Coxarthrosis of the 3rd degree
Coxarthrosis is a deforming arthrosis of the hip joint. Coxarthrosis of the third degree is the latest stage of the development of the disease, in which there is almost complete thinning of the articular cartilage, the absence of synovial fluid and damage to the entire structure of the joint, which is accompanied by severe pain and severe limitation of mobility.
Treatment of coxarthrosis of the 3rd degree without surgery
Conservative treatment of the disease( without surgery) includes a set of measures to reduce inflammation and repair of cartilage joint tissue:
- The administration of non-steroidal anti-inflammatory drugs in tablets or as injections.
- Given that pain with coxarthrosis of 3 degrees is usually permanent and strong enough, at the initial stage of treatment of non-steroidal anti-inflammatory drugs for anesthesia may not be enough. In this case, additional painkillers are prescribed or complex treatment, including both injections and taking of tablets, as well as the use of special ointments with anti-inflammatory and analgesic effect.
- In the case of severe inflammation affecting the ligaments, intra-articular injections of corticosteroids are performed.
- Reception of chondroprotectors.
- Reception of muscle relaxants and vasodilators.
- Regular sessions of physiotherapy to improve the mobility of the joint.
Surgical treatment of grade 3 coxarthrosis
At this stage of the disease, conservative treatment is often ineffective and in most cases surgery is required.
The operation, depending on the degree of damage to the joints, can be of three types:
- Artoplasty. The most sparing version of surgical treatment. Restoration of joint functions is carried out by restoring its surface, restoring interarticulate cartilage and linings, replacing them or with pads from the patient's tissue, or with implants from a special artificial material.
- Endoprosthetics. Radical version of the artoplasty, which replaces the damaged joint or its part with a special prosthesis. The prosthesis is implanted in the bone and completely repeats the functions of a normal joint.
- Artrodes. An operation in which the joint is fixed and completely lost its mobility. It is used only in cases when other methods of treatment are ineffective, since a complete restoration of the motor function after such an operation is impossible.
CoxarthrosisCoxarthrosis ( deforming arthrosis, osteoarthrosis of the hip joint) is a degenerative-dystrophic disease affecting mainly middle-aged and elderly people. Coxarthrosis develops gradually over several years. It is accompanied by pain and restriction of movements in the joint. In later stages, atrophy of the hip muscles and shortening of the limb are observed. Coxarthrosis can be provoked by various factors, including trauma, congenital pathology, pathological curvature of the spinal column( kyphosis, scoliosis), inflammatory and non-inflammatory joint diseases. Hereditary predisposition is noted. Sometimes coxarthrosis occurs for no apparent reason. It happens both one-way and two-way. The course is progressive. In the early stages of coxarthrosis, the treatment is conservative. With the destruction of the joint, especially - in patients of young and middle age, surgery( endoprosthetics) is indicated.
Coxarthrosis( osteoarthritis or deforming arthrosis of the hip joint) is a degenerative-dystrophic disease. Usually develops at the age of 40 years and older. It can be the result of various injuries and joint diseases. Sometimes there is no apparent reason. Perhaps both one-sided and two-sided defeat. For coxarthrosis is characterized by a gradual progressive course. In the early stages of coxarthrosis, conservative methods of treatment are used. In the later stages, the function of the joint can be restored only in an operative way.
In orthopedics and traumatology, coxarthrosis is one of the most common arthrosis. High frequency of its development is caused by a significant load on the hip joint and a wide spread of congenital pathology - joint dysplasia. Women suffer from coxarthrosis a little more often than men.
Anatomy of the hip joint
The hip joint is formed by two bones: the ileum and the femur. The head of the thigh is articulated with the acetabulum of the ilium, forming a kind of "hinge".At movements the acetabulum remains immovable, and the head of the femur moves in different directions, ensuring flexion, extension, withdrawal, reduction and rotational movements of the thigh.
During movements, the articular surfaces of the bones slide smoothly relative to each other, thanks to the smooth, resilient and durable hyaline cartilage covering the cavity of the acetabulum and the femoral head. In addition, hyaline cartilage performs a damping function and participates in the redistribution of the load during movements and walking.
There is a small amount of articular fluid in the joint cavity that plays the role of lubricant and provides nutrition to the hyaline cartilage. The joint is surrounded by a dense and firm capsule. Above the capsule are large femoral and gluteal muscles, which provide movement in the joint and, along with the hyaline cartilage, are also shock absorbers, protecting the joint from injuries in case of unsuccessful movements.
Mechanism of development of coxarthrosis
With coxarthrosis, the joint fluid becomes thicker and more viscous. The surface of hyaline cartilage dries up, loses its smoothness, becomes covered with cracks. Because of the roughness that has arisen, the cartilages are constantly injured each other, which causes their thinning and aggravates the pathological changes in the joint.
As the coxarthrosis progresses, the bones begin to deform, "adapting" to the increased pressure. Metabolism in the joint area worsens. In the late stages of coxarthrosis, a marked atrophy of the muscles of the diseased limb is observed.
Causes of development of coxarthrosis
Primary coxarthrosis( arisen for unknown reasons) and secondary coxarthrosis( developed due to other diseases) are isolated.
Secondary coxarthrosis can result from the following diseases:
- Hip dysplasia.
- Congenital dislocation of the hip.
- Diseases of Perthes.
- Aseptic necrosis of the femoral head.
- Infectious lesions and inflammatory processes( eg, arthritis of the hip joint).
- Post-traumatic injuries( traumatic dislocations, hip fractures, pelvic fractures).
Coxarthrosis can be either unilateral or bilateral. With primary coxarthrosis, concomitant lesion of the spine( osteochondrosis) and knee joint( gonarthrosis) is often observed.
Among the factors that increase the likelihood of development of coxarthrosis include:
- Constant increased load on the joint. Most often observed in athletes and people with excessive body weight.
- Blood circulation disorders, hormonal changes, metabolic disorders.
- Pathology of the spine( kyphosis, scoliosis) or stop( flat feet).
- Elderly and old age.
- A sedentary lifestyle.
Coxarthrosis itself is not inherited by itself. However, certain features( metabolic disorders, structural features of the skeleton and weakness of the cartilaginous tissue) can be inherited by the child from the parents. Therefore, in the presence of blood relatives suffering from coxarthrosis, the probability of the onset of the disease increases somewhat.
Symptoms and degrees of coxarthrosis
Among the main symptoms of coxarthrosis are pain in the joint, groin, hip and knee joints. Also, with coxarthrosis, stiffness of movements and stiffness of the joint, abnormalities of gait, lameness, atrophy of the hip muscles and shortening of the limb on the side of the lesion are observed. A characteristic feature of coxarthrosis is the limitation of the lead( for example, the patient has difficulty in trying to sit "on" the chair).
The presence of these or other signs and their severity depends on the stage of coxarthrosis. The first and most constant symptom of coxarthrosis is pain.
When coxarthrosis 1 degree , patients complain of periodic pain that occurs after physical exertion( running or long walking).The pain is localized in the joint area, less often in the thigh or knee area. After rest it usually disappears. Gait with coxarthrosis 1 degree is not broken, the movements are kept in full, there is no muscle atrophy.
On the radiograph of a patient suffering from coxarthrosis of 1 degree, undeveloped changes are defined: a moderate uneven narrowing of the joint space, and also bone growth around the external or internal edge of the acetabulum, with no changes in the head and neck of the femur.
With coxarthrosis of 2nd degree , the pain becomes more intense, often appearing at rest, radiating to the thigh and groin area. After considerable physical exertion, the patient with coxarthrosis begins to limp. The volume of movements in the joint decreases: the retraction and internal rotation of the thigh are limited.
In X-ray images with co-xarthrosis of the 2nd degree, a significant uneven narrowing of the joint gap( more than half of the normal height) is determined. The head of the femur is somewhat shifted upward, deformed and increases in size, and its contours become uneven. Bony growths at this degree of coxarthrosis appear not only on the inner but also on the outer edge of the acetabulum and extend beyond the cartilaginous lip.
With coxarthrosis, the 3rd degree pains become permanent, patients worry not only during the day, but also at night. Walking is difficult, with the movement of patients with coxarthrosis is forced to use a cane. The volume of movements in the joint is severely limited, the muscles of the buttocks, thighs and lower legs are atrophied. The weakness of the hamstrings removes the pelvis in the frontal plane and shortens the limb on the affected side. In order to compensate for the shortening, a patient suffering from coxarthrosis, while walking, tilts the trunk to the sore side. Because of this, the center of gravity shifts, the load on the diseased joint sharply increases.
On X-rays with coxarthrosis of the third degree, there is a sharp narrowing of the joint gap, a pronounced expansion of the femoral head and multiple bony expansions.
Diagnosis of coxarthrosis
Coxarthrosis is diagnosed on the basis of clinical signs and additional studies, the main of which is radiography. In many cases, X-rays provide an opportunity to establish not only the degree of coxarthrosis, but also the cause of its occurrence. For example, an increase in the neck-diaphyseal angle, slanting and flattening of the acetabulum indicate dysplasia, and changes in the shape of the proximal femur suggest that coxarthrosis is a consequence of Perthes disease or juvenile epiphysiolysis. On the X-ray patterns of patients with coxarthrosis, there may also be changes that indicate trauma.
As other methods of instrumental diagnosis of coxarthrosis, CT and MRI can be used. Computed tomography allows us to examine in detail the pathological changes from the side of the bone structures, and magnetic resonance imaging provides an opportunity to assess violations from soft tissues.
Differential diagnosis of coxarthrosis
First of all, coxarthrosis should be differentiated from gonarthrosis( osteoarthrosis of the knee joint) and osteochondrosis of the spine.
Muscle atrophy, occurring in stages 2 and 3 of coxarthrosis, can cause pain in the knee joint, which is often more pronounced than pain in the affected area. Therefore, when the patient complains of pain in the knee, a clinical examination( examination, palpation, determination of the volume of movements) of the hip joint should be performed, and if the coxarthrosis is suspected, refer the patient to a radiograph.
Pain with rootlet syndrome( nerve root compression) in osteochondrosis and some other diseases of the spine can mimic pain syndrome with coxarthrosis. Unlike coxarthrosis, when the roots are squeezed, the pain arises suddenly, after unsuccessful movement, sudden turn, weight lifting, etc., localizes in the buttock area and spreads over the hindface of the thigh. A positive symptom of tension is revealed - a pronounced soreness when the patient tries to lift a straightened limb, lying on his back. In this case, the patient freely withdraws his foot to the side, whereas in patients with coxarthrosis the withdrawal is limited. It should be taken into account that osteochondrosis and coxarthrosis can be observed simultaneously, therefore in all cases careful examination of the patient is necessary.
In addition, coxarthrosis is differentiated with trochanteritis( bursitis) - aseptic inflammation in the area of attachment of gluteal muscles. Unlike coxarthrosis, the disease develops rapidly, within 1-2 weeks, usually after trauma or considerable physical exertion. The intensity of pain is higher than with coxarthrosis. Restrictions of movements and limb shortening are not observed.
In some cases with an atypical course of Bechterew's disease or reactive arthritis, symptoms resembling coxarthrosis may be observed. Unlike coxarthrosis, in these diseases peak pain occurs at night. Pain syndrome is very intense, it can decrease when walking. Typical morning stiffness, which occurs immediately after awakening and gradually disappears within a few hours.
Treatment of coxarthrosis
Orthopedics treat coxarthrosis. The choice of treatment methods depends on the symptoms and stage of the disease. Conservative therapy is performed at stages 1 and 2 of coxarthrosis.
During the exacerbation of coxarthrosis, non-steroidal anti-inflammatory drugs( piroxicam, indomethacin, diclofenac, brufen, etc.) are used. It should be taken into account that the drugs of this group are not recommended for a long time, since they can have a negative effect on the internal organs and inhibit the ability of the hyaline cartilage to recover.
For the restoration of damaged cartilage with coxarthrosis, agents from the group of chondroprotectors( arteparone, chondroitin sulfate, structum, rumalone, etc.) are used. To improve blood circulation and eliminate spasm of small vessels, vasodilator drugs are prescribed( cinnarizine, nikoshpan, trental, theonikol).According to the indications, muscle relaxants are used( medicines for muscle relaxation).
In case of persistent pain syndrome, patients suffering from coxarthrosis may receive intra-articular injections using hormonal drugs( hydrocortisone, Kenalog, Metipred).Treatment with steroids should be done with caution.
In addition, with coxarthrosis, local remedies are used - warming ointments that do not have a pronounced therapeutic effect, but in some cases they relieve muscle spasm and reduce pain due to their "distracting" effect.
Also with coxarthrosis, physiotherapeutic procedures are prescribed( light therapy, ultrasound therapy, laser therapy, UHF, inductothermy, magnetotherapy, etc.), massage, manual therapy and therapeutic gymnastics.
Diet with coxarthrosis has no independent therapeutic effect and is used only as a means to reduce weight. Reducing the body weight can reduce the burden on the hip joints and, as a consequence, facilitate the course of coxarthrosis.
In order to reduce the strain on the joint, the doctor, depending on the degree of coxarthrosis, can recommend the patient to walk with a cane or with crutches.
In the advanced stages( with coxarthrosis of 3 degrees), the only effective method of treatment is surgery - replacing the destroyed joint with an endoprosthesis. Depending on the nature of the lesion, either a single-pole( replacing only the head of the thigh) or a bipolar( replacing both the femur head and acetabulum) prosthesis can be used.
The operation of endoprosthetics in coxarthrosis is carried out in a planned manner, after a complete examination, under general anesthesia. In the postoperative period, antibiotic therapy is performed. Sutures are removed for 10-12 days, after which the patient is discharged for outpatient treatment. After endoprosthetics, rehabilitation measures are necessarily carried out.
In 95% of cases, joint replacement surgery with coxarthrosis ensures complete restoration of limb function. Patients can work, actively move and even play sports. The average life of the prosthesis, subject to all recommendations, is 15-20 years. After this, a repeated operation is necessary to replace the worn endoprosthesis.
Coxarthrosis of the third degree is characterized by practically no synovial fluid, articular fissure strongly narrowed, cartilaginous tissue is thinned to the limit. Bony surfaces begin to rub against each other causing inflammation, swelling and pain, the rigidity of the hip joint is manifested. Two-sided coxarthrosis is relatively rare, the patient becomes practically immobilized, the treatment is complicated. Constant pain is reflected in the appearance of a person, he becomes gloomy, uncommunicative, sleeps badly, is irritable and depressed.
The inability to fully move, let alone work, forces the patient to go to the disability registration. The definition of a disability group is a rather complicated and tedious process, as a rule, a number of surveys are needed to determine exactly which group is put to the person. Coxarthrosis in the third degree implies the receipt of a second group of disability, in the event that the patient is able to service himself, tolerably move with a cane.
In patients with coxarthrosis of 3rd degree,
is disabled. If coxarthrosis of the third degree is defined in the hip area, a person needs to agree with the attending physician as soon as possible about disability. It will be necessary to undergo medical and social expertise, where he will be assigned a group of 2 and 3 for one year, the first( for two years).After this time the patient will be forced to again confirm his illness and re-pass the examination. Obtaining lifelong disability is possible only if the pathological process has completely immobilized a person.
Therapy: conservative and prompt
Treating coxarthrosis of the third degree is difficult. At present, there are a lot of "miracle" means, which, if you believe advertising, will cure the disease and return the patient the joy of movement. Unfortunately, such zazyvaniya - cheating, really helping methods with coxarthrosis is small, and they are all unable to return a young and healthy joint to a person.
It is important to remember that collapsing cartilaginous tissue can not be returned to a holistic state by any medication, it does not have the ability to regenerate. Preparations can only slightly delay the process of destruction.
Treatment of coxarthrosis should be carried out only in a complex, any one method is practically ineffective. With arthrosis in the third degree in the region of the hip joint, there is practically a tonous layer of cartilage, and the articular area is strongly deformed. Most doctors will advise the patient on the operation( and will be right) proceeding from the fact that only a small number of patients with such a diagnosis will be able to execute painstakingly all the prescriptions of the doctor with conservative treatment.
However, even with such a will to restore the joint is completely unrealistic, it will probably only improve the condition of the muscles, blood vessels and bones surrounding the diseased joint. It is due to this that it will be possible to reduce the burden on the affected cartilage, the pain will decrease somewhat, and under favorable conditions it will disappear altogether.
Currently, coxarthrosis shows surgical treatment - endoprosthetics. This is a complete replacement of the "native" joint by an artificial joint.
Schematically it looks like this: a part of the femur is cut off, a pin is inserted into the cavity, made of various alloys, fixed in different ways. At its end there is an artificial joint. In parallel, the operation is also performed on the other articulating surface of the hip joint: a part of the acetabulum is removed, its place is occupied by a concave bed( of maximum strength polyethylene).
Conservative treatment of coxarthrosis of the 3rd stage is ineffective. Therefore, an endoprosthetics
is prescribed. With a successful operation, the patient feels relief, the pain disappears, the mobility in the joint is restored. But not everything is so rosy, one should consider the following:
- high risk of infection;
- a large number of complications;
- possibility of poor fitting of the denture.
The most important thing is that even with a high-quality prosthesis and exceptional surgeon's skill, an artificial hip joint requires replacement after 15-18 years of service. That is why early prosthesis is not recommended, done( for example) at 45 years, it will require a repetition of 60 years. The risk of complications with secondary intervention in the elderly is very high.
Any operations, especially such a plan, give a strong load on the body, in addition, endoprosthetics - an expensive "pleasure."After it is required and a long period of rehabilitation( a group of people "secured").Therefore, you need to treat coxarthrosis as early as possible, so sometimes you can avoid the operating table.
Coxarthrosis. Treatment of the hip joint of varying degrees of disease.
Coxarthrosis - deforming arthrosis of the hip joint. Coxarthrosis of joints develops usually after forty years. Women are sick slightly more often than men. The disease can affect both one and both hip joints( bilateral coxarthrosis).But even in the case of a bilateral defeat, one joint usually becomes ill first, and only then the second.disability with coxarthrosis
Causes of coxarthrosis
The causes of coxarthrosis can be different, but the picture of the disease is always the same. It all starts with a change in the articular cartilage, which is thinned and loses the property of absorbing the load. Stratification of cartilaginous tissue body compensates for the formation of bone growth along the edge of articular surfaces, which leads to deformation of joints and bones of different degrees.
The main causes of coxarthrosis are associated with a fixed lifestyle or other diseases. One of the causes of the disease is the constant restriction of mobility, for example, with sedentary work the risk of coxarthrosis of the hip joint is high, it is not possible to treat it without changing the way of life. Soon the disease will return, if after the treatment leave everything as is.
The second cause of coxarthrosis is often excessive load, resulting in systematic microtrauma, as well as injury to the joints. Most often it occurs in people engaged in heavy physical labor or professional athletes. In this case, treatment without changing the lifestyle or limiting the workload is also ineffective and often accompanied by relapses.
Often the causes of coxarthrosis are such diseases as congenital hip dislocation, hip dysplasia, and some others. Diagnosis is carried out using X-rays, which help to detect the growth of articular surfaces. Magnetic resonance imaging( MRI) can identify the disease in the early stages, so it is considered a fairly effective method of diagnosis.
Symptoms of coxarthrosis
The most common symptom in the beginning of the disease for patients with coxarthrosis is the appearance of minor pain when walking or by the end of the day. As a rule, patients with coxarthrosis do not pay attention to this pain and do not receive treatment. In some cases, patients in the beginning are concerned not with pain, but with pulling sensations in the groin. In the future, the intensity of the pain syndrome in walking is usually increased, patients note that they can go less without stopping, in the evening and at night after a greater than usual physical load, a severe aching pain in the hip joint area is disturbed.
Pain in coxarthrosis
In most cases it is the development of the pain syndrome that causes the patient to seek medical help. Some patients turn to friends, friends, etc.and according to their advice, they are treated independently, taking all kinds of drugs uncontrollably, and analgesics. However, over time, the pain with coxarthrosis becomes more and more permanent, reaching a constant character when walking, and its intensity is greatly enhanced. Analgesics in most cases either do not help or their effect is significantly reduced.
Degrees of coxarthrosis
Coxarthrosis of the 1st degree. Periodically, after physical exertion( long walking, running), there are pains in the hip joint, less often in the thigh or knee area. As a rule, after rest the pain passes. The amplitude of movements in the joint is not limited, muscle strength is not changed, the gait is not broken. On the roentgenograms, slight bony growths that do not extend beyond the joint lip are visible. Usually they are located around the outer or inner edge of the articular surface of the acetabulum. The head and neck of the femur are practically unchanged. The incisors of the joint are unevenly slightly narrowed.
Coxarthrosis of 2nd degree .The pains are more intense, they irradiate into the thigh, the groin area, arise at rest. After a long walk there is lameness. The function of the joint is impaired. First of all, internal rotation and hip removal are limited, i.e.forming a flexural and leading contracture. The strength of the muscles withdrawing and extending the thigh decreases, their hypotension and hypotrophy are determined. On the roentgenogram, significant bony growths are seen along the outer and inner margins of the acetabulum, extending beyond the cartilaginous lip. Mark deformation of the head of the femur, its increase and contour irregularity. Cysts can form in the most loaded part of the head and acetabulum. The neck of the femur is thickened and dilated. The joint gap is unevenly narrowed( up to 1 / 3-1 / 4 of the original height).The tendency to shift the head of the femur to the top is determined.
Coxarthrosis of the 3rd degree. Pains are permanent, occur even at night. When walking, patients are forced to use a cane. They note a sharp restriction of all movements in the joint( flexion-leading contracture) and gluteus in the gluteal muscles, as well as the muscles of the thigh and lower leg. There may be a positive Trendelenburg symptom. The flexor-leading contracture causes an increase in pelvic incline and an increase in lumbar lordosis. The pelvic incline in the frontal plane, associated with the weakness of the hamstrings, leads to a functional shortening of the limb on the side of the lesion. The patient is forced to step on the toes to reach the floor, and tilt the trunk to the affected side while walking, to compensate for the pelvic tilt and shortening of the limb. Such a compensation mechanism leads to the movement of the center of gravity and the overload of the joint. On radiographs, extensive bone growths are determined from the side of the roof of the acetabulum and the head of the femur, a sharp narrowing of the joint gap. The neck of the femur is considerably widened and shortened.
Treatment of coxarthrosis of joints
Treatment in connection with the absence of a single pathogenetic mechanism of the disease development is symptomatic, aimed at reducing pain syndrome and statodynamic disorders of the musculoskeletal system. In this case, it is necessary to take into account the stage of the disease, the age of the patient, his general condition and the specific features of the clinical manifestations.
coxarthrosis how to treat
Treatment of coxarthrosis 1 degree
Coxarthrosis 1 degree is most easily treated, and with timely treatment, joint therapy is quick and painless. Often, coxarthrosis 1 degree is treated at home under normalized loads. In the course of treatment prescribe analgesics and non-hormonal anti-inflammatory drugs in combination with normalization of metabolic processes in the cartilage of the joint. Auxiliary treatment of coxarthrosis of 1 degree - treatment with folk remedies, physiotherapy exercises, massage.
Treatment of coxarthrosis of 2nd degree
Certainly, it is impossible to completely heal, because with arthrosis of the second stage, not only the cartilage of the joint, but also its bones are damaged - they are perceptibly deformed. And it is clear that it is almost impossible to return the former form to the deformed bones. But it is possible to significantly improve the condition of the patient's joints by increasing the special methods of feeding the cartilaginous tissue, improving the blood circulation of the joint and dilating the joint ends of the bones, that is, expanding the joint gap. This is entirely within our power.
And although we will not be able to return the original joint to its aching joint and provide an ideal gliding of the cartilaginous surfaces, but at least we can make it so that the pain decreases and the mobility of the joint improves. There is an opportunity to postpone the operation for an indefinitely long period, and even completely avoid it. But I repeat that this will happen only if the patient himself is very determined: he is ready to do special gymnastics and do not forget to take a course of maintenance treatment every six months.
To treat coxarthrosis of the 2nd degree follows the same as the 1st degree, adding laser therapy, magnetic therapy, ultrasound therapy and electrophoresis, performed in an ambulatory or semi-stationary setting. As a rule, this is enough to stop coxarthrosis of the 2nd degree.
Treatment of coxarthrosis of the third degree
In coxarthrosis of the third stage, the situation is much more complicated. As already mentioned, in the third stage of arthrosis, only the minimal thinned layer of defective cartilaginous tissue remains in the hip joint, and the articular area of the femoral head is strongly deformed.
Most doctors in this situation will tell the patient( and most likely will be right) that the only way out is an operation. And only on the strength of 10-20% of patients, endowed with enormous willpower and perseverance, who are very willing to prevent surgical intervention in their bodies, will be able, with great efforts, to avoid joint surgery.
Of course, they are unlikely to be able to cure their severely affected joint. But such stubborn patients can, with the help of gymnastics, some kinds of physiotherapy and medications to strengthen bones, stabilize the condition of the affected joint and reduce pain. Simply put, the condition of the joint itself remains practically the same, but the condition of the bones, blood vessels and muscles surrounding the joint will improve. Due to this, the load on the affected areas of the joint will decrease, and the pain will cease to increase, or even completely weaken.
As a result, a person who for some reason categorically does not want or can not agree to an operation( say, because of age or because of a poor condition of the heart and blood vessels) will be able to at least normally sleep and sit, getting rid of unbearable "pain of rest ".And even if he can not live and move perfectly, as before, he will most likely be able to walk for short distances: let little by little, even with the help of a stick or stick, but walk.
Coxarthrosis of the third degree is treated both conservatively and operatively. For conservative treatment, use medicamental anti-inflammatory drugs and analgesics, administered intramuscularly, intravenously and directly into the joint cavity. Apply the means of physiotherapy. In severe pain syndrome, intra-articular blockades are performed, helping to stop pain. In the absence of a therapeutic effect in conservative treatment, coxarthrosis of the third degree can be treated promptly, by prosthetic joint.
Gymnastics with coxarthrosis
During gymnastic exercises, the synovial fluid flushes all the articular surfaces, ensuring the delivery of cartilage tissue of nutrients and the removal of metabolic products from them. This is the simplest and most natural method of treating your cartilage. However, it should be remembered that incorrectly performed exercises can have a negative impact on the joints. Gymnastics with coxarthrosis should ideally be performed under the supervision of a physician, but if this is not possible, then you can use the exercises and recommendations from this article.
Exercises for coxarthrosis
- All exercises should be performed smoothly, neatly. You must not allow sharp and strong movements.
- All axial loads on the affected joint should be eliminated.
- If pain occurs, the exercise should be discarded immediately.
- Exercises must be performed daily.
- Before performing the exercises, during the exercise, if pain or discomfort occurs in the joint and after the exercises, a gentle massage should be performed in the area of the affected joint.
- After doing the exercises, you can take a warm bath that will relieve muscle tension and soothe the pain.
- Swimming is the best method of caring for your joints. Swimming with coxarthrosis also has a beneficial effect.
In coxarthrosis of the hip joint, gymnastics is absolutely contraindicated in the following situations:
- The presence of malignant neoplasms.
- Presence of open or closed hemorrhages.
- In acute pre-infarction or pre-condition.
- With fractured tubular bones.
Treatment of coxarthrosis 2 and 3 degrees without surgery. Coxarthrosis - treatment in St. Petersburg
The defeat of the hip joint, the most powerful in the human body, perhaps, can be put on the first place and clinically among a number of degenerative joint diseases.
Speaking about the age limits of coxarthrosis, it must be emphasized that this disease is in fact "all ages submissive", with the exception of early childhood.To early signs( of course, nonspecific) it is necessary to include the restriction of passive rotational movements in the hip joint.
Causes of coxarthrosis
Classifying the dystrophic pathology of the hip joint, it is possible to distinguish the following coxarthrosis groups depending on the causative factors:
3) coxarthrosis, which develops after Perthes' disease;
4) coxarthrosis in adults due to defeat of the femoral head with aseptic necrosis, cystic perestroika;
5) post-traumatic coxarthrosis;
7) metabolic intoxication arthrosis;
8) dystrophic lesions of the hip joint of an unknown origin( idiopathic).
To early signs( of course, nonspecific) it is necessary to include the restriction of passive rotational movements in the hip joint. But no noticeable swelling of the joint area, nor pronounced atrophy of soft tissues with initial arthrosis usually does not find. Gradually, as arthrosis progresses, pain and limitation of mobility in the joint increase, lameness and flexion-leading contracture appear. The patient is forced to resort to a stick, crutches, and is unable to work. The x-ray picture of coxarthrosis is very variable, because the primary factors( dysplasia, trauma, inflammation) superimpose their seal on the regular sequence of the stages of development of the dystrophic process in the joint.
In a schematic view, a typical process of development of coxarthrosis can be divided into three stages:
Treatment of coxarthrosis of 1 degree
In the first stage of the disease, an insignificant narrowing of the height of the X-ray joint gap and small bone marginal growths( osteophytes) along the edges of the joint cavity are revealed radiologically. The biliary nature of these marginal sprouts is especially noticeable in the upper part of the acetabulum, which creates the impression of a progressive deepening of this cavity. If there is a decentralization of the head in the cavity, narrowing of the joint gap occurs unevenly, it occurs more quickly in the zone of load concentration, in the upper part of the cavity. Here you can notice the beginning sclerosis of the subchondral plate both in the zone of the cavity and in the area of the joint of the femur.
Marginal growths around the articular surface of the head in the first stage of coxarthrosis occur infrequently, much less often than the marginal proliferation of the acetabulum.
In case of deforming arthrosis of the 1st stage, which has arisen on the soil of some other pathological process, it is possible to see on the roentgenogram a layer of signs of a primary process that has terminated or passed to a chronic or latent form, for example inflammation, and signs of developing initial arthrosis, for example, narrowing of the joint gap, marginal osteophytesin combination with foci of destruction in the marginal or subchondral zone of the femoral head or in the zone of the acetabulum.
Treatment of coxarthrosis of the 2nd degree
In coxarthrosis of the 2nd degree , with the increase in the limitation of movements in the joint and pain intensification, the joint is sharply marked radiographically, the marginal growths of the acetabulum and the head of the bud increase, thus increasing the area of mutually interfacing surfaces. Often, bony growths form in the region of the lower edge of the joint cavity, as if pushing the head of the thigh outward and upward, leading it to a state of subluxation. As the head of the femur is dislocated outward and upward in the upper margin of the acetabulum, it is formed due to a predominantly osteophytic bone that merges into a single whole with the roof of the acetabulum, a peculiar neoarthrosis. The head of the femur in the lower quadrant begins to mushroom flatten. It is worthwhile to apply for treatment of coxarthrosis of the 2 nd degree.
Treatment of coxarthrosis of the third degree
In the third degree of deforming arthrosis of the hip joint, when the clinical manifestations acquire the maximum severity( contracture, flexion-leading thigh setting, loss of limb supporting function), destructive phenomena to the fore appear in the x-ray image: the radiographic joint gap gradually disappearsall areas, the bared and sclerotized bone surfaces of the articulating ends are separated by a thin, sometimes broken slot, articular cavitiesand the head of the femur lose their rounded shape, they become disfigured. Their bone structure changes: places of coarsely tubercular structure of bone tissue appear, places of cystic enlightenment, areas of sclerosis of spongy bone, in particular, between cysts. The total mass of bone tissue of the joint due to massive bone marginal growths is significantly increased in comparison with the norm.
Coxarthrosis - treatment, diagnosis. In the clinical picture of coxarthrosis to the fore and the earliest symptom is pain. Roughness on the surface of the articular cartilage, a decrease in the amount of synovial fluid in the joint, reactive processes in the synovial membrane, circulatory disorders in the joint, manifested by venous congestion, deterioration of microcirculation, contribute to the appearance of pain in the joint when moving in it. Patients begin to complain that pain intensifies at the end of the day, after walking and prolonged exercise, it's hard for them even to stand on a sick leg for a long time. Often in the morning, patients feel stiffness of movements in the joint, they need to move, "disperse", after which it becomes easier. It is very important to know that due to the nature of innervation of the lower extremity, often the pain is initially felt in the knee joint zone on the same side.
Especially severe is the defeat of both hip joints. For 2 and especially 3 degrees of bilateral lesion, the symptom of "bound legs" is characteristic: both lower extremities are sharply reduced, bent in the hip and knee joints at an obtuse angle, because of the limitation of mobility in the hip joints, patients( more often women) move with difficulty, smallsteps, mainly due to the movements of the shins in the knee joints. Legs seem to be connected above the knees.
Differential diagnosis of coxarthrosis presents certain difficulties, usually in adolescence or young age, in the initial stages of the process. Differentiate from chronic arthritis, protrusional arthrosoarthritis, in which the inflammatory reaction comes to the fore, although arthrosis typical changes are obvious. Signs of the development of true protrusion( deepening) of the acetabulum help to isolate protrusional arthrosoarthritis into a separate nosological form, which is important in determining therapeutic tactics. Dynamic observation of the patient allows us to ultimately determine the root cause, diseases, the secondaryity of dystrophic arthrosis changes in the joint in those cases when the root cause of the disease 8 initial stages of the disease is difficult to determine.
With dysplastic arthrosis, which is based on disadaptation of loading due to biomechanical disorders in the joint, arthrosis changes can clinically manifest very early, already in adolescence, especially the disruption of adaptation is observed after pregnancy, childbirth.
Such dystrophic processes in the hip joint, aseptic necrosis of the femoral head, cystic perestroika in the head and roof of the acetabulum, first proceed like the true primary arthrosis, without a clear specific clinical picture( pain, restriction of movements in the joint).Differentiation of these processes is assisted by X-ray study.
Conservative treatment. Its main goal is to eliminate or at least reduce pain, improve the trophism of the joint tissues, especially the articular cartilage. In the initial stages of the degenerative process in the joint, when symptoms of are not yet clearly expressed, the pain does not wear out the patient, conservative therapy can lead to more or less prolonged remission, some slowing down the development of subsequent stages of arthrosis. Conservative therapy should be based on funds aimed at improving microcirculation, and stimulating metabolic processes and regeneration in articular cartilage. Of the non-medicament means treatment of coxarthrosis of the third degree , massage and therapeutic gymnastics were the most popular - this treatment must be carried out persistently, especially medical gymnastics, which must be carried out daily on a regular basis.
You can also get acquainted with the information on the treatment of psoriasis and the treatment of hypothyroidism of the thyroid gland.The defeat of the hip joint, the most powerful in the human body, perhaps, can be put on the first place and clinically among a number of degenerative joint diseases. Contact our medical center for the treatment of coxarthrosis 2 and 3 degrees without surgery
When treatment of coxarthrosis without operation, the following conditions must be met:
Treatment of coxarthrosis of 2nd degree by the methods of eastern medicine
Coxarthrosis - acupuncture treatment
Massage and manual therapy with coxarthrosis
Hirudotherapy with coxarthrosis
Traditional Tibetan herbal medicine with coxarthrosis
Sle.tres.bdun.thang( Letre 7 Tan, Lide 7, Tinospora cordifolia, the seven decoctions, Lide 7)
Stone therapywith coxarthrosis
The use of hot and cold stones has the effect of "gymnastics" for blood vessels. Massage with the use of stones is easier for the masseur and, accordingly, more prolonged in time. The use of hot stones in the projection of the acupuncture zones contributes to the tonification of the energy "Yan".And the procedure of stone therapy, carried out by stones through the fabric, has a wonderful relaxing effect.
Vacuum therapy with coxarthrosis
The methods of active vacuum therapy( can massage) allow to further strengthen the drainage of soft tissues, cause local vasodilatation, positively affect the condition of skin pores and sebum secretion.
Carrying out vacuum procedures in the projection of any part of the spine helps to reduce local fat deposits, which positively affects the amplitude of the movements of the corresponding segment, which in turn improves metabolic processes and reduces local congestion.
The methods of passive vacuum therapy, in addition to all the above, allow painless formation of disseminated subcutaneous hematomas, which effectively replaces the immune-modulating effect of good auto-auto-transfusion.
Su-Jock in coxarthrosis
Su-Jok therapy, using the principle of "similarity", allows you to work on the diseased organ, part of the body, meridian, point and even the chakra! It is a kind of subtype of reflexotherapy , often allowing to carry out a curative effect without detaching the patient from solving their own daily tasks.
It is strongly recommended that you try to use some of the principles of Su-Jok therapy yourself( of course better after consulting a specialist).Currently, a huge amount of literature on the system of Su-Jok for "non-smokers" has been published, where in a simple and accessible form recommendations for the treatment of a number of pathological conditions are given. Recommended source: books published by the Su-Jok Academy of Moscow( Twist for All, Thumb-head, Yoga Smile, etc.).CALL AND WRITE IN FREE CONSULTATION TELEPHONE:( 812) 9812594 OR FILL IN THE FORM OF RECORDING FOR A FREE CONSULTATION( Address: St. Petersburg, Lomonosova St. 14) Name and date of admission?
Treatment of coxarthrosis without surgery in St. Petersburg
Consultation on treatment with traditional oriental medicine methods( acupressure, manual therapy, acupuncture, phytotherapy, Taoist psychotherapy and other non-drug therapies) is held at: St. Petersburg, ul..Lomonosova 14, Medcryogen Clinic( 7-10 minutes walk from Vladimirskaya / Dostoevskaya metro station), with 9.00 to 21.00, without lunch and weekends .
It has long been known that the best effect in the treatment of diseases is achieved with the combined use of "Western" and "eastern" approaches. The treatment period is significantly reduced, the probability of recurrence of is reduced. Since the "eastern" approach, in addition to techniques aimed at treating the underlying disease, pays much attention to "cleaning" blood, lymph, vessels, digestive tracts, thoughts, etc. - it is often even a necessary condition.
The consultation is free of charge and does not oblige you to anything. It highly desires all the data of your laboratory and instrumental research methods for the last 3-5 years. After spending only 30-40 minutes of your time, you will learn about alternative methods of treatment, learn how you can improve the effectiveness of the already prescribed therapy , and, most importantly, how you can fight the disease on your own. You may be surprised - how everything will be logically constructed, and the understanding of the essence and the reasons - the first step to a successful solution of the problem!