Symptoms, degrees and treatment of coxarthrosis of the hip joint
What is coxarthrosis of the hip joint?
Coxarthrosis of the hip joint is a permanent change in the integrity of the articular surfaces, which is based on the violation of metabolic processes. As a rule, coxarthrosis is a slowly developing disease that gradually affects cartilage tissue with subsequent deformation of bones and a violation of the functional capabilities of the joint system.
Coxarthrosis is the most common disease among all degenerative-dystrophic pathologies of the musculoskeletal system, occurring at the age of 40 years.
Symptoms of coxarthrosis of the hip joint
Symptomatic at different stages of development of coxarthrosis differ slightly. However, there are a number of common signs on which you can determine the onset of the disease and take all the necessary measures to restore health. Often, patients turn to doctors already in the late stages of the pathology, which significantly reduces the chances of a full recovery.
Symptoms of a general nature:
severe pain in the affected joint - the main sign of joint damage;at the first stage the pain manifests itself during the movement, on the subsequent stage it has a permanent character;
stiffness( restriction in movement) - in the early stages this state is observed after awakening or heavy physical exertion;
changing the length of the legs is a sign of a neglected form of the disease accompanied by a deformity of the pelvis;
muscle atrophy is the most severe symptom, manifested in the late stages of coxarthrosis;in the early stages there is a slight weakening of the muscles;
lameness, an obvious change in gait is a sign of bone system deformation;
marked crunch in the joint area, which may indicate a pathological lesion.
Causes of coxarthrosis of the hip joint
The causes of the development of this disease can be very different, we will consider the most common:
Circulatory disturbance in the area of the affected joint. In view of the most varied causes, a person's blood circulation system fails - deterioration of venous outflow and arterial inflow. Due to all these processes, metabolic products accumulate in the tissues surrounding the hip joint, which contribute to the production of enzymes that destroy cartilage.
Injuries. The development of coxarthrosis is promoted by chronic microtrauma, which contributes to thinning and damage to the cartilage.
Excessive load on the joint. The development of degenerative processes is promoted by constant heavy physical exertion, often in combination with predisposing factors.
Obesity. The large mass of the body overloads the joint, thereby causing the inflammatory process, and subsequently the deformation of the joint itself.
Genetic predisposition. Directly the disease is not inherited, the features of the structure of cartilaginous, bony tissue and joints are transmitted. Therefore, for a number of unfavorable factors, this cause can affect the development of coxarthrosis more than in others.
Hormonal background. Frequent changes in the level of hormones can affect the metabolic processes in the human body, thereby contributing to the development of inflammation of the joint tissues.
A sedentary lifestyle is one of the main reasons for the development of hip joint pathologies.
Other diseases( necrosis of the head of the thigh, severe infections).In the case of improper treatment or timely medical care, a number of diseases can further influence the development of coxarthrosis, as a complication or concomitant disease.
Congenital pathology( dysplasia, congenital hip dislocation).
Degrees of coxarthrosis of the hip joint
Coxarthrosis of the hip joint of the first degree
1 degree - this is the easiest form of the disease, which can not worry the patient for a very long time, but if you do not navigate and treat the disease in time, it will develop to more severe forms.
In the first stage of the disease, periodic pain in the area of the affected hip is noted after prolonged and intense physical exertion. With bilateral involvement of joints, pain is manifested in both joints, with unilateral - in one. This stage is not characterized by the appearance of lameness and severe muscle rigidity. Pain syndrome occurs immediately after the end of physical activity and is not of a permanent nature. On the radiographic image, one can see a slight narrowing of the gap located between the joints.
Coxarthrosis of the hip joint of the second degree
2 degree is characterized by more significant lesions of the joint - destruction of the cartilaginous tissue. With this degree, all symptoms are intensified.
Pain syndrome in the second stage of the lesion is increased often marked by the irradiation of pain in the groin and thigh. Pain occurs not only after physical exertion, but also in a state of rest. In the absence of restorative measures, the normal movement mechanism is broken - the patient begins to limp, the gait gradually changes. The strength of the muscles responsible for extension and retraction of the thigh decreases. Over time, there is a syndrome of morning stiffness.
Third-degree coxarthrosis of the hip joint
3rd degree is one of the most severe forms of pathology, which is characterized by almost complete destruction of the articular cartilage. A filiform narrowing of the joint gap is noted on the radiographic photograph. The joint is strongly deformed.
The pain syndrome for this condition is permanent, it can be eliminated only temporarily with the help of medications. The patient is difficult to move without a cane or other auxiliary devices, since the joint is constrained, his movements are limited. In the field of the joint, development of edema is noted, tissues are atrophied.
Coxarthrosis of the hip joint of the fourth degree
This is the last stage of the disease, the heaviest. This condition is characterized by complete fusion of the bones of the hip joint with each other.
Symptoms of coxarthrosis of the third stage
Constant pain, which does not lead to a normal life, severe swelling of surrounding tissues. Complete absence of movements in the hip joint.
Diagnosis of diseases of the osteoarticular system
At the first stage, the diagnosis of coxarthrosis includes a survey, collection of anamnesis of life and disease, patient complaints, joint examination and functional tests.
In the clinical analysis of blood with coxarthrosis, there is a slight increase in ESR( sedimentation rate of erythrocytes) - up to 30 and above mm / h.
In the biochemical analysis of blood, the level of markers of inflammation is significantly increased: c-reactive protein, globulin, immunoglobulins and seromucoid. This analysis provides significant assistance in conducting differential diagnosis of joint damage: arthritis or arthrosis?
The basis of all diagnostic activities are instrumental methods.
The main method for the detection of joint damage is X-ray, which notes:
the presence of osteophytes - bone growth along the edges of the articular cartilage;
narrowing the gap between the joints;
sites of ossification of the articular cartilage;
osteoporosis( rarefaction of bone tissue);
bone compaction under the cartilage.
Minus in radiographic examination - only bones are visible, soft joint tissues( cartilage, joint capsule) are not visible in the pictures.
No less informative method of diagnosis is magnetic resonance or computed tomography, which allows to recognize the disease at the earliest stages of its development.
Subject: Hip pain
Treatment of coxarthrosis of the hip joint
With such a pathology as coxarthrosis, the treatment is rather complicated and long-term, consisting of many stages. The main condition for effective treatment is the prompt start of therapeutic measures, regardless of the stage of the disease.
For treatment of the initial stage of pathology development, it is enough to correct the lifestyle, nutrition, eliminate problems with blood circulation and metabolism. More severe forms of the disease require as much effort as possible to restore.
Drug treatment for destructive changes of the hip joint
Drug therapy is mainly a symptomatic treatment. The main actions that are required from medications are elimination of pain syndrome, removal of puffiness and inflammation, improvement of blood circulation, nutrition of cartilaginous tissue and relaxation of muscles.
Non-steroidal anti-inflammatory drugs:
These preparations are shown in the reactive stage of the inflammatory process. Excellent removal of swelling, inflammation, eliminate pain due to the strongest anti-inflammatory effect. Minus in the use of this group of drugs is quick addiction, cartilage tissue ceases to regenerate independently, and a number of side effects negatively affect internal organs.
To date, developed the newest drug with a smaller list of side effects - movalis. Due to its improvement, habituation does not develop so quickly.
Specialists do not recommend taking several anti-inflammatory drugs at the same time, if the drug does not bring the necessary effect, it is worth either increasing the dosage or changing it.
The goal of these medications is to relax the smooth muscles of the vessels and expand their lumen to ensure good circulation. With proper use, the drugs in this group have a minimal amount of contraindications and complications. Vasodilator drugs have a very important effect - they relieve spasm, including night "vascular" pains, which bring maximum discomfort to the patients.
Before using these medications, it is worth consulting with your doctor, since one of the most common side effects is an allergic reaction to the ingredients. Efficiency depends on this factor.
Preparations of this group with coxarthrosis should be taken with extreme caution. They are used to eliminate painful muscle spasm and improve blood circulation. The danger with the use of muscle relaxants is that they affect the nervous system manifested in the form of frequent dizziness, nausea, blocking consciousness or intoxication.
This category of drugs is the most useful and effective, its actions are aimed at restoring the structure of the cartilage. Regular application of chondroprotectors can stop the development of coxarthrosis in the early stages. Contraindications to use are pregnancy, allergy and inflammation of the joints.
Hormonal preparations( injection):
This type of therapy has a positive effect in the absence of inflammatory processes affecting the tendon of the femur. The injections are not recommended to be done more than once every two weeks and no more than three injections per joint.
Drugs of local action( ointments, lotions, compresses)
Such therapy is not fundamental in the treatment of coxarthrosis, since the likelihood that all the necessary substances will penetrate the skin, the fat layer and muscles is very small, therefore positively affects directly the process of rubbing,blood circulation in the affected area.
Related: List of modern medicines and preparations for joints
Operation with coxarthrosis of the hip joint
Surgical intervention is performed at the last stage of the disease development, when the joint's functional capabilities are completely violated.
Endoprosthetics - joint replacement. This is the most difficult of all operations associated with hip joints, its success is almost 70% of all performed interventions. When choosing a prosthesis takes into account the patient's age, sex, weight and anatomical features of the body, this determines the amount of time that the implant will serve. Often this is the only way to return the patient's ability to walk.
Externally, a conventional endoprosthesis is identical with a normal joint, it is designed for the same functions and in a state to withstand the same loads as a natural joint.
By type of prosthesis, these joints are distinguished:
single-pole( only the head of the hip joint is prosthetic);
bipolar( all the anatomical elements of the joint are replaced).
Artrodes - the bones of the joint are fastened with special screws and plates to restore functionality. The minus of this technique - the joint, as before, is constrained in movements. This surgical intervention is prescribed only in cases where other types of treatment do not produce any result.
Arthroplasty is a simulation of the destroyed surface - cartilage.
Osteotomy is a specific dissection of bones to eliminate deformity. In contrast to artodez, this surgical intervention restores not only the supporting function, but also the motor function.
Gymnastics with coxarthrosis of the hip joint
Therapeutic gymnastics for this disease is one of the most effective therapeutic methods of treatment, yielding a positive result. At the initial stages of the exercise, aimed at strengthening the muscles surrounding the joint, can prevent further development of coxarthrosis.
It is very important that therapeutic gymnastics be conducted under the supervision of a highly qualified specialist, since there are a number of exercises that can both benefit and harm the patient.
Exercises for the treatment of coxarthrosis of the hip joint have a certain mechanism. Training the gluteal and pericardial muscles helps improve blood circulation, fixation and nutrition of the cartilage. Exercise for stretching allows you to even out the shortened limbs due to the specific extension of the joint capsule.
For treatment, statistical exercises, rational dynamic loading and stretching are excellent. Complex of the most rational exercises:
in the supine position, it is necessary to raise and as much as possible strain the gluteus muscles;
without getting up, in the same position - bend the leg in the knee and gradually expose it;
remaining in the prone position to straighten your legs and try to lift them, like, you can not raise the upper end of the trunk at the same time;
sitting on a chair, squeeze the ball for fitness between the legs and with maximum force to try to squeeze it;
in sitting position, straight legs trying to clasp your hands on your toes.
All exercises must be performed regularly and correctly. To relieve tension, you can take a relaxing bath with oils.
Contraindications for conduction of the treated gymnastics:
elevated body temperature( over 37);
inguinal hernia, abdominal hernia and back;
rehabilitation period after surgery;
acute inflammatory processes affecting the internal organs;
cardiac and pulmonary insufficiency;
severe pain syndrome;
exacerbation of joint diseases;
high blood pressure.
Look at the visual video:
Before starting the exercises at home, you should consult your doctor and get all the necessary recommendations regarding the methodology for doing certain exercises.
Physiotherapy with coxarthrosis is not the main method of treatment, rather an auxiliary one. Positive result physiotherapeutic procedures can bring only in the early stages of the development of the disease, they are prescribed for the purpose of alleviating spasm and improving blood circulation.
Most commonly used:
mud treatment - spa treatment;
thermal procedures - electrophoresis;
application of lasers;
Massage for hip dysplasia:
Massage is prescribed for any of the 4 stages of the disease, regardless of the treatment: conservative or surgical. It is absolutely safe, relieves tension, swelling, spasm and strengthens muscles. Conduct it recommended as often as possible. In addition, any massage procedures improve blood circulation, which contributes to the restoration of cartilaginous tissue.
In the first stage of the disease, massage is prescribed only after the use of drugs that repair cartilage, vasodilating and anti-inflammatory. Before the start of the massage, the patient is recommended to minimize the load on the affected joint, walk less, lie more.
Massage is performed manually in the hip, waist and hip areas. It is recommended to combine it with therapeutic gymnastics and water procedures, ideal for visiting the pool 3 - 4 times a week.
In specially equipped sanatoriums massage with water jet( hydrokinetic therapy) is carried out. You can also draw the joint with a manual massage.
In the third to fourth stages, coxarthrosis is treated with surgical intervention. Therefore, massage procedures are appointed after the removal of stitches. During this period, massage is simply necessary, it helps improve blood circulation, relieves muscle tension and provides a speedy recovery.
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Nutrition for coxarthrosis of the hip joint
Since the development of the disease depends directly on the metabolism, nutrition, with coxarthrosis, should be aimed at excluding all possible factors that cause this pathology.
Balanced nutrition, the right approach to the distribution of food intake - these are the most important factors affecting the recovery of the patient's health. Nutrition with coxarthrosis of joints should be fractional, up to 5-6 times a day, portions should be small, but nutritious.
Thanks to the correct establishment of a meal schedule, the following results can be achieved:
restoration of cartilaginous tissue;
the formation of new tissues.
Diet for coxarthrosis should exclude such foods:
fat meat broths;
products contain a large amount of fat in its composition( cottage cheese, mayonnaise, chocolate, red fish, sour cream, cream);
meat and fish semi-finished products;
large amount of salt( more than 1 tablespoon per day);
food with increased content of preservatives( chips, canned food, sausages, caviar, sauces, some types of cheeses, nuts).
Useful food for coxarthrosis
Suffice it to restore joints is sour-milk products, because the human body easily absorbs milk protein, necessary for tissue regeneration. In addition, dairy products, namely cottage cheese and cheese, are rich in calcium fortifying the bone system.
Part of the required protein can be obtained from certain types of meat and fish products, a very important aspect is that these products should be non-fat. In the daily diet, in addition to animal protein, it is also necessary to include the vegetable that is found in lentils and buckwheat.
To restore bone tissue and cartilage, an element such as collagen is needed. It is found in jellied fish or cold.
With regard to desserts, the ideal for restoring the normal operation of the joints is an option of fruit jelly, rich in vitamin complexes and gelatin. It also positively affects the restoration of joints and cartilage foods rich in phosphorus and phospholipids.
A separate role in proper nutrition in the treatment of joint coxarthrosis is played by carbohydrates, which provide the body with the necessary energy reserve. Energy potential is the basis of all human life processes. Preference is best given to complex carbohydrates - polysaccharides and monosaccharides. As a consequence, it is better to replace the usual sugar with natural honey.
No less useful and necessary in the recovery are cereals that are also rich in complex carbohydrates and essential elements that feed the brain.
Are Fats Useful?
When considering all the advantages and disadvantages of consuming fats, then for nutrition with coxarthrosis it is best to use vegetable fats.
Nutrition should be organized in such a way as to work on such factors:
decrease in total body weight;
normalization of metabolic processes.
The diet for destructive changes in the hip joint is one of the important steps towards a speedy recovery.
Related: Modern BAA for Joint Restoration
Prevention of Coxarthrosis
The main and most important method of preventing coxarthrosis of the hip and other joints is early diagnosis, as well as such activities as:
skiing, with sticks;
self-massage with the help of ointments;
regular reception of chondroprotectors.
Physical activity in the treatment of coxarthrosis should be directed to the following properties:
restoration of joint functionality;
strengthening of the muscular system;
improved blood supply to the joint and the area around it;
increase in lumbar spine stability;
prevention of severe complications.
Prevention and self-treatment are two big differences, therefore, before proceeding to any measures aimed at restoring the joints, it is necessary to consult with specialists.
Author of the article: Muravitsky Igor Valerievich, rheumatologist, orthopedist
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 andsecondary changes in hip joint structures. 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.
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.
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 joint 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 micro-trauma 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, flat feet, curvature of the spine);
- 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 - the main symptom of coxarthrosis
Symptoms of coxarthrosis of the hip joint
The signs and severity of their dependence 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;
- 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:
- 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.
- 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.
- 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.
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.
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 is the main method of diagnosis of coxarthrosis
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.
Therapeutic gymnastics is one of the main methods of treatment and prevention of arthrosis
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: Hip arthrosis stages
Apply medications from the following groups:
- non-steroidal anti-inflammatory drugs and analgesics;
- 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.
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 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.
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 already impossible to eliminate the pain and stiffness of the joint with conservative methods. Can perform organ-saving operations, but more common and effective is hip replacement. Sometimes only surgical treatment can return the patient the opportunity to move freely without pain.
The prognosis and consequences of coxarthrosis depend on the timing of the diagnosis, as well as on the discipline of the patient 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.
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.
The structure of the hip joint
To gain a deeper understanding of the meaning of all measures for the treatment of coxarthrosis, you need to know a little about the structure of the joint and about the changes that occur with it in arthrosis of the hip joints .
Two jointed bones 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 condition, 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 slip 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 the entire free space in the joint cavity, the joint 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 the 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 to 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, due to the reduction of blood circulation 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 spinal column( scoliosis, kyphosis) and feet( flat feet);
- congenital hip dislocation - takes about 20% of all arthrosis of the hip joints;
- congenital dysplasia( joint development disorder);
- "lack of training" as a result of a sedentary lifestyle;
- 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:
- pains 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 symptom of coxarthrosis and the main complaint with which patients refer to a 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 pain in the knee region and in the attachment of 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 1 degree, periodic pains occur after physical exertion( prolonged walking or running).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 grade 2, 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 3 degrees 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 roentgenologic 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.
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), pains occur in the hip joint area, 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. There is a sharp restriction of all movements in the joint( flexion-leading contracture) and gluteus gluteus 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 3rd 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 one way out is surgery. 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 diseased 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 joint surfaces, ensuring the delivery of cartilaginous 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 tumors.
- Presence of open or closed hemorrhages.
- In acute pre-infarction or pre-condition.
- With fractured tubular bones.
Types of coxarthrosis of the hip - concepts of this disease
Types of coxarthrosis of the hip
Different types of coxarthrosis are determined by the causes that cause the disease. There are 7 types of the disease:
Involuntary coxarthrosis occurs as a result of age-related changes in cartilage and joint.
Coxarthrosis, which develops as a complication of Perthes disease. As a result, there is osteochondropathy( necrosis of spongy tissue) of the head of the femur.
Dysplastic coxarthrosis, that is, congenital malformation of the joint. It occurs in 75% of cases, and 6 times more often in women. In every tenth case, the blame for the disease is a congenital subluxation of the femoral head( dysplasia).
Post-infectious coxarthrosis occurs as a complication after arthritis. This changes the composition of the cartilaginous tissue and joint fluid, which leads to a decrease in the strength of the articular cartilage.
Posttraumatic coxarthrosis. Direct injuries are caused to him - fractures of the head and neck of the thigh and microtrauma, appearing with a constant incorrect load on the hip joint. Microtraumas are especially dangerous because, accumulating, they lead to destruction of articular cartilage and adjacent bone.
Dyshormonal coxarthrosis. The risk group includes people taking corticosteroids and antidepressants, as well as people with diabetes, osteoporosis and other hormonal disorders that lead to a decrease in the mechanical properties of the bone tissue of the joint.
Idiopathic coxarthrosis. The diagnosis is made if the cause of the disease is not known.
This classification gives us to understand that the main causes of the disease are excessive loads on the hip joint, especially for professional athletes, arthritis, various hormonal disorders. In addition, a certain role is played by the hereditary factor, since from parents we get features of the structure of bone and cartilaginous tissues, as well as metabolism, which under certain circumstances can serve as a catalyst for the development of the disease.
Another possible cause of coxarthrosis is chronic stress. The fact is that with constant nervous tension, the adrenal glands begin to release an excessive amount of corticosteroid hormones, which leads to a decrease in the production of hyaluronic acid, which is an important component of the joint lubricant. Due to lack of fluid in the joints, drying begins, excessive friction of the joints, which leads to various joint injuries. Moreover, "stress hormones" reduce the permeability of capillaries thereby worsening the blood supply of the joint.
Arthrosis of the hip joint is one-sided and two-sided. Two-sided coxarthrosis affects both hip joints immediately. Coxarthrosis is more common in medical practice than other types of arthrosis( knee joints, shoulder joints).Osteoarthritis of the hip joint is very common because the hip joint experiences increased loads, and as a result, is more often deformed.
Operation with coxarthrosis is shown, as a rule, at the last stages, when organic changes are pronounced and regeneration of tissues is practically impossible. With the help of endoprosthetics, osteotomy or arthroplasty, the joint maximally approaches the initial form, thereby restoring its mobility. The use of surgical methods can also be effective at earlier stages - if tissue changes are already pronounced and the prognosis is unfavorable.
Types of operations for the treatment of coxarthrosis of the hip joint:
Arthroplasty - the essence of this operation is to model the destroyed surfaces, including cartilaginous tissue.
Endoprosthetics - complete joint replacement. Carried out with bilateral coxarthrosis.
Arthroplasty and endoprosthetics are able to give a full life to patients even with the most neglected forms of the disease. To date, these are the most technologically advanced treatments for coxarthrosis.
An arthrodesis - bones are fastened with screws and plates. The operation allows to restore the supporting function of the affected limb, but not its mobility. The arthrodesis is shown only in cases when other types of operations are impossible.
Osteotomy - bones are dissected in order to eliminate deformation, then fasten in the most favorable position. The operation is similar to anarthrodesis, but it allows to restore not only the supporting, but also the motor function of the joint. The operation is effective in the early stages of coxarthrosis.
The causes of arthrosis of the knee joint are detailed here.
All you need to know about coxarthrosis of the hip joint is described in the article on the link http: //sustavprof.ru/bolezni/kks/ koksartroz-tazobedrennogo-sustava.html.
Dysplastic coxarthrosis is one of the most serious diseases, which is based on congenital underdevelopment( dysplasia) of the hip joints, which can appear already in childhood. This is due to its early appearance and rapid progression, a high incidence of bilateral pathology, a decrease in the quality of life and disability up to disability.
Thus, patients who have a history of congenital hip dislocation or hip dysplasia are at risk for developing severe hip dysplastic coxarthrosis.
The disease is rapidly progressive. Clinically dysplastic coxarthrosis is manifested by "inconvenience", unpleasant sensations in the region of the hip or knee joint, restriction of movements in the hip joint.
The initial stages of the disease are confirmed radiologically.
The outcome of the disease is ankylosing of the joint( complete immobilization), with the formation of a vicious thigh setting.
In recent years, endoprosthetics of the hip joint have been widely used. But in a growing organism, the operation of endoprosthetics is unacceptable. The installation of an endoprosthesis in childhood causes controversy due to the insufficiently long service life of the endoprosthesis. This is due to the high motor activity of children and the rapid wear of the prosthesis.
Our specialists diagnose and orthopedic treatment of dysplastic coxarthrosis, which allows to slow the progression of the disease and delay arthroplasty of the joint. The choice of optimal treatment is considered in each case individually.
Dysplastic coxarthrosis develops on the background of dysplasia of the hip joint more often at the age of 25-55 years, against the background of the hormonal reorganization of the body during pregnancy and in the postpartum period, as well as a decrease in motor activity and deterioration of the functional state of the hip joint muscles. Usually the onset of the disease is associated with the termination of sports, with a decline in active lifestyles, joint trauma or childbirth.
Two-sided dysplasia of the hip joint in patient M., 35 years old with initial clinical signs of left-sided coxarthrosis. Subluxation of the femoral head to the left.
The onset of the disease is acute, the course is rapidly progressive. Clinically, dysplastic coxarthrosis is manifested by "inconvenience", unpleasant sensations in the region of the hip or knee joint, restriction of abduction and rotation of the thigh. Radiographically, edge incisions in the region of the upper and outer margin of the acetabulum are determined radiographically, and the osseous plate is compacted in the area of the acetabular roof. In the later stages, a cystic reshaping of the femoral head and acetabular region is determined, which must be distinguished from the adjustment zones for aseptic necrosis of the femoral head. The outcome of the disease is ankylosing of the joint, with the formation of a vicious thigh setting in the flexion, alignment and external rotation position. Unlike other forms of coxarthrosis( arthrosis after joint trauma and aseptic necrosis of the head of the femur), ankylosis of the joint is rare. Indication for surgical treatment( hip replacement) is pain syndrome and vicious thigh setting.
Thus, patients who have a history of congenital hip dislocation or hip dysplasia are at risk for developing severe hip dysplastic coxarthrosis.
Given the high prevalence of dysplastic variant of hip joint development, severity of the disease and unfavorable prognosis, one of the tasks of outpatient orthopedics is first of all an early detection and dispensary observation of patients with signs of hip dysplasia.
When detecting dysplasia, a follow-up is necessary, which includes an annual examination of the orthopedist with a mandatory radiographic examination. In this case, it is necessary to take into account the genetically determined need for the motor activity of this contingent. Prevention of dysplastic coxarthrosis consists in observing the orthopedic regimen( avoiding injuries and movements associated with inertial loads on the joint, such as running, jumping, lifting weights), as well as in active physical activity aimed at strengthening the muscles that stabilize the hip joint( groupgluteus muscles, 4 main muscles of the thigh, extensors of the back and abdominal muscles): swimming, skiing, etc. For women, properly organized exercises of exercise therapy and compliance with orthopedic regimens are importantin the pre- and postpartum period
Coxarthrosis is one of the most common degenerative-dystrophic diseases of the musculoskeletal system
coxarthrosis Coxarthrosis is a dystrophic process in which degenerative changes occur in the hyaline cartilage of the hip joint, as a resultwhich the cartilage is thinning, eventually disappearing, marginal osteophytes( bone growths) are formed, deformation and violation of the hip joint function occur. Hence another name for coxarthrosis - deforming arthrosis of the hip joint.
Coxarthrosis affects both men and women, but if previously it was thought that this disease is typical mainly of older people, recently there has been a tendency to decrease the age of patients with coxarthrosis to 30 years. What is the degree of coxarthrosis of the hip joint disability?
The answers of lawyers of the Center for Medical Law:
Olesya, at stage 2 of both joints or 3 stages of one of them, at least can be considered as the first condition for determining disability.