Deforming coxarthrosis of the hip joint

Coxarthrosis of the hip joints

Coxarthrosis of the hip joint is a degenerative-dystrophic musculoskeletal disease characterized by a slow but progressive course accompanied by destruction of the intraarticular cartilaginous tissue and secondary changes in the structures of the hip joints. Due to such changes, the mobility of the joint is impaired, and eventually, if no medical measures are taken, it disappears completely. Ankylosis develops, which can lead to disability and the inability to move independently.

There are other names for this disease: deforming coxarthrosis, osteoarthritis, osteoarthritis. This is the most frequent form of degenerative-dystrophic lesions of the motor apparatus, which has great medical and social significance. Mostly elderly and elderly people are ill, but pathology occurs even in adolescents and children.

What is coxarthrosis

So what happens inside the coxarthrosis of the hip joint? Due to the long negative impact of causative or risk factors, the composition and consistency of intraarticular fluid changes. As you know, it is this substance that feeds the cartilaginous tissue, since there are no blood vessels in the cartilage itself. Synovia becomes thick, viscous, its amount decreases, it becomes much less nutrients necessary cartilage tissue for renewal.

Joint damage with coxarthrosis
Changes in the hip joint with coxarthrosis

In such pathological conditions, the cartilage ceases to receive all that is needed, is susceptible to degenerative changes. And permanent overloads and micro-trauma contribute to its drying and cracking. Hyaline cartilage gradually thinens, and eventually disappears completely, revealing articular surfaces of bones.

The joint becomes unstable. The organism, in order to somehow adjust this situation, reacts by the formation of osteophytes( marginal bone growths).In severe cases, they completely "wall" the articular gap, causing deformity and complete ankylosis of the hip joint. As a rule, coxarthrosis is bilateral, but one joint may also suffer.

Causes of the disease

Depending on the cause of the occurrence, coxarthrosis of the hip joint may be primary or secondary. In the first case, it is not possible to detect a specific etiologic factor that resulted in cartilage damage. In such patients, only the risk factors for this disease are present. In the case of secondary coxarthrosis of the hip joints, there is a clear relationship between the primary disease and its consequence in the form of osteoarthritis.

Consequences of obesity
Excessive body weight not only leads to arthrosis of the hip joint

The following diseases can lead to secondary coxarthrosis:

  • congenital dysplasia and hip dislocation( dysplastic coxarthrosis);
  • aseptic necrosis of the femoral head;
  • Perthes disease;
  • traumatic injuries in the hip in the anamnesis;
  • Inflammatory lesions of articulation( arthritis).

The risk factors for coxarthrosis of the hip joints include:

  • long-term joint overload;
  • frequent injuries and microtrauma components of the joint;
  • metabolic and endocrine disorders;
  • worsening of microcirculation in the region of the hip joint;
  • congenital or acquired diseases and deformations of the musculoskeletal system( gonarthrosis, flatfoot, curvature of the spine);
  • overweight;
  • hypodynamia or, conversely, a very active lifestyle;
  • advanced age;
  • poor development of the muscles of the body;
  • approach of menopause in women;
  • hereditary predisposition.
Pain in the hip
Pain in the hip joint - the main sign of coxarthrosis

Symptoms of coxarthrosis of the hip joint

The signs and degree of their severity depend on the stage of osteoarthritis. It is possible to identify the main clinical symptoms of the disease, in which coxarthrosis should be suspected:

  • pain in the joint area, in the groin, in the thigh and knee joint area under load, and subsequently and at rest;
  • development of stiffness in the joint, stiffness of movements in it;
  • lameness;
  • shortening of one leg;
  • a crunch and clicks when moving in the thigh;
  • slimming muscles of the thigh and buttocks.

It's important to remember! At the initial stage of coxarthrosis of patients, only minor pain or discomfort in the articulation area is concerned. Often, such signs are ignored and the disease progresses. Therefore, all alarming symptoms, albeit minor, should not be left without medical attention. If this is repeated often, then you should suspect the disease and undergo an examination. At the first stage, pathology is perfectly suited to conservative treatment.

Degrees of the disease

In the clinical course of the disease there are three degrees:

  1. Arthrosis of the 1st degree. At the same time, in the region of the hip joint, pain or discomfort occurs after unusual physical overload, at the end of the working day. The usual motor activity of pain, as a rule, is not accompanied. Restrictions of movements in a joint are not present, muscles of a femur do not suffer. As a rule, pathology at this stage is not diagnosed, since rarely anyone treats such minor complaints to the doctor. Nevertheless, treatment at the first stage is the most successful.
  2. Osteoarthritis of 2nd degree. In this case, the pain becomes intense and occurs even after normal load, and sometimes even at rest. Painful sensations are localized not only in the region of the joint, but in the groin. The amplitude of movements in the thigh decreases( rotation and outflow are limited).At movements there is a characteristic crunch and clicks. The muscles of the thigh begin to gradually become atrophy. The patient can develop limp.
  3. Osteoarthritis of the 3rd degree. With this, the pain becomes permanent, worries even at night. Anesthetics stop helping. All movements in the hip are severely restricted. Patients can not move without additional support. Often observed such a sign as a shortening of the limb on the patient side. The muscles of the thigh and buttocks are atrophied.
Walking with crutches
In the late stage, arthrosis of the hip joint can lead to the inability to move independently.

4 degrees of coxarthrosis does not exist, but the 4th X-ray stage of the disease is isolated. This is a complete ankylosis of the hip joint. You can treat such an arthrosis only with the help of an operation.

Diagnosis

The diagnosis is based on history data( identifying risk factors or causative diseases), clinical data and additional survey methods.

To clarify the diagnosis and conduct differential diagnosis will help:

  • radiography of the hip joints;
  • ultrasound articulations;
  • MRI or CT.

As a rule, a clinical and radiological examination is sufficient to establish an accurate diagnosis. X-ray patterns show specific changes characteristic of each stage of the disease: narrowing of the joint gap, the presence of osteophytes, displacement and deformation of the femoral head, subchondral cysts and periarticular osteosclerosis, osteoporotic bone changes. Depending on the presence of these pathological changes and their severity, the degree and stage of the disease is established.

Radiography of the hip
Radiography is the main method of diagnosis of coxarthrosis

Treatment of

Treatment of coxarthrosis completely depends on the stage of pathology. If at the beginning of a positive effect can be achieved with the help of therapeutic physical exercises, medications and other conservative measures, then with a long-gone process, only an operation will help to get back on its feet.

The main objectives of the curative program:

  • to eliminate pain and discomfort in the area of ​​the affected joint;
  • to adjust the nutrition of intraarticular cartilage and start the process of its recovery;
  • to eliminate intra-articular fluid deficiency;
  • activate microcirculation in the tissues of the articulation;
  • eliminate the increased load on the hip joint;
  • strengthen the muscles that surround, protect and support the articulation;
  • prevent deformation and increase mobility in the hip joint.

All this can be achieved only through an integrated approach that should include not only therapeutic measures, but also lifestyle changes in order to get rid of the risk factors for coxarthrosis.

Nutrition for coxarthrosis of the hip joint

Diet for coxarthrosis of the hip joint is not specific. Nutrition with coxarthrosis should be full and balanced, enriched with vitamins and trace elements, necessary for the restoration of intraarticular cartilage. A low-calorie diet is necessary in case of overweight. Very often the normalization of the mass index leads to the cessation of the progression of pathological changes and the restoration of cartilage.

LFK in coxarthrosis of the hip joint

Medical gymnastics with coxarthrosis of the hip joint is one of the main methods of treatment and prevention. No patient can achieve long-term improvement without performing special exercises with coxarthrosis of the hip joint. Charging should be selected depending on the stage of the pathological process, the general state of health, the presence of concomitant diseases, the age of the patient. It's great if a therapeutic and prophylactic gymnastic complex is picked up by a physiotherapist, because there are also contraindicated sports with coxarthrosis, for example, running.

Physiotherapy
Therapeutic gymnastics is one of the main methods of treatment and prevention of arthrosis

Medical therapy

Treatment with medications is used in all cases of coxarthrosis. This is an affordable method that does not require special efforts and allows you to quickly rid the person of pain. But it is important to understand and remember that the use of medicines allows only for a while to eliminate the pain. This is by far not the most important method of treatment, it allows you to get rid of the pain so that the patient can start other therapeutic activities.

Recommended reading: coxofemoral joint Hip arthrosis stages

Apply medications from the following groups:

  • non-steroidal anti-inflammatory drugs and analgesics;
  • chondroprotectors;
  • glucocorticoid hormones;
  • drugs that improve microcirculation;
  • muscle relaxants.

These medications are used in the form of intravenous, intramuscular and intraarticular injections, tablets, ointments, gels for topical application. In the case of severe pain, the doctor may prescribe a blockade of the hip joint. In this case, a local anesthetic and a glucocorticoid anti-inflammatory drug are injected into the soft tissues around the articulation. This procedure effectively relieves pain for several weeks.

In the joint cavity, drugs - liquid transplants of synovial fluid( Sinvisk, Hyastat, Fermatron, etc.) can also be injected. They are based on hyaluronic acid, which compensates for the deficiency of synovia, promotes the regeneration of cartilaginous tissue and the reduction of its trauma.

Blockade of joint with coxarthrosis
Joint blockade with coxarthrosis is an effective method to quickly get rid of pain

Manual methods of exposure to

Must necessarily be included in the treatment complex. They allow you to establish blood circulation, improve the elasticity of muscles, strengthen them, reduce the load on the structure of the articulation.

Most often used:

  • massage and self-massage;
  • manual therapy;
  • post-isometric relaxation;
  • spinal column traction.

Physiotherapy

Physiotherapy methods for coxarthrosis are of secondary importance. This is due to the deep occurrence of the articulation and a massive layer of soft tissue above it. Nevertheless, laser therapy, magnetotherapy, UHF, electrophoresis, shock wave therapy are often prescribed. Some patients feel relieved from such treatment.

Shock wave therapy of the hip joint
Shockwave therapy allows to achieve improvement with arthrosis of the hip joint

A large number of people with coxarthrosis resort not only to traditional, but also to alternative therapies, for example, to folk remedies, hirudotherapy, apitherapy, phytotherapy. Such techniques can be used, but not as a main therapy, but only as a supplement. It is also important to get expert advice about this, since the chosen method may be contraindicated for you.

Surgical treatment of

Surgery for arthrosis of the hip joint is prescribed at the third degree of the disease, when it is no longer possible to eliminate pain and stiffness of the joint with conservative methods. Can perform organ-preserving surgery, but more common and effective is hip arthroplasty. Sometimes only surgical treatment can return the patient the opportunity to move freely without pain.

The prognosis and consequences of coxarthrosis depend on how timely the diagnosis was established, as well as on the patient's discipline and the implementation of all medical recommendations. To avoid surgery with coxarthrosis, in no case be lazy. Do gymnastics should be daily and for life. Already after 3-4 months of regular lessons, the result will not be long in coming.

MoyaSpina.ru

Deforming hip osteoarthrosis( coxarthrosis)

Deforming arthrosis of the hip joint( osteoarthritis, coxarthrosis) is a progressive, degenerative-dystrophic disease characterized by articular cartilage degeneration followed by bone changes, development of osteophytes, and either explicitly or hidden by a pronounced pronouncedinflammation of the synovium.

Deforming osteoarthritis of the hip joint is of very great practical importance due to its significant prevalence, disability and even disability of patients, deterioration of quality of life.

There is a very clear dependence of osteoarthritis on age and sex. Thus, modern researchers believe that individual cases of osteoarthritis occur even at the age of 16 - 25 years, and in persons who have crossed the 50-year boundary, the symptoms of the disease are diagnosed in 50% of cases.

Coxarthrosis is more common in males, while females suffer more from knee inflammation.

The main causes of occurrence of

The most frequent and important causes of osteoarthritis:

  • genetic factor;
  • old age;
  • is overweight;
  • chronic overload and microtraction of articular cartilage.
aged people
More common coxarthrosis develops in old age

Certain sports and professional factors with excessive and prolonged repetitive effects create an increased risk of coxarthrosis. Most often the disease develops in representatives of the following professions:

  • builders;
  • firefighters;
  • workers in the food and processing industry;
  • of farmers.

Among athletes, a greater risk of developing osteoarthritis is noted in:

  • tennis players;
  • persons lifting the barbell;
  • professional long distance runners.

Diagnostics

Recently, great importance in diagnosis is given to ultrasound examination of the hip joint. In a number of cases, computed tomography and magnetic resonance imaging can be used. But the first and basic method of diagnosing osteoarthritis remains X-ray.

apparatus for computed tomography
The device for carrying out a computer tomography

looks like. Symptomatics

We advise you to read:
osteoporosis of the hip joint Gymnastics for osteoporosis of the hip joint

The main symptoms of coxarthrosis are:

  • pain when walking, giving to the buttock, inguinal region, the front surface of the thigh. Pain can be given to the knee joint or lumbar region;
  • stiffness in the hip joint area, appearing after any inactive condition, resulting in bending difficulties;
  • tenderness around the joint and in the groin when palpation;
  • increasing shortening of the affected limb;
  • lameness;
  • infringement of flexion and extension in the hip joint.

Therapeutic program

In order for ongoing medication to have an effect, the joints affected by osteoarthritis should be as much as possible unloaded. For this purpose, a whole range of measures is recommended.

Unloading the joints

Patients with osteoarthritis of hip joints are not recommended walking long distances, long standing on their feet, wearing heavy weights, frequent use of stairs. It is better to use the elevator.

Walking on high heels
Walking with high heels increases the risk of developing coxarthrosis.

Women are not recommended to wear high-heeled shoes. Sit better on a high chair, which should be raised with the help of hands.

Avoid fixed positions that reduce blood flow to diseased joints.

When developing a reactive synovitis, you should walk with a stick or crutches. With the initial stages of osteoarthritis after 40 minutes of walking, you should rest for 10 minutes, and if the patient is sitting for a long time, then every 40 minutes he should walk for 10 minutes.

Do homework, in particular cooking, some elements of cleaning the apartment in a convenient position( for example, sitting or at least not tilting).It is advisable to install a handrail in the bathroom in the bathroom and near the toilet in the toilet to facilitate getting up.

Medications

Voltaren
Voltaren - ointment, which is used for the treatment of osteoarthritis

To begin treatment of coxarthrosis is recommended symptomatic drugs of quick action. These include preparations of the following groups:

  1. Paracetamol - is one of the main drugs for pain relief. The anti-inflammatory effect of paracetamol is low and significantly inferior to analgesic.
  2. Non-steroidal anti-inflammatory drugs( NSAIDs).Treatment with these medicines allows you to combine anti-inflammatory and analgesic effects. Treatment of NSAIDs is carried out in short courses because of the high probability of complications.
  3. Ointments, gels based on NSAIDs. Are used for topical application. The advantage is that they are sufficiently effective and well tolerated by the patient. They do not have a negative side effect, in contrast to the cases when the treatment of NSAIDs is prescribed in the form of oral tablets.
  4. Analgesics. Most often, with a pronounced pain syndrome, treatment with tramadol is prescribed.
  5. Intra-articular injection of glucocorticoid drugs and hyaluronic acid preparations. With coxarthrosis is rarely used.
  6. Treatment with arthrophion. Sometimes there is a good analgesic effect after applying this homeopathic remedy.
  7. Treatment with preparations containing glucosamine and chondroitin sulfate. These drugs improve the condition of the damaged cartilage.
arthrophone
Homeopathic preparation arthrophone

Surgical treatment

Surgical treatment of osteoarthritis is performed if conservative treatment is not effective and the function of the joint continues to be disrupted. The patient may be offered endoprosthetics( joint replacement).

Other methods of treatment

In combination with ongoing drug therapy, patients are recommended:

  • phytotherapy;
  • balneotherapy;
  • sanatorium treatment;
  • physiotherapy: laser, magnet, electrophoresis, barotherapy, diadermic currents, ultrasound, etc.;
  • massage;
  • exercise therapy. In the period of exacerbation of coxarthrosis and in the subacute period, exercise therapy can only be done under the guidance of an experienced specialist. During the remission of the disease, the patient himself must work on the development of the movements.

Prophylaxis of coxarthrosis should begin when your joints are healthy. It is necessary to get rid of excess weight, to lead a physically active way of life, to avoid high loads. As you can see, the process of treating the disease is long, complex, not always effective. Think about your health, take care of it.

MoyaSpina.ru

Treatment of coxarthrosis - treatment of arthrosis of the hip joint.

To date, there are many different methods for the treatment of arthrosis of the hip( coxarthrosis).We will try to talk about each method, taking into account its pros and cons. We do not induce you to self-medicate, but only give an opportunity to evaluate the effectiveness of different methods of treatment. Knowing exactly how each of these methods works, you will be able to more consciously approach the treatment of .Depending on the degree of coxarthrosis treatment is different.

At the third degree of arthrosis of the hip joint, the treatment is only surgical, with the help of endoprosthetics. Endoprosthetics of the hip joint is a replacement of the damaged joint with an artificial prosthesis. Technically, this is a rather complicated procedure. Part of the prosthesis is implanted in the femur, part in the pelvis, as shown in the figure. This prosthesis completely repeats the characteristics of a conventional joint.

When I and II degrees of arthrosis of the hip joint treatment is performed without surgery. The following methods are used:

Drugs( tablets, injections and ointments)

1. Non-steroidal anti-inflammatory drugs ( indomethocin, piroxicam, ketoprofen, brufen, diclofenac, etc.) are shown during the period of "reactive inflammation of the joints".

Pros : Very good pain in joints due to strong anti-inflammatory effect, relieve edema and inflammation.

Cons : With prolonged use, drugs in this group suppress the natural ability of articular cartilage to repair, and side effects often adversely affect various internal organs.

The output was found. Especially for long-term use, the anti-inflammatory drug mohvalis was developed. Its effect is "softer", and it gives fewer side effects with prolonged use. Many doctors recommend using just movalis when it comes to prolonged exposure to an inflamed joint for pain relief.

Important : It is not recommended to use several different anti-inflammatory drugs at once. If the drug used does not relieve the pain, then either increase the dose or replace the drug with another.

2. Vasodilator preparations ( theonikol, trental, nikoshpan, tsinaresin, etc.) relax the smooth muscles of the vessels, expand their lumen. With coxarthrosis, treatment with these drugs produces tangible results.

Pros : Very useful drugs to treat coxarthrosis. When used correctly, they have very few contraindications. They promote the speedy restoration of the joint due to the improvement of the joint blood supply, improve the delivery of "building materials" to the joint, and relieve the spasm of small vessels. As well as vasodilator drugs eliminate night "vascular" pain.

Cons : The effectiveness depends on the individual tolerability of the drugs. Before use, consult a doctor.

Important: : Before use, check individual drug tolerance. The first three days take this drug one tablet, and only with good efficiency and no side effects go to the recommended course of admission.

3. Muscle relaxation medications - myorelaxates ( midokalm, sirdalud).In coxarthrosis of the hip joint, treatment with myorelaxates should be done with caution.

Pros : It helps to remove painful muscle spasm with coxarthrosis, improve blood supply to the joint.

Cons : Can affect the nervous system - cause dizziness, intoxication and mental retardation.

4. Preparations for the restoration of cartilage - chondroprotectors ( glucosamine, rumalon, don, structum, chondraitin sulfate, arteparone)

Pros : The most useful drugs for the treatment of deforming arthrosis of the hip joint. Improve the restoration of the structure of the cartilage, feed it with the necessary elements. Regular use of chondroprotectors can stop the development of coxarthrosis. You will not notice a positive effect right away, but it will be more noticeable in the future. Restoration of cartilage will continue after the drug is discontinued.

Cons : Almost has no contraindications. Exceptions are: pregnancy, individual intolerance and inflammation of the joints.

5. Hormonal steroid preparations - intraarticular injections of ( motel, kenalog, hydrocotisone).

Pros : In some cases, such injections have a good result, especially when there are concomitant diseases like inflammation of the tendons of the femur.

Cons : Such injections rarely give persistent positive results. Have many side effects.

Important : It is not recommended to do more than three injections in one joint. The gap between each injection should be at least two weeks.

6. Medicinal preparations of topical application - ointments, lotions, compresses.

Many people naively believe that all kinds of ointments, creams, lotions are the main drug in the treatment of joint diseases. This myth, moreover, is actively inflated by advertising. But this is just a myth. The problem is that the hip joint is deep beneath the skin, fatty tissue and muscles. The likelihood that some substances will overcome these barriers and in sufficient quantity reach the joint is extremely small. But nevertheless the positive effect from use of ointments is. And it does not consist in a "miraculous" composition, but in the very process of rubbing the ointment. For this use, conventional warming ointments are suitable.

Pros : The process of rubbing the ointment improves blood circulation, in some cases helps to relieve painful muscle spasm.

Cons : The composition of the ointment does not have a therapeutic effect.

Physiotherapy in the treatment of coxarthrosis of the hip joint

Physiotherapy includes: electrotherapy, magnetotherapy, inductothermy, UHF therapy, ultrasound therapy, the use of lasers, aeroionotherapy, ultrasound therapy, light therapy.

The situation with physioprocedures is about the same as with ointments. The hip joint is deep. Therefore, it is reasonable to use physiotherapy only to improve blood circulation and relieve spasm. As for specific procedures, everything is individual, some are helped by someone, others by others. Everything depends on the person and the particular case. According to some physiotherapists, good results with coxarthrosis are provided by laser therapy, cryotherapy and massage. The latter method deserves special attention.

Pros : Improves blood circulation and reduces painful muscle spasm.

Cons : No serious effect on the course of the disease as a whole.

Massage in the treatment of coxarthrosis

With deforming arthrosis of the hip joint, treatment with a massage gives good results. Massage with coxarthrosis is a very effective and useful method. It is desirable that the massage was conducted by a good specialist and as often as possible. Its action is aimed at improving blood circulation, strengthening the muscles, relieving painful spasm, swelling and tension of the muscles, as well as increasing diastasis between the articulating elements of the joint. In the absence of a professional masseur, you can do the massage yourself. Massage with arthrosis can be performed both manually, and with the help of various massage aids and even a jet of water( hydrokinetic therapy).

Pros : Very effective and harmless method. The beneficial effect of using massage is difficult to achieve using other methods.

Cons : With proper administration of complications does not cause.

Joint Extension

This procedure is usually carried out using a traction device or manual. This is one of the few procedures that can dissolve articulating joint bones and reduce the burden on them.

Disadvantages of the traction device : The pull is made only on the vertical axis. Although it would be more useful to perform traction a little in the side and in the outer side.

Pros of the traction device : Ease of pulling.

Manual traction is free of this disadvantage. In addition to the angle of traction, it is more physiological. This stretching is performed directly by the manual therapist.

Pros of manual traction : Allows you to calculate the load taking into account the individual characteristics of the patient, its weight and ligamentous muscle tone.

Cons of manual traction : First, this is a very time consuming procedure. It is physically difficult for both the patient and the doctor. Secondly, it is important not to be mistaken with the choice of the manual therapist. The consequences of poorly performed stretching can be very serious.

Important : When addressing a chiropractor, always ask him to present a diploma and a license for medical care. Because of the complexity of implementation and the possible consequences of such treatment can be equated to the operation.

Diet for coxarthrosis

To date, the relationship between eating any specific products and the development of coxarthrosis is not proven. No miracle diets to cure coxarthrosis. The only thing that can be useful diet is a decrease in body weight. Decreased body weight leads to a decrease in the load on the hip joints. The less a person weighs, the easier he tolerates coxarthrosis.

Pros : All diets that lead to weight loss are useful.

Cons : The disease itself does not affect the diet.

Gymnastics for the treatment of arthrosis of the hip

Caution should be chosen for gymnastic exercises with coxarthrosis. Movements should not be too sharp, energetic - they can injure a sick joint. In no case can you do those exercises that cause severe pain. It is recommended to give preference to exercises aimed at strengthening the muscles, not loading the joint itself. With coxarthrosis, it is useful to go swimming, especially in pools with salt water or at sea.

Pros : Gymnastics with coxarthrosis strengthens muscles, improves blood circulation.

Cons : Select exercises with caution. There is a risk of injuring the joint.

Auxiliaries for the treatment of osteoarthrosis of the hip joint

With coxarthrosis of I and II degrees it is recommended to walk with a cane, to reduce the load on the diseased joint. At the III stage it is recommended to walk with crutches.

In conclusion, it should be said that with coxarthrosis of the hip joint treatment, it is always a balanced set of methods - drugs and medical procedures. Choose and balance the treatment will help you your doctor.

koksartroz.ru

Coxarthrosis - arthrosis of the hip joint. Degrees and symptoms of coxarthrosis.

There is both a lesion of one, and both hip joints at once. So bilateral bilateral coxarthrosis of the hip joints is not uncommon. When the primary is very often affected knee joint and spine.

Structure of the hip joint

To get a deeper understanding of the meaning of all measures for treatment of coxarthrosis, you need to know a little about the structure of the joint and about the changes that occur with it when arthrosis of the hip joints .

Two joints are involved in the formation of the hip joint: the femoral and iliac bones. It is the acetabulum of the iliac bone that serves as a "pocket", into which the joint ball-shaped head of the femur is inserted. Together, the joint and the acetabulum form a hinge, thanks to which the hip joint is able to produce various rotational movements in a healthy state.

In normal state, the femoral head and the cavity of the acetabulum are covered with a layer of hyaline cartilage. The articular cartilage is a very smooth, firm and resilient "padding" that provides an ideal glide of the connecting bones relative to each other. Also, the cartilage is involved in depreciation and load distribution during walking and movement.

Ideal gliding of articulated bones is possible due to the special physiology of the cartilage. It works on the principle of a wet sponge, which during the squeezing releases water, and after compression again fills its pores with water. Only in contrast to the usual sponge, from the cartilage is not allocated water, and articular fluid, which has a special lubricating properties. It is the articular fluid that forms the protective film on the surface of the cartilage. The thickness of the protective film depends on the degree of stress on the joint. That is, the greater the pressure force, the larger the layer.

Filling all the free space in the joint cavity, articular synovial fluid provides nutrition and lubrication of the cartilage. The joint cavity is surrounded by a capsule, which consists of very strong and dense fibrous fibers.

A very important role for normal functioning of the hip joint is played by the surrounding massive muscles - gluteal and femoral. If the muscles are poorly developed - the correct movement of the joints is impossible. In addition, the femoral and gluteal muscles take on a part of the load when running and walking, thus playing the role of active shock absorbers. It is thanks to very well developed muscles, the joint trauma decreases with unsuccessful movements, running, jumping or long walking.

And do not forget about another very important function of the muscles: during their intense motor work they perform the role of a kind of pump and pump through their blood vessels very large volumes of blood. It is because of this that the blood circulates better around the joint and delivers the necessary nutrients to it. Accordingly, the more perfect the work of the muscles, the more circulating blood circulates through them and the more nutrients the joint gets from the body.

Mechanism of arthrosis development

So what happens with the joint during the development of deforming coxarthrosis? At the beginning of the disease, the properties of the joint fluid change - for various reasons it becomes viscous and dense. And without proper "lubrication" articular cartilage begins to dry up, and its surface becomes rough and covered with cracks. As a result, the cartilage begins to thin, as it does not withstand increased friction during movement. And the distance between the articulating bones of the joint gradually decreases. Bones seem to be exposed from under the cartilage, the pressure on them increases and they begin to deform. That is why the disease of coxarthrosis is called deforming arthrosis of the hip joint.

In addition to changing the properties of the joint fluid, there is a violation of blood circulation and thus slows the metabolism in the joint, by reducing the circulation of blood through its vessels. Over time, the muscles of the sore leg atrophy. The whole process takes place in the body gradually. But sometimes the chronic course of the disease is accompanied by periods of severe exacerbation of joint pain, this is the so-called period of "reactive" inflammation of the joints. It is during this period that sick patients often seek medical help from a doctor.

Causes of coxarthrosis

Reasons for the appearance of this disease are in fact very many:

  • circulatory disturbance in the joint - worsening of venous outflow and arterial inflow. As a result of insufficient supply of tissues, accumulation of under-oxidized metabolic products takes place, activating enzymes that destroy cartilage;
  • mechanical factors causing overload of the joint. Most often overloads are subject to professional athletes. But you can also include people with excess body weight. And since complete people are also characterized by metabolic and circulatory disorders, then in combination with overload on the joint, it is they who very often joints are affected by arthrosis;
  • biochemical changes in cartilage, metabolic disorders in the human body, hormonal changes;
  • trauma( pelvic fractures, cervical fractures and traumatic dislocations).It is the trauma that leads to the development of coxarthrosis of the hip joints in young people;
  • aseptic necrosis of the head of the hip;
  • infectious processes and inflammation of the joints;
  • pathology of the vertebral column( scoliosis, kyphosis) and feet( flat feet);
  • congenital hip dislocation - occupies about 20% of all arthrosis of the hip joints;
  • congenital dysplasia( joint development disorder);
  • "lack of training" as a result of a sedentary lifestyle;
  • age;
  • predisposition and heredity of the body. Undoubtedly coxarthrosis itself is not inherited, but here the weakness of the skeleton, the features of the structure of the cartilaginous tissue and metabolism are transmitted genetically from the parents to the child. Therefore, if your parents or close relatives are ill with arthrosis, then the risk of getting a diagnosis of coxarthrosis rises.

Symptoms of coxarthrosis

General symptoms of coxarthrosis of the hip can be identified, but it must be understood that the symptoms depend on the stage of the disease:

  • pain in the joint, thigh, inguinal region, at the knee, both under load and at rest;
  • stiffness and stiffness of movements;
  • the aching leg becomes shorter;
  • there is an atrophy of muscles of a femur;

The main sign of coxarthrosis and the main complaint with which patients turn to the doctor is pain. The nature, duration, intensity and localization of which depends on the stage of the disease. At the initial stage, when it is best to start treatment, joint pain is still quite weak. That's why patients do not immediately rush to see a doctor, hoping that the pain will go somehow miraculously by themselves. And this is the most important mistake, which leads to loss of time and destruction of the joint. Painful sensations begin to increase, and the mobility of the aching leg is limited. Pain appears already at the first steps and subsides only in a state of rest. The patient begins to limp, crouching when walking on a sore leg. The muscles of the thigh atrophy - shrink and decrease in volume.

The most interesting thing is that the atrophy of the hip muscles causes the appearance of pain in the knee area and in the places of attachment of the tendons. And the intensity of pain in the knee can be much more pronounced than the femoral or inguinal. That is why very often the wrong diagnosis is made - arthrosis of the knee joint and the doctor prescribes a completely inappropriate treatment, and the present disease only progresses.

By the way, pain in the thigh and groin, can be caused in the patient not only by arthrosis. Very often pains in these areas are given from the inflamed femoral tendon or damaged spine. Moreover, the complaints of such patients almost coincide with the complaints of those people who suffer from coxarthrosis of the hip joint. Therefore, the correct diagnosis should be entrusted only to experienced doctors. Diagnosis of the degree of disease and choice of treatment is determined only by a doctor!

Degrees of coxarthrosis

There are three degrees of arthrosis of the hip joint:

For coxarthrosis of 1 degree, periodic pains arising after physical exertion( prolonged walking or running) are characteristic. Basically, pain concentrates in the hip joint area, rarely occurs in the thigh and knee area. Usually after rest the pain passes. The amplitude of the movements is not limited, the gait is not violated, muscle strength is not changed. If you make an x-ray at this stage, you will see slight bony growths, but they do not go beyond the joint lip. Bony growths are located around the inner or outer edge of the articular surface of the acetabulum. The cervix and the head of the femur are practically unchanged. The joint gap is unevenly narrowed.

In coxarthrosis of the 2nd degree, the pain intensifies and is more intense. In addition to pain in the joint itself, they are given to the inguinal region, thigh and arise even in a state of rest. Long walking causes lameness. Normally, the joint can no longer function. The internal rotation and hip removal are significantly limited. The muscles that remove and unbend the hip loosen their former strength. On the roentgenogram of the patient, significant bone growths are seen both on the inner and outer edges of the acetabulum, which extend beyond the boundaries of the cartilaginous lip. The head of the femur is deformed, enlarged in volume and has an uneven contour. In the most loaded parts of the head and swivel cavities, cysts are possible. The neck of the femur extends and thickens. The slit of the hip joint is unevenly narrowed( up to 1/3 - 1/4 of the initial height).The patient tends to shift the head of the hip to the top.

Pain in coxarthrosis of the 3rd degree is already permanent, arising even at night. When walking, the patient must use a cane. Movement in the joint is severely limited, the muscles of the thigh, lower legs and buttocks - atrophy. Because of the weakness of the hip muscles, the pelvis tilts in the frontal plane, which leads to a shortening of the limb on the affected side. To get to the floor when walking, the patient has to step on the toes and tilt his torso on the sore side. This is how you have to compensate for the shortening of the limb and the slope of the pelvis. But the method of compensation leads to the movement of the center of gravity and to overloads on the joint. On the radiographs, extensive bony enlargements are seen from the side of the femoral head and the roof of the swivel cavity. The joint gap narrows sharply. The neck of the thigh is greatly expanded.

Deforming osteoarthrosis of the hip joint and its diagnosis

Diagnostics is based on clinical and radiological data. Radiographic examination helps to establish the stage of the disease and its etiology. For example, with dysplastic coxarthrosis, flattening and slanting of the acetabulum and an increase in the neck-diaphyseal angle are clearly visible. If the disease was a consequence of juvenile epiphysiolysis or Perthes disease, then changes in the shape of the proximal end of the femur are noticeable. There is deformation of the head and the neck-diaphyseal angle decreases with the formation of coxa vara. Features of the x-ray picture of posttraumatic coxarthrosis depend on the nature of the resulting injury and the shape of the articular surfaces after the fusion of the bones forming the hip joint.

Recall once again that the complexity of the primary diagnosis is that the symptoms of arthrosis of the hip joint resemble the symptoms of the knee. But X-ray studies help to make an accurate diagnosis. It is from the correct diagnosis of the disease depends on the choice of treatment methods. More details about all possible methods of treatment of this disease, we will tell in the article - "Treatment of coxarthrosis."

And most importantly - do not make a diagnosis yourself. Only an experienced doctor can correctly diagnose and select the optimal method of treatment.

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Coxarthrosis of the hip joint: symptoms, signs and causes of the disease

Coxarthrosis of the hip joint is an irreversible disease of the articular surfaces, which is based on a metabolic disorder of the cartilaginous tissue. As a rule, this is a process that has been going on for many years, characterized by a gradual change in cartilage with subsequent deformation of bones and loss of joint functionality. Primarily affects people after 40 years, but there are very young patients.

IMPORTANT TO KNOW!Doctors are dumbfounded! The pain in the joints is FOREVER!Just before bedtime. .. Read on - & gt;

Disease of coxarthrosis of the hip joint is a "local" type of osteoarthritis - a common noninflammatory joint disease( in the Latin name of "coke" - thigh).Other synonyms: arthrosis, deforming osteoarthritis. Discovered at the initial stage of arthrosis pretty well suits the conservative treatment of .In the later stages, disability generally develops, but it is possible to restore the function of the joint with the help of endoprosthesis surgery.

Joint structure: norm and pathology

To understand what coxarthrosis of the hip joint is, if you thoroughly understand what the hip joint consists of. The basis of the joint is the joint bones - iliac and femoral. The head of the femur has a spherical shape, which is "inserted" into the iliac hollow of the iliac. In a normal joint, they fit tightly to each other and form a unique hinge.

The joints are covered with cartilaginous tissue, which acts as a shock absorber. Slip during rotation of the joint is achieved through a protective film, which is released by the pores of the cartilage. Thus, the joint is located in the synovial membrane, filled with joint fluid. With an increase in the fluid load, more is released, with a decrease - its quantity is reduced.

The equilibrium is disturbed when the synovial fluid thickens and becomes viscous. This happens because of a violation of blood circulation in the epiphysis - the "living" part of the bone pierced with blood vessels. As a result of the thickening of the fluid, the cartilage dries, cracks and thinens, the joint loses its mobility. When loaded, the bones rub against each other, deform and expand. Therefore, the disease is called deforming coxarthrosis of the hip joint.

Symptoms of

Symptoms of coxarthrosis of the hip joint at each stage of development are usually different. However, there are some common signs that a person can assume, for example, the initial stage of the disease and take possible measures. This can significantly improve the chances of recovery. In fact often happens so, that the help of the expert is necessary already when the disease is difficult to stop.

Coxarthrosis of the hip joint symptoms of a general nature may have the following:

  • pain in the joint area is the most obvious symptom by which one can assume any disease of TBS.The intensity and nature of the sensations usually depends on the stage;
  • limb limb limitation is also a symptom of coxarthrosis. For the early stage, the feeling of "stiffness" of the joint, which passes after a certain load, is characteristic;
  • change in leg length due to deformity of the pelvis is characteristic of "neglected" osteoarthritis;
  • weakening of the thigh muscles can be observed already in the second stage of the disease, reaching the third until complete atrophy;
  • lameness or gait change is a very likely sign of bone deformation;
  • distinct crunch in the joint - not always a sign of arthrosis. It is usually taken into account when there are other symptoms.

Types of coxarthrosis

Primary coxarthrosis usually forms imperceptibly. It is difficult to say what is its true cause. The first place is usually the violation of blood circulation in the joint due to a sedentary lifestyle and endocrine pathologies that cause obesity, osteoporosis, or other metabolic disorders. Also, the cause may be unnoticed microtrauma and age-related changes in the joints.

Secondary coxarthrosis is formed against the background of a pronounced inflammatory disease of the joints, the musculoskeletal system as a whole or a serious injury. Dysplastic coxarthrosis of the hip joint has a cause in its name: most often uncorrected dysplasia of TBS in childhood turns into a disease of arthrosis at a later age.

As a rule, if one joint is deformed, it is possible - over time or immediately - the defeat of another. This is because the causes that cause the development of this disease are usually common to the entire osteochondral cartilage system. Depending on the number of organs involved in the disease, one-sided and two-sided coxarthrosis of the hip joint and polyarthrosis are isolated.

Degrees of the development of the disease

The formation of coxarthrosis, especially the primary, most often occurs over a long period, so it can take a long time to develop in a latent form. Secondary arthrosis of TBS under the action of the trigger mechanism, for example, in the form of trauma, can have a shorter course. Nevertheless, there are clearly expressed parameters of the transition from one degree of arthrosis to another:

  • coxarthrosis of the 1st degree of the hip joint is characterized by periodic pains in the hip area after prolonged loads that pass at rest. In the mornings a feeling of "stiffness" can be felt. Mobility is not limited, bone tissue grows slightly, the gap between the bones is almost not narrowed, the head of the femur is not deformed;
  • coxarthrosis of the 2nd degree of TBS begins when the pains are greatly amplified and given away in the groin, can arise at rest. The load on the joint causes lameness, the periarticular muscles become weaker. On the X-ray, the following changes are visible: bone growths go beyond the boundaries of the joint elements, the head and neck of the femur deform, possibly the formation of cysts, the joint gap narrows to a third;
  • coxarthrosis of the third degree of the hip joint can be assumed when the pains are permanent. The mobility of the joint is broken down to ankylosis( immobility), the periarticular muscles are atrophied, a shortening( in rare cases, lengthening) of the foot is observed, pains in the spine and other joints appear from overloads. The picture shows extensive growth of bones, the neck of the hip is widened, the gap between the bones of the joint is as narrow as possible.

Reasons for

Common causes of coxarthrosis of the hip joint can be both long acting, as if gradually "undermining" the normal operation of the joint, and sudden, causing acute illness, rapid deformities and disability.

The most common cause of coxarthrosis of the hip joint is the cause of "long-playing":

  • developmental abnormalities( dysplasia) of TBS and heredity( 10% of cases).Predisposition to metabolic disorders and weakness of the musculoskeletal system can be congenital. The probability of developing the disease increases somewhat if close relatives are ill with arthrosis;
  • chronic stress( 30-50%).Strong suppressed emotions usually throw into the blood of a large number of "stress hormones" - corticosteroids. They actively destroy hyaluronic acid, which is an important component of the joint fluid. This leads to a gradual destruction of the cartilaginous tissue.

If coxarthrosis is secondary, the picture of the prerequisites may be different. The causes are:

  • infarction TBS( 10-30%).It can cause a sharp violation of blood circulation in nearby vessels, caused by trauma, alcohol or drug intoxication. Almost always accompanied by coxarthrosis;
  • overload of the joint( 20-30%).Dangerous if the joint already has some inferiority: congenital flaw, weakness due to an inflammation, trauma, age-related changes or the initial stages of arthrosis. All this can lead to the rapid development of coxarthrosis;
  • joint overload at high weight( 5-10%).This point is particularly relevant to people who have recovered sharply - an unexpectedly increased load on the lower limbs creates the effect of a constant overload, to which the cartilaginous tissue can not adapt;
  • trauma of TBS( 10-20%).Frequent repetitive or severe mechanical damage to joint elements can provoke irreversible deformation development;
  • inflammatory joint disease( rheumatoid arthritis).They are a frequent cause of the appearance of secondary arthrosis, since the inflammatory process disrupts the circulation and causes a change in the cartilaginous tissue;
  • sharp hormonal changes. Such phenomena as menopause and pregnancy with all the resulting metabolic disorders can provoke hip coxarthrosis.

Diagnostic methods

A doctor's examination is an informative enough way to recognize the patient's coxarthrosis. Often, only with personal consultation can you learn the nature and strength of pain, determine the degree of joint mobility and gait disturbance. By analyzing the blood, you can determine the source of changes in the joint: if there is an inflammatory process, then it makes sense to suspect arthritis.

In addition, in fact, inspection is possible technical methods of research:

  • X-ray - one of the most reliable diagnostic methods. It is not particularly suitable for the diagnosis of arthrosis in the early stages, since it can not assess the condition of the cartilaginous tissue and joint fluids. But on the roentgenogram you can see such signs of coxarthrosis of the hip joint as the size of the joint gap, the degree of deformation of the joint bones, the presence and prevalence of bone growths, the presence of tumors;
  • magnetic resonance imaging is certainly the most effective method for diagnosing most diseases, but in the case of bone tissue it is not particularly informative. But MRI allows you to see the state of cartilage and synovial fluid, which increases the chance to detect coxarthrosis at the earliest stage.

A more accurate diagnosis allows you to put a combination of all listed diagnostic methods.

Coxarthrosis of the hip joints has a rather favorable prediction of .At an early stage of the disease, regular physical exertion and massage are sometimes sufficient to treat it. With late detection of the disease, modern orthopedic surgery offers an alternative to disability - an operation to replace a part of the affected joint with a prosthesis.

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Causes of the pathological condition of the bone joint

Coxarthrosis of the 2nd degree of the hip joint treatment

Deforming changes in the formation of the femoral head and the trough of the pelvic bone disrupt the load distribution during walking and performing various rotational movements. This is due to the change in the elasticity and density of the hyaline cartilage, which is lined with bone and performs an amortization function. It consists of a carcass, which should normally have a percentage of 65-80% hydration. Disturbed nutrition with the necessary trace elements of the solid surface connection structures leads to a change in the stability of the synovial fluid composition. In the intercellular substance, the level of the physical property of the intensity of hydrophilicity falls. Propagation of the movement of individual molecules varies and leads to a decrease in the possibility of penetration of nutrients into cartilage tissue. The normal maintenance of the ratio of moving joints is disrupted. Their mobility decreases. Slipping of the bone surface worsens.

Why are the processes of recovery in the human body weakened?

This pathological condition is noted in people aged 40 years, when the unconditional basis of physiological restructuring of the body begins to form. The weakening of the processes of recovery of chondrocytes and chondroblasts causes dystrophic changes in the intercellular substance and cells. Cartilage tissues can not fully implement their biomechanical function of support. Coxarthrosis of the first degree of the hip begins to appear, treatment should be performed immediately. At this stage, it is possible to restore the balance between the onset of degradation of the cartilage surface and synthesis. It will be aimed at restoring the metabolism in the body, reducing the inflammatory process, so that we do not have to start treatment for coxarthrosis of the 2nd degree of the hip joint, when regeneration will be more difficult to start than at the beginning of this process and friction begins to appear.

It should be noted that coxarthrosis of the hip joint of the 1st degree is quite a complicated disease.

And even at the beginning of it there will already be changes, which during therapy can only partially fill the supply of cartilage tissue with nutrients, and the appearance of a new tissue can not replace the original one, sincechanges are partially restored, and its new property does not correspond to the ability to fully absorb loads. The onset of a decrease in physiological regeneration in cartilage tissue, trauma( microtraumatism) can cause a decrease in the metabolism necessary for the cartilage layers and cause coxarthrosis of the 1st degree of the hip joint. In addition, the appearance of pain, which prevents the physical movements of the lower limb in full, is caused.

Disintegration can occur unequally

Accordingly, additional factors are created for the disruption of the transfer of nutrients to the joint structures due to a decrease in the mechanical load on the hyaline surface, without which the diffusion process decreases. Duplex coxarthrosis of the 1st degree can not compensate the transferred load on the second limb, t. It causes defeat of both structures of articulations. Destruction can occur unequally in one and the other articulation. When dystrophic changes occur in the hip, bone surface changes may occur. To the body did not have to use its own internal resources and the mechanisms of the junction joint work did not start, it is necessary to know: how to treat coxarthrosis of the hip joint of the 1st degree and what is coxarthrosis of the hip joint of the 2nd degree.

Symptomatic relief of

It is necessary to use agents whose action will help reduce symptomatic manifestations( inflammation, pain).For emergency indications( acute inflammatory process), hormones( hydrocortisone, prednisolone cortisol) are used. Non-steroidal anti-inflammatory drugs are used: Diclofenac, Indomethacin, Voltaren, Ibuprofen, they will reduce the acute development of the process. When the diagnosis is established, coxarthrosis of the hip joint of 1 degree, treatment is performed only after determining the causative beginning of the reduction in cartilage nutrition. The condition can be caused by endocrine and metabolic imbalances, and some non-steroid drugs can cause deterioration in the general condition of the patient or cause acute conditions. According to modern standards of therapy, medicines, which will be strengthened by the regulation of metabolic processes in the layers of cartilaginous tissue and will halt the processes of degeneration, will be mandatory. The main active ingredient in their composition should be a chondroprotector. The group of modifying components with delayed action include: Hyaluronic acid, Chondroitin, Glucosamine. The effectiveness of any of the methods depends on how to treat coxarthrosis of the hip joint of the 2nd degree. But in any of the therapeutic options, the principle of retaining the mobility of the hip joint is fundamental.

In coxarthrosis of the 2nd degree of the hip joint, the treatment is carried out with preparations whose composition will have a combined action: anti-inflammatory( in some cases antimicrobial), anesthetic, stimulating metabolic processes in cartilage and hard tissues.

uses vasodilator drugs.

Drugs should have a long lasting effect. Prolonged use of anti-inflammatory drugs can intensify the process destroying the course. Clinical efficacy of drugs should be with maximum preservation of compounds at the time of delivery of active substances that activate the regenerating properties of connective and cartilaginous tissue. Treatment of coxarthrosis of the hip joint of the 2nd degree should necessarily reduce the accompanying intense pain caused by muscle spasm. Muscle relaxants are used. To improve blood circulation, vasodilator drugs are used.

Prevention of disease

arthrosis of the hip

To prevent this disease, it is necessary to follow preventive measures that will help prevent the onset of pathological changes in the area of ​​bone connections. And in the case when the process has already begun, do everything to stop it, and prevent complex destruction at the point of contact between the pelvic bone and the femoral head, which subsequently causes the deforming coxarthrosis of the hip joint of the 2nd degree. It is necessary to adjust the diet. Lifestyle changes are carried out by taking into account the therapeutic plan, taking into account the patient's natural constitution. Present pathological conditions in the body caused by disturbances in regulation must be normalized, with the help of internal influence( the appointment of appropriate pharmacological groups).

Alternative therapies can be carried out through external influence, they include: acupuncture, massage( spot, local), balneotherapy, weak manual methods, use of compresses with tinctures.

The result of the deformation of hard tissues is the erasure of their surface. The patient has painful manifestations that make it impossible to perform rotational or retracting movements with his foot. The contact of the head in the place of the cavity in the connecting formation takes place directly in the place of the damaged parts of the cartilage, and the bone material is erased when in contact with each other. This condition is attributed to complications that do not lend themselves to conservative therapies.

A person with such destructive consequences should be treated internally, which on an open or damaged area of ​​the hard surface will help restore the cartilaginous surface. Dystrophic changes are chronic, with a disease such as coxarthrosis of the hip joint of the 2nd degree, treatment may require removing the small particles that appear from the destruction of the cartilaginous tissue. The positive effect can persist for two years. Complex changes in bone surfaces are processed to transfer the load point. In severe cases, an enoprosthesis is indicated.

Exercise of exercise therapy

Diagnostics include examination, laboratory data. When coxarthrosis of the 2nd degree of the hip joint is determined, a functional test is performed to determine the disturbance of movement. In the X-ray examination data, the articular joint is narrowed by a factor of 2, and the appearance of bony proliferation is determined. Carrying out the courses of physiotherapeutic procedures will improve local blood circulation and local trophism of tissues, which will improve the delivery of nutrients to the affected structures. Individually selected exercises will help to restore the rotational movement of the legs, especially the performance of exercise therapy, if internal intervention is performed.

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Coxarthrosis of 2nd degree: symptoms and treatment of

Mechanism of development and causes of coxarthrosis

The main mechanism in the development of pathology is the degeneration( destruction) of cartilaginous tissue, which develops due to disruption of its nutrition( dystrophy), chronic inflammatory process( arthritis)or increased loads. The cartilage at the same time loses its elasticity, strength, its surface becomes rough, which only aggravates the processes of destruction. In the future, inflammation and changes in the shape of the hip joint( deformation) develop. The main causative factors that trigger the process of degeneration of the cartilage are as follows:

  1. High loads - the hip joint, even under physiological conditions, experiences the greatest load in comparison with other joints. Additional functional loads in the form of long standing, weight bearing increase the pressure on the cartilage, causing its gradual degeneration.
  2. Hereditary predisposition and congenital diseases( dysplasia, congenital dislocation) - from the parents the defective gene is transmitted, as a result of which the cartilaginous tissue is synthesized with the initially altered properties.
  3. Injuries - any traumatic impact( dislocation, bruise, fracture) further causes a disturbance in cartilage nutrition, a decrease in synthesis and quality of synovial articular fluid that provides trophic and lubrication for the cartilaginous surface of the hip joint.
  4. Chronic inflammation( arthritis) - can be infectious( bacteria) or autoimmune( cartilage and connective tissue damage by intrinsic antibodies, due to a malfunction in the immune system).

Types of coxarthrosis

The process of degeneration can be one-sided( more often) or two-sided( less often).Depending on the severity of changes in the properties and structure of the cartilage, the presence of inflammation and deformation of the joint, 3 degrees of severity of coxarthrosis are recognized.

Symptoms of

The severity of the manifestations depends on the severity of the process and the changes in the cartilage. With coxarthrosis 1 degree, changes are not expressed, so there may be almost no symptoms. Sometimes there is a sensation of crunch when moving with the foot, minor pain after doing physical work, standing or a long walk, which disappears after rest. Coxarthrosis of the 2nd degree is characterized by the presence of such clinical manifestations:

  • constant pain, which is not associated with physical exertion and can be present at rest;
  • localization of painful sensations in the region of the hip joint, pain can radiate to the thigh, inguinal region, knee and shin;
  • stiffness of movements - it becomes difficult to rotate the hip, withdraw the leg, bend and unbend it, the movements are accompanied by increased pain;
  • after prolonged walking or standing, there is lameness associated with increased pain - one of the symptoms that causes a person to see a doctor;
  • marked crippling( crunching) during the performance of any movements with the foot;
  • reddening and swelling in the area of ​​coxarthrosis localization is the result of joining the inflammatory process;
  • change in shape( deformation) - determined using an X-ray.

At 3 degrees of severity of this pathology, all the symptoms become even more pronounced, a person can not walk independently without auxiliary means( crutches, walking stick), disability and disability develop.

Diagnostics

A typical clinical picture allows you to put a preliminary diagnosis of coxarthrosis. To clarify the severity of structural changes, additional instrumental diagnostics is carried out-radiography and tomography. At the 2-nd degree, bone growths along the margin of the cartilage, deformation and joint cavities, the presence of cysts( cavities in the joint filled with fluid), narrowing of the gap between the joint surfaces( up to 2/3 of the normal width) are visualized.

Treatment of coxarthrosis

Therapy is complex and complex, allocating several directions that can be effective with coxarthrosis of the 2nd degree:

  1. The use of medications is necessary to reduce inflammation and intensity of pain by using non-steroidal anti-inflammatory drugs( diclofenac) and restoring structure and nutritioncartilage tissue( chondroitin).
  2. Physiotherapy - mud baths, magnetotherapy and electrophoresis are used.
  3. Therapeutic gymnastics is used after the reduction of inflammation and pain, dosage physical exercises are performed that help in the restoration of cartilage, reduce the deformation of the joint.

Surgical intervention is used at grade 3.During the operation, removal of bony outgrowths, areas of cartilaginous tissue, cysts, correction of joint shape is performed. With significant changes that can not be corrected, implantation of an artificial joint made of titanium alloy is carried out.

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