the disease is already very advanced. There is almost no cartilage left. The X-ray image shows narrowing of the space between the joints like a strong rope. At this stage, the pain is permanent and can only be relieved with the help of drugs. At the same time, the patient is very limited in his movements and needs crutches or a cane on which he can lean to move. Atrophy of soft tissues begins, swelling appears in the joint area. This raises the question of how to treat grade 3 arthrosis of the hip joint: 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 almost disappears, 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. |
It seems understandable with types of coxarthrosis. 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 it is 1, then they say that coxarthrosis is unilateral. If the joints on both sides of the hip bone are affected, then they talk about bilateral arthrosis.
But there is another less popular classification, which indicates a disease based on the causes of its occurrence. Here are 7 types:
- A change in the joint and cartilage with the age of a person is the so-called involutional coxarthrosis.
- Coxarthrosis caused by complications of Perthes disease. As a result, necrosis of the spongy tissue surrounding the head of the femur.
- Disruption of the congenital development of joints or joints is called dysplastic coxarthrosis. A fairly frequent occurrence, 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. This is the result of improper constant loading of the joint, which causes microtraumas, which in turn slowly destroy the cartilage tissue.
- The next risk group includes people taking antidepressants and corticosteroid drugs, as well as those suffering from any 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. The whole treatment can be divided into three stages.
- Prevention or prevention of disease.
- 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 only eliminate everything that causes a constant increased load on the joint. There will be no more moderate loads that will develop the joint. This includes light loads, for example, therapeutic exercises, swimming, cycling, etc. includes. Such exercise will help not only to develop the joint, but also to keep it in good condition.
Equally important is the correction of weight, its excess and proper nutrition. You should also pay attention to regular enough sleep and rest. Both special and self-massage massages will also help. In the second stage, with increasing pain, it is necessary to take non-steroidal anti-inflammatory drugs. Well, if the disease progresses and reaches the 3rd degree, it can be treated without surgery, but there is no need to neglect a stick or crutches to remove the extra load on the pelvis.
Surgery
The attending physician can decide on surgical intervention already at the third stage to treat arthrosis of the hip joint. There are 4 types of operations:
- Arthroplasty - cartilage modeling is done in the joint. With its help, you can almost completely restore the functionality of the joint.
- Osteotomy is the splitting of bones, performed in such a way that the deformed areas are completely removed and the normal tissue is not deformed.
- Arthrodesis - the joint is attached to the bone with the help of special plates and screws. A more radical method of intervention. After that, the joint remains immobile.
- Endoprosthetic hip joint is a complex operation. To be honest, this is not an operation on the joint, but its complete replacement with a prosthesis made taking into account the patient's anatomical characteristics. Thus, complete or partial replacement is carried out, so it is possible to treat coxarthrosis. The success rate is about 70%. In the next article, we will explain what procedures take place before the operation and how to treat yourself psychologically after the operation.
Prevention
Many people think that arthrosis in the elderly cannot be treated at all, but if it is treated in time at an early age, then it can be cured. This is not true. Since coxarthrosis can be treated only during arthroplasty, it is better to warn about it in advance. This includes controlling excessive stress on the joint, maintaining an active lifestyle, nutrition and weight control. Normal sleep and rest are also important. You can go for regular massage procedures. Regular intake of chondroprotectors is recommended.