As you know, the largest joint in our body is the hip. When walking, it takes almost the entire load. But also, it is often exposed to diseases such as arthrosis or coxarthrosis. What is it and how is hip osteoarthritis treated? We will talk about it in our article.
What is coxarthrosis?
In order to understand the essence of coxarthrosis, the treatment of which is extremely problematic, it is necessary to delve a little into the very structure of the hip joint. It itself has the shape of a "hinge", and its function is to connect with the pelvis of the femur. Fastening takes place with the help of a spherical head, which is embedded in the cavity of the hip bone. Both the surface of the head and the surface of the cavity are covered with cartilage. They perform functions of cushioning and protect against wear.
Therefore, damage to the structure of these cartilages becomes the cause of arthrosis, which contributes to its development. That is, elastic and durable cartilage, due to some internal or external factors, becomes dry, hardens, and its surface becomes rough instead of smooth. Such a structure interferes with normal functioning and leads to slow and painful destruction of the hip joint. Therefore, it is important here to know how to relieve the pain of 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 a definition of such a disease as arthrosis of the hip joint - the destruction of the complete or partial integrity of the surface of the joints. It is also important to understand that the terms arthrosis, coxarthrosis and osteoarthritis are practically the same thing. It's just that arthrosis is a broader definition, and the other two are one and the same and refer only to the hip joint.
Causes of manifestation
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 hip dislocation. They almost always cause grade 1 hip dysplastic coxarthrosis.
- hereditary predisposition. Then this disease is quite common in your family.
- Passive lifestyle. With inactivity, cartilage loses its elasticity and elasticity, and can be deformed.
- Violation of the hormonal background. Such a violation can easily cause inflammation of the joint tissue.
- Age. In 70% of cases, arthrosis occurs in people over 40 years old. It all boils down to the natural aging of the body and maintaining a mostly sedentary lifestyle with age.
- Injuries. Injury to the joint leads to thinning of the cartilage or even to its deformation, and this is the inevitable pre-joint of the hip.
- Excessive weight. Sign - heavy weight, which will constantly overload the hip joint. Such long-term loads inevitably lead to cartilage wear, as a result - the destruction of the hip joint.
- Heavy loads. Athletes are in this risky category.
- Simple circulatory disorder. For one reason or another, blood circulation in the human body can fail. So, in the periarticular tissues, after metabolism, many residues accumulate, and this leads to the production of enzymes, but they in turn destroy the cartilage tissue.
- Hip diseases. Another fairly common cause of coxarthrosis. The thing is that improper or untimely treatment of any other hip disease (various infections or even necrosis of the femoral head) easily leads to the development of osteoarthritis.
Symptoms
Symptoms in the early stages of the disease are mild, so no one thinks about treating arthrosis 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 increases with physical effort, and during rest it weakens or disappears completely. Patients often do not pay attention to such symptoms, but prevention of coxarthrosis will not help here.
In advanced stages, the disease already begins to bother completely, even during rest, and everyone thinks about which doctor treats coxarthrosis in order to contact him in time. Furthermore, 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, movements are quite limited. Here you will need information on how to treat coxarthrosis of the 3rd degree, which you can find with us.
Then the cartilage completely disappears 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, starts deforming osteoarthritis of the hip joint. The length of the legs can also be changed. Lameness is obvious. Conservative treatment of 3rd degree coxarthrosis will no longer help here. The last stage is the complete loss of the ability to walk.
Diagnostics
In order to properly diagnose and treat osteoarthritis of the hip joint, it is necessary to consult a doctor. So, which doctor treats osteoarthritis of the hip joint without surgery? You need to consult a rheumatologist or orthopedic traumatologist. The diagnosis will begin by examining the patient, that is, what hurts, where exactly it hurts, how often the pain is felt, etc. To assess the severity 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 configuration of the joint.
However, a clinical blood test can more accurately confirm the diagnosis. Here, the erythrocyte sedimentation rate will be significantly increased, i. e. from 30 mm/h and more. An increase in globulin, seromucoid, immunoglobulin 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.
Mandatory event is radiography. But here there is a significant minus - only bones and a bone seal are visible in the picture, cartilage and soft tissues are not visible. Therefore, making a diagnosis at an early stage will be quite difficult. In this case, computer tomography will help to create a complete picture, and based on this it will be possible to say how to treat arthrosis of the hip joint. But all these procedures will become unnecessary if you have dou or deforming arthrosis of the hip joint of the 4th degree. After all, the disease will be visible to the naked eye, and prevention of arthrosis and treatment without surgery will no longer be useful.
Degrees and types
Based on the neglect and symptoms of the disease, 4 degrees of its manifestation can be distinguished.
| Degree | Description |
|---|---|
| First | Grade 1 osteoarthritis of the hip joint is easy to overlook. Its symptoms are recurring pain in the hip joint after prolonged physical exertion. The pain disappears as soon as the load is removed. X-ray will show only a slight narrowing of the interarticular space. If you orient yourself in time, the disease can be easily prevented. |
| A second | Osteoarthritis of the hip joint 2nd degree - the symptoms that begin to appear, it is the beginning of the destruction of the cartilage tissue. The pain intensifies and radiates to the thigh and groin. They begin to manifest even in a state of calmness. There may be obvious lameness. Morning stiffness syndrome occasionally occurs in the morning. We will talk about how to treat coxarthrosis of the hip joint of the 2nd degree. |
| Third | The third stage is when the disease is already very advanced. There is almost no cartilage. On the X-ray image, a strong stringy narrowing of the space between the joints is visible. Pain in this phase is permanent and can only be eliminated with the help of medication. At the same time, the patient is very restricted in his movements and in order to move he needs crutches or a stick, on which he can lean. Soft tissue atrophy begins, swelling appears in the joint area. This raises the question of how to treat stage 3 hip osteoarthritis: conservative methods or surgical intervention. |
| Fourth | The fourth stage is the most neglected and cannot be done without surgical intervention. It is accompanied by severe pain in the joint area. There is almost no joint as such, 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 that we understood the types of coxarthrosis. Now a few words about the types of this disease. So, the most popular are 2 classifications. The first is the classification based on how many joints are affected - 1 or 2. Here everything is simple, 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 speak of bilateral arthrosis.
But there is another no less popular classification, which designates the disease based on the cause of its occurrence. There are 7 types here:
- The change of joint and cartilage with age is the so-called involutive coxarthrosis.
- Coxarthrosis caused by a complication of Perthes disease. As a result, there is necrosis of the spongy tissue covering the head of the femoral bone.
- Congenital underdevelopment of a joint or joints is called dysplastic coxarthrosis. A fairly common occurrence, according to doctors, one in ten cases is the result of congenital subluxation of the femoral head, or the so-calleddysplasia.
- Complications after arthritis or post-infectious coxarthrosis.
- Post-traumatic coxarthrosis. It is the result of improper constant loading of the joint, which leads to microtraumas, which in turn slowly destroy the cartilage tissue.
- The next risk group includes people who take antidepressants and corticosteroids, as well as others who suffer from any hormonal disorders. This type is called dyshormonal arthrosis.
- Well, if it is not possible to determine the cause of the disease, then you have been diagnosed with idiopathic coxarthrosis.
Treatment methods
There are many methods of treating arthrosis of the hip joint, but the disease cannot be completely cured. All treatment can be divided into three phases.
- 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 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 in the development of the joint, but will also keep it in good shape.
Equally important is weight correction, with its excess, as well as proper nutrition. You also need to take care of constant enough sleep and rest. Massages, special and self-massages will also help. In the second phase, with increasing pain, it is necessary to take non-steroidal anti-inflammatory drugs. Well, if the disease progresses and reaches stage 3, it can be treated without surgery, but you don't have to disdain a stick or crutches to alleviate the additional load on the pelvis.
Operation
The doctor can decide on surgical intervention already in the third stage in order to cure arthrosis of the hip joint. 4 types of operations are performed:
- Arthroplasty - modeling of cartilage on the joint is performed. With its help, you can almost completely restore the functionality of the joint.
- Osteotomy is a bone dissection performed in such a way as to completely eliminate the deformed areas, without deforming the normal tissue.
- 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 immobilized.
- Endoprosthetics is a complex operation on the hip joint. Frankly speaking, it is not about joint surgery, but about its complete replacement with a prosthesis that is made taking into account the anatomical characteristics of the patient. Thus, a complete or partial replacement is carried out, which makes it possible to cure coxarthrosis. The success rate is about 70%. What procedures take place before the operation and how to heal from a psychological point of view after the operation, we will tell in the next article.
Prevention
Many people think that arthrosis in the elderly cannot be treated at all, but if it is solved in time at an early age, then it can be cured. This is not true. Since coxarthrosis can be cured only in the case of arthroplasty, it is better to warn him in advance. These include controlling excessive stress on the joint, maintaining an active lifestyle, and controlling diet and weight. Normal sleep and rest are also important. You can go for regular massage treatments. It is recommended to take chondroprotectors regularly.