What kind of treatment is prescribed for arthrosis of the hip joint of the third degree?
This disease is also known as coxarthrosis. Osteoarthritis of the knee joint, toes, feet and hip joints can have three degrees of disease. Currently, arthrosis of the hip joint is treated by various methods. Each separate method of treatment has both positive aspects and negative. To begin with, it should be noted that this disease is quite serious and self-medication is not recommended in this case.
It is very important to take measures at the first signs of the disease, because otherwise the pelvis gradually collapses, which often leads to its deformation. This is arthrosis of the third degree hip joint, the treatment of which requires serious surgical intervention. This operation is considered to be rather complicated, time-consuming. In addition, the rehabilitation period will take quite a long time.
3rd degree of arthrosis: what is the treatment for the disease?
The method of treatment of coxarthrosis depends on the stage of the disease. As already described, arthrosis of the third degree requires surgical intervention - endoprosthetics. The purpose of this operation is to replace the damaged part with a special artificial prosthesis. On the technical side, the process is very difficult, but the implanted prosthesis is absolutely analogous to an ordinary joint. At 1 or 2 stages of the disease, surgery is not required. Treatment of arthrosis of the hip joint in the initial stages is carried out exclusively with the help of medications in the form of injections, ointments and tablets.
Treatment of arthrosis with non-steroidal anti-inflammatory drugs
Very often, for the treatment of arthrosis of the hip joint, doctors prescribe such drugs as:
- indomethacin, etc.
Their use has an anti-inflammatory effect on the joints, anesthetizes and relieves swelling. But it is necessary to know that prolonged use of drugs of this group often suppresses the restoration of articular cartilage in a natural way. In addition, like any other medicines, these drugs have their contraindications and side effects, which have a negative impact on the internal organs of man.
It was for long-term use of the drug to cure arthrosis was developed movalis. The duration of its use practically does not have a negative effect on internal organs. This allows us to apply it for a sufficiently long time, until the affected areas are completely restored.
Keep in mind that only one anti-inflammatory drug should be used to treat arthrosis of the hip joint. In case your drug does not have a strong effect( for example, it relieves painful feelings), consult a doctor, increase the dose or change the drug.
Drugs that dilate the vessels
For the expansion of blood vessels doctors prescribe such drugs as nikoshpan, trental, cinnarizine, theonikol, etc. Their use is necessary in the fight against arthrosis. These drugs have a very effective effect on the treatment of the disease. When applied, following exactly the appointment of a doctor, side effects are excluded. The use of drugs in this group affects the acceleration of recovery of the hip joint, which is promoted by proper blood supply.
However, in any case, the above medicines should only be used as directed by the doctor.
Muscle relaxants, or drugs, relaxing muscles. Sirdalud, midokalm - these drugs effectively relieve painful sensations, in addition, normalize blood supply to the joints. Treat arthrosis with muscle relaxants should be, only after consulting with a doctor. In some cases, this drug may have a negative effect on the nervous system.
Chondroprotectors, or preparations restoring cartilage. In the fight against the disease, doctors prescribe drugs that affect the restoration of cartilage: dona, chondraitin sulfate, glucosamine, arteparone, rumalon. Very often, this group of drugs is prescribed for coxarthrosis of the third degree, because they are very effective in the treatment of hip joint deformities. Correct application of chondroprotectors prevents the development of arthrosis of the 3rd degree. These drugs have virtually no contraindications. In spite of this, chondroprotectors should be used only according to the doctor's prescription.
Treatment of coxarthrosis with hormonal steroid drugs( intra-articular injections): hydrocotisone, Kenalog, mieltpred. In diseases of the tendons of the femurs, these injections have a positive effect. The use of these drugs is prescribed by a doctor, since hormonal steroid injections have many side effects.
Hip joint: treatment of coxarthrosis of 3 degree
Cure arthrosis of the hip joint to 3 degrees by injection and drugs that improve blood circulation, reduce pain, etc., is impossible. They will eliminate the symptoms, but the cause of the disease will remain.
Osteoarthritis of the hip joint of the third degree and surgical treatment. The third stage of the disease requires surgical intervention in order to restore the mobility of the lower extremities. When the change in tissues is clearly expressed already in the early stages of the disease, doctors recommend an operation.
Arthrosis can be treated in several types of operations.
- Arthroplasty - modeling of destroyed tissues.
- Endoprosthetics, as mentioned above. The purpose of this operation is to replace the joint with a special prosthesis. Most often this method of treatment is used in the case of bilateral coxarthrosis. Treatment of arthrosis with these operations is very effective and returns to the full life of patients even with the most neglected stages of the disease.
- Artrodes - is a bonding of bones with the help of special plates and screws. Thus, the supporting function of the affected limb is restored. But to regain its mobility is almost impossible.
- Osteotomy - dissection of bone tissue in order to eliminate deformation. This type of operation makes it possible to restore both the supporting and motor functions of the joint. Very often, osteotomy is used to cure arthrosis in the early stages.
As you can see, arthrosis of the hip joint is a serious disease. It is very important not only to apply correct and timely treatment, but also the postoperative period must be accompanied by special procedures and exercises. Rehabilitation methods include therapeutic massages, gymnastics and breathing exercises. It is necessary to monitor the volume of loads, they should increase gradually. All actions should be under the supervision of a physician.
The patient can begin to perform restorative exercises within 3-5 days after surgery. Six months later, the patient returns to a full-fledged lifestyle. It is recommended to avoid heavy loads. Patients who are overweight, doctors recommend a special diet that will reduce body weight, and also normalizes metabolism.
Coxarthrosis of the hip joint of the third degree
Deforming arthrosis with localization in the hip joint is commonly called coxarthrosis. The disease has a chronic progressive course and is accompanied by a gradual destruction of all components of the joint. The disease is more common in the elderly due to involuntary changes in the musculoskeletal system, but it can affect young able-bodied patients as a result of the influence of unfavorable factors. Depending on the severity of the pathological process, 1,2,3 degrees of the disease are isolated, which lead to a decrease in the quality of life and disruption of normal motor activity.
Clinical manifestations, anatomical and functional disorders and treatment of coxarthrosis of the 3rd degree differ from the initial stages of the disease and without the qualified medical assistance cause the development of disability.
Mechanism of the appearance of pathology
The hip joint is the articulation of the acetabulum of the pelvis and the head of the femur. The surfaces of the bone tissue in the area of contact are covered with hyaluronic cartilage, which facilitates physiological movements in the joint without friction and pain. The pelvic and femoral bones are strengthened by the joint bag and the musculoskeletal apparatus. Inside the joint a joint gap is formed, filled with synovial fluid, which is synthesized by the inner membrane of the joint capsule. Thanks to this, the biomechanics of the articulation is improved, and the cartilage receives nutrients and is constantly updated.
With the influence of adverse factors such as congenital diseases of the musculoskeletal system, excessive physical exertion, metabolic disorders, sedentary lifestyle, lower limb injuries, metabolic disorders in the cartilaginous tissue are impaired, blood supply to the joint is impaired. As a result, the cartilage is thinned, deformed, the synovial fluid synthesis is reduced and its composition changes. Particles of cartilaginous tissue, getting into the joint cavity, form an inflammatory reaction inside the articulation and outside the joint bag. In the pathological process, bone tissue is involved, and its growth is osteophytes. They injure nearby soft tissues and cause pain when walking.
Schematic representation of a healthy hip joint and coxarthrosis
The pain syndrome makes one spare the affected joint, active movements in the joint deliberately cease. In this case, gluteus muscles and hamstrings at the side of the lesion are atrophied, blood circulation disorders in the pathology site are aggravated, metabolism and reconstructive processes in the cartilage are worsened. Ankylosis( immobility) of the hip joint develops, necrosis of the bone tissue of the acetabulum and the femur in the head region leads to the destruction of the articulation.
Degrees of development of the disease
At the initial stages of the pathology, tolerance( endurance) to physical stresses is violated. This causes pain in the hip joint due to heavy physical labor, heavy lifting, long walking. Sometimes the only symptom of the disease may be discomfort in the groin. Usually at this stage, the manifestations of the disease are ignored, as the pain syndrome passes on its own after a short rest. On the roentgenogram, no pathological changes are detected or a slight narrowing of the joint gap is detected. These manifestations correspond to the 1 st degree of coxarthrosis.
However, the progression of the disease continues, and after a while the painful sensations worry at the end of the working day, after a slight physical exertion. The restoration of work capacity and the cessation of painful sensations require more time. Discomfort causes the need for analgesics. Appears lameness, pain extends to the thigh and knee area, the amplitude of movements in the hip joint decreases. On the roentgenogram, a significant narrowing of the joint gap, deformation of the femoral head, and growth of the osteophytes are revealed. Such manifestations correspond to the second degree of coxortosis.
Coxarthrosis on the radiograph, corresponding to the third degree of the disease( left)
It is possible to stop the development of the disease at the initial stages of the pathological process. In advanced cases of disease that correspond to the third degree, the destruction of the joint requires a radical approach to therapy. At the same time, a thickening of the femoral neck, deformation of the acetabulum and femoral head, large osteophytes, aseptic necrosis of bone tissue, absence of an articulation gap are found on the roentgenogram.
Clinical manifestations disrupt the habitual motor activity. Patients can walk only with the help of special devices( crutches, canes), there is a "duck" gait. There is a significant skew of the pelvis, shortening of the affected lower limb, atrophy of the gluteus muscles. Disturbing intense initial pain( after the movement).The pain syndrome acquires a persistent character, arises at rest, especially at night. The general condition is broken because of constant discomfort in the joint, lack of sleep, emotional depression. The disease leads to loss of ability to work and the emergence of disability of 1 st - 2 nd degree.
Therapy of arthrosis of the hip joint of the third degree
Coxarthrosis of the third degree is characterized by severe anatomical and functional disorders of the hip joint. The use of conservative therapy, which is prescribed at the initial manifestations of the disease, becomes ineffective and even useless. Treatment with chondroprotectors, non-steroidal anti-inflammatory drugs( NSAIDs), physioprocedures, plasmolifting can not repair the broken joint.
Schematic representation of surgery for endoprosthetics of the affected hip
In the formation of the third degree of the disease, an operation is performed to replace the affected joint with an artificial prosthesis. This gives patients a chance to return to everyday motor activity, to improve the quality of life, to find work according to physical possibilities after the surgical intervention. If surgery is not possible, symptomatic therapy is prescribed: NSAIDs( nimesil, diclofenac, movalis), corticosteroids( dexamethasone, diprospan), muscle relaxants to reduce spasticity of the muscles( midocals).The drugs have a short-term anesthetic effect and prevent the inflammatory process, but they can not eliminate the progression of the disease and restore the normal functioning of the joint.
Surgical interventions for coxarthrosis of the 3rd degree are divided into several types:Still advised: What is coxarthrosis?
- endoprosthetics - replacing the broken joint with an artificial prosthesis made of wear-resistant materials( metal, polymer alloys, ceramics), completely restores the function of the joint;
- arthrodesis - is appointed in the impossibility of carrying out prosthetics, consists in bonding bones with metal plates and screws, preserves only the supporting function of the lower limb;
- osteotomy - cleansing of the affected joint from bone proliferation and deformation of the cartilaginous tissue, is used as a preliminary preparation for carrying out radical operations;
- arthroplasty is a technique for modeling deformed bone and cartilage surfaces, contributing to the preservation of the motor and supporting function of the foot.
After a surgical procedure, rehabilitation is performed to restore the lost functions of the affected joint. In the first 10 days, recommend breathing exercises, simple exercises to strengthen the muscles in bed, walking using crutches. Seams removal on the 7th - 12th day after the operation requires the appointment of physiotherapy exercises to strengthen the musculoskeletal system and a gradual return to full motor activity in conditions of using the endoprosthesis.
Roentgenogram of coxarthrosis before and after endoprosthesis
The wear time of the prosthesis depends on the materials from which it is made and the operating conditions. Modern endoprostheses can last no more than 20 years, after which a repeated operation is scheduled to replace the device. To prolong the life of the prosthesis should not be subjected to heavy physical labor, intensive sports, violate the doctor's orders and skip regular preventive examinations with a specialist. The feasible physical load, proper nutrition, timely treatment of infections and other diseases helps maintain the prosthesis in a functional state and prevents the occurrence of pathology in the paired joint.
Deforming coxarthrosis of the third degree refers to a serious disease that causes disability. For the prevention of pathology, it is necessary to consult a doctor at the first signs of manifestation of the disease and undergo complex therapy. Coxarthrosis can be treated with a conservative method only at the 1st or 2nd degree. In advanced stages, surgical intervention is necessary, which entails the risk of complications and significant financial costs.
Coxarthrosis of the hip joint - degrees and features of treatment.
Coxarthrosis of the hip joint is a disease that is associated with changes in the tissues of the hip joints. This disease is also called osteoarthritis or arthrosis of the hip joint.
How to understand that a person develops coxarthrosis of the hip joint?
Symptoms of the disease will be as follows:
- pain in the area that abuts the hip joints
- limping and uncertain gait of the person
- fast fatigue
- can be heard crunching in the joint, but not necessarily
- fast fatigue
- limited mobility of the affected leg
- atrophy of the hamstrings
Pain at the initial stage may be unstablecharacter, but it will be aching, and can be repeated in bad weather and physical exertion.
The hamstrings of the affected leg can also give pain to the knee area, so they can be confusing when diagnosing.
This disease affects the body, as a result of which it loses the ability to perform its functions.
Like any other disease, it is provoked to appear coxarthrosis of the hip joint in our body. For primary coxarthrosis, it is rather difficult to establish the cause. A secondary often develops against the background of existing pathology.
For example, the patient had traumas that appeared as a result of heavy loads, or he had defects in the joint area, or the inflammatory process was already developing in the joints.
Secondary oxarethrosis may have several forms:
- aseptic necrosis of the femoral head
- of the development of the disease against the background of rheumatoid arthritis
Usually at 1 degree the disease manifests itself as periodic pain concentrating in the hip region.
Pain sensations are unstable, occur after physical exertion, pass by themselves after a certain time, or are activated when a person moves from a calm state to motion.
Special violations of motor functions are not observed, so a person may not attach special importance to symptoms. Only on the roentgenogram you can see a small bone growth.
With the 2nd degree of the disease, the pains are more frequent. They can arise even at rest, transmitted to the knee or thigh.
With prolonged physical exertion, regardless of their intensity( running, walking), a person begins to experience painful sensations, involuntarily limping.
On the roentgenogram, pathological changes are more noticeable, manifested in deformation of the head of the femur, thickening of its neck, narrowing of the joint gap, deviating from the norm by one third.
It is usually at the second stage of the disease, a person feels unwell, turns to the doctor for professional help.
When a disease develops to grade 3, a person experiences severe pain that is permanent in nature. They arise regardless of the intensity of physical exertion, rest or activity. Often, such feelings cause insomnia and anxiety of the patient.
There is a sharp restriction of the person in movements, movement becomes impossible without assistance or a walking stick. An X-ray study shows a significant aggravation of all changes.
The narrowing of the joint gap is more noticeable, the neck of the femur is very wide, and its head is strongly deformed.
Doing self-treatment at the last stage is useless!
How to treat coxarthrosis of the hip joint?
If a person is diagnosed with coxarthrosis of the hip joint, treatment can be prescribed depending on the stage of the disease.
In the first stages of
In the first two stages, the disease can be stopped. A conservative method and medicines will be used here.
All drugs that will be prescribed to the patient, activate the blood circulation in the joint and tissues, and also allow to restore the mobility of the joint and provide full recovery.
Folk remedies and gymnastic exercises can be effective( about them below).
At the last stage of the
At the last stage, the operation of endoprosthetics, osteotomy or arthroplasty is most often indicated. Joint at one of them try to bring to the maximum natural form, and thus comes its restoration. In this case, you need to follow the doctor's recommendations.
When the disease is only at the initial stage of development, it can be fought with using folk remedies. Its effectiveness has not been proven, but it can be affirmatively said about the absolute improvement of the human condition.
The first known method is the infusion of lemon, celery and garlic, it is taken inwards, provides a fairly quick effect.
For cooking, you need to take three lemons of medium size, two hundred and fifty grams of well-ground celery roots and one hundred twenty grams of garlic.
All the ingredients must be grinded well and mixed, then pour three liters of boiling water, insist for 24 hours.
Also often used lapping, prepared from iodine, alcohol, glycerin and flower honey. All ingredients are readily available, so finding them is easy. Compresses from ordinary cabbage are widely used, which simply need to be applied to the joint.
No less important and effective ointments, the main components are: honey, turnip, mint, nettle. Natural components effectively relieve pain and inflammation.
At the initial stages of the disease, gymnastics is a very effective tool - a complex of simple exercises that can effectively restore the mobility of the joint.
Physical exercises should be performed under the strict supervision of a specialist, not to be reinforced, so as not to do more harm to the joint.
All actions are carried out smoothly and measuredly, be sure to ensure that the person at this time did not experience pain. At the 1 st, 2 stages of coxarthrosis, the effect is noticeable in the near future.
Usually the complex consists of a small number of gymnastic exercises that are performed several times, lying on your back or sitting.
It is necessary to begin with the most minimal loads, which should be increased gradually. Only regular and measured exercises will bring positive results, exclude the occurrence of complications, injuries.
You also need to watch for proper, free breathing during physical exertion, in no case can it be delayed.
Special attention requires nutrition( diet) with coxarthrosis, you need to adhere to simple rules of eating, which will help make treatment more effective.
It is required to exclude from the diet products that can contribute to weight gain, these are simple carbohydrates, too salty, fatty, spicy food.
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 the third degree, the disability
If coxarthrosis of the third degree is defined in the hip region, a person should agree with the attending physician as soon as possible about the establishment of a 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: conservatively and promptly
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 the whole 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, the 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 qualitative prosthesis and the exceptional skill of the surgeon, the 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 in coxarthrosis
Causes of coxarthrosis
The causes of coxarthrosis may 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 diseases such 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. 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 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 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 cartilage delivery of nutrients and 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 exercise, a gentle massage should be performed in the area of the affected joint.
- After performing 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:
- Malignant neoplasm.
- Presence of open or closed hemorrhages.
- With acute pre-infarction or pre-condition.
- With fractured tubular bones.
Coxarthrosis of the hip - what you need to know
Coxarthrosis of the hip joint
Hip joint arthrosis( coxarthrosis) usually develops after forty years. Women are sick slightly more often than men. Coxarthrosis can affect both one and both hip joints. But even in the case of a bilateral defeat, first, as a rule, one joint becomes ill, and only then the second one "pulls" to it.
8. In children
Most often symptoms of deforming arthrosis( DOA) of the hip joint begin gradually and imperceptibly - in the form of initially very weak pains or just uncomfortable sensations in the joint area that begin with walking and which stop inalone. These pains can occur not only in the field of the hip joint itself, but also in the knee and even in the groin.
At this stage of the disease, patients are not yet rushing to consult a doctor: "it will pass by itself", "will get sick and stop."But, ironically, this is just the right time to call a doctor when the disease is at an early stage and is easy to treat.
Along with the painful sensations, there is another very important symptom of the disease, which doctors call "morning stiffness".It is expressed in the fact that in the morning, as well as after a long sitting or lying, when a person was at rest, there is a certain tension in the movements, stiffness, when the patient needs time( from 15 minutes to an hour) to "disperse" afterwhich the joint begins to work in the usual mode. At the same time, pain in walking is accompanied by a crunch in the joint during movements, as well as characteristic "creaks" of bones at this time.
Most often even in such cases the person does not consult a doctor, so the severity of the symptoms continues to increase gradually. Gradually, the pain in walking in the hip begins to increase and is often present all the time, while the person is moving. Then the patient tries to spare his leg, and soon his limp appears: a person begins to walk, slightly falling on a sore leg.
After the gait has begun to change, violations in other organs and tissues automatically start to occur. Movements become more limited and deliver more and more pain while doing so. At this time, the normal axis of motion is modified. In this regard, the ligaments that support the joint and attach its strength, begin to overextend. In the muscles of the thigh also begins to form areas of stress, which are soon replaced by muscle atrophy - as the foot increasingly participates in walking and the load on it decreases. Usually at this stage a person needs to use a walking stick to move around.
As the disease progresses further, the pain becomes more severe, and lameness and restriction in the joint work - more and more. In the most neglected stages of the disease, the joint almost completely stops working, and the pains that used to be only during walking, appear already on their own, at rest, especially at night, and medications to relieve this pain help less and less.
A person can move only on crutches, and the only way to improve the situation at this stage is only surgical - replacing the worn hip joint with an artificial one.
There are 3 degrees of development of this disease.
In coxarthrosis 1 degree, periodic pain can occur after severe physical exertion. Most often the pain is localized in the hip joint itself, sometimes it can appear in the region of the knee or thigh. At the same time after rest the pain passes. The main problem is the fact that no more symptoms appear - the muscles do not weaken, the gait is not violated and the freedom of movement is not limited. Because of this, people often ignore the symptom that appeared in an insignificant measure, they do not address the doctor, but the disease progresses peacefully. But it is at this stage that the disease is easiest to cure. Degrees of arthrosis of the hip joint
At this stage, also begins the appearance of small bony growths that are located around the outer or inner edge of the joint surface. On the joint gap appears uneven narrowing, the head and neck of the femur are not yet changed. Such minor changes to a person do not interfere with life, joint mobility does not limit.
The second degree of the disease is characterized by an active lesion of the cartilaginous tissue. It is even more refined, the narrowing of the lumen between the articular parts is seen on the x-ray, the number of osteophytes increases. Inflammation of the periosteum develops. Symptoms intensify: pains become intense and often occur at night, there is lameness( the patient is forced to use the cane).Upon examination, the doctor notes the dystrophy of the muscles on his leg.
Pain in coxarthrosis of the third degree is already permanent, arising even at night. When walking, the patient must use a cane. Movement in the joint is severely limited, the muscles of the thigh, lower legs and buttocks - atrophy. Because of the weakness of the hip muscles, the pelvis tilts in the frontal plane, which leads to a shortening of the limb on the affected side. To get to the floor when walking, the patient has to step on the toes and tilt his torso on the sore side. This is how you have to compensate for the shortening of the limb and the slope of the pelvis. But the method of compensation leads to the movement of the center of gravity and to overloads on the joint. On the radiographs, extensive bony enlargements are seen from the side of the femoral head and the roof of the swivel cavity. The joint gap narrows sharply. The neck of the thigh is greatly expanded.
Osteoarthritis has 4 stages. The 4th stage is called ankylosis, when the joint completely loses mobility.
Causes of the disease
The following causes of coxarthrosis can be identified:
Joint overload. Often happens at professional sportsmen and at people who are compelled on a duty of duty much to go on foot. Also, joint overload often occurs in fat people. When running and walking on the knee or hip joints, the load is 2 to 3 times greater than the body weight. While a person is young, his cartilaginous tissue is still able to withstand constantly high blood pressure. But with age, when the elasticity of the cartilage decreases, the joints begin to wear out quickly. Also, people with excess weight are almost always characterized by metabolic and circulatory disorders, which also contributes to knee and hip joints arthrosis.
Joint trauma. Injuries, especially chronic, lead to the development of coxarthrosis, even in young people who, for natural reasons, have not yet had arthrosis. Chronic trauma( microtrauma) contributes to "accumulation" in the joint of damage, eventually causing cartilage atrophy or destruction of the underlying bone with its subsequent deformation and development of coxarthrosis.
The role of heredity in the development of coxarthrosis of the hip joint is debated. Coxarthrosis itself is not inherited. But the features of metabolism, the structure of cartilaginous tissue and the weakness of the skeleton are transmitted from parents to children genetically. Therefore, the risk of getting coxarthrosis is slightly higher in those people whose parents or relatives also suffer from coxarthrosis or other types of osteoarthritis. Such a risk increases if a person has abnormalities or underdeveloped joints from birth - this significantly increases the risk of developing the disease in old age.
Inflammation of the joints( arthritis) very often causes the appearance of so-called secondary arthrosis. When the joints are inflamed, the presence of infection in their cavity and changes in the properties of the joint fluid lead to the fact that the properties of the cartilaginous tissue itself change and it becomes inferior. In addition, with arthritis, blood circulation disorders and unfavorable changes in the synovial membrane of the joint almost always occur. Therefore, arthritis, even cured, later in about half the cases "triggers a mechanism" for the development of osteoarthritis.
Other factors contributing to the emergence of coxarthrosis are hormonal changes, diabetes, osteoporosis and some metabolic disorders.
Until recently, all of the above adverse factors were considered by scientists as the root cause of coxarthrosis. However, recently the views have changed a little - the main cause of development of coxarthrosis, gonarthrosis and other arthrosis changes in the joints is the chronic stress state of the patient.
The bottom line is that with prolonged negative experiences, the adrenal glands secrete an increased amount of corticosteroid hormones. This leads to a decrease in the production of hyaluronic acid, an important component of the joint fluid( "joint lubrication").When there is a shortage or inferiority of the articular fluid, the articular cartilages dry out, their "cracking" and thinning, which in a short time leads to arthrosis. The process is aggravated by the fact that "stressful" hormones reduce the permeability of capillaries and, thus, worsen the blood supply of damaged joints.
The combination of chronic stress with the above unfavorable circumstances( joint overload, trauma, heredity, etc.) leads to a deterioration in the structure of the articular cartilage. As a result, osteortrosis develops, including coxarthrosis.
Diagnosis is based on history and results of radiographic examination of the hip joint. Depending on the stage of the disease, the changes in the joint, articular fissure and femur are clearly visible on the roentgenogram. Usually the diagnosis is not difficult for the doctor.
General symptoms of coxarthrosis of the hip may be distinguished, 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 turn 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 area 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!
Prophylaxis of deforming coxarthrosis is simple. To do this, it is sufficient to lead a mobile lifestyle, to avoid excessive loads and, if necessary, to undergo specialized surveys every year.
Regardless of the stage of the disease or the need for its prevention, doctors recommend the use of preparations "Collagen Ultra".Supplements and cream "Collagen Ultra" contain in their composition collagen hydrolyzate, which with regular and long-term use( about 3 months) will accelerate the restoration of bones and cartilaginous tissue. In addition, they have an analgesic and anti-inflammatory effect.
There is no specific prevention of arthrosis of the hip joints. The measures of primary prevention are early detection( in the first months of life of the child) and treatment of congenital dislocations of the hip and dysplasia of the hip joints.
Treatment of coxarthrosis of 1-2 degrees is aimed at reducing pain attacks, reducing inflammation and improving blood circulation in the joint and limbs. For this purpose, analgesic and non-steroidal anti-inflammatory drugs( Analgin, Ibuprofen, Indomethacin, Orthofen) are prescribed, and it is also recommended to reduce the vertical load on the legs( during the exacerbation you should walk less, do not carry weights, etc.).When walking for a long time, you should use a walking stick. In addition, patients are prescribed muscle relaxants - a means that relieve muscle tension around the joint and improve its blood circulation. Positive effect on the affected joint has physiotherapy: electrophoresis with novocaine, magnetotherapy, laser therapy. When the pain subsides, perform massage of the waist and hips, perform therapeutic gymnastics aimed at normalizing the muscle tone, restoring the mobility of the affected joint and strengthening the surrounding muscles. In some cases, patients are prescribed stretching the patient joint in conjunction with hydrokinetic( aquatic gymnastics).
Conservative therapy for coxarthrosis of the third degree, in addition to the above-described measures, includes intra-articular drug administration. Extension of the patient joint at the third degree of the disease is contraindicated, because the joint is severely limited in mobility and attempts to "stir" it cause additional microtraumatism and only increase the pain syndrome.
The optimal way to treat severe forms of coxarthrosis is surgical endoprosthetics, arthroplasty, arthrodesis and osteotomy - these operations make it possible to maximize the mobility of the joint. With arthroplasty, only the damaged surfaces, including cartilaginous tissue, are restored. In endoprosthetics, the joint is completely replaced with an artificial prosthesis - this operation is recommended for bilateral coxarthrosis. The arthrodesis allows to restore the supporting function of the leg, but not its mobility, while the bones are fastened with special screws and plates. Osteotomy is similar to arthrodesis, but it allows you to restore not only the supporting function of the limb, but also its mobility. As a rule, two weeks after surgery the patient can already move with support, and two months later he starts walking alone. In the rehabilitation period, any loads are prohibited. The patient returns to a full-fledged life 5-6 months after successful operation.
When a person thinks about how to treat coxarthrosis of the hip joint, he should understand that there is no one standard mechanism of the disease, therefore the treatment takes a symptomatic character. The main goal of the treatment is to reduce the disruption of the musculoskeletal system and the elimination of pain.
When choosing a treatment, also take into account at what stage the disease is, what the general condition of the patient is and what its age is. Treatment should be comprehensive and set a goal to normalize the patient's well-being. The obligatory component of the treatment is physiotherapy.
With the diagnosis of coxarthrosis of the hip joint, surgery can be prescribed only if the patient is at the last stage of the disease. The operation is designed to maintain or resume mobility in the affected joint( most often by endoprosthetics).
non-steroidal anti-inflammatory drugs are prescribed. It should be noted that such drugs are not able to reverse the changes occurring in the joint, but due to the removal of the inflammation, the pain is eased or disappears, which is very important in the late stages of the disease;
vasodilator preparations. Their use should help to relieve the painful muscle spasm around the joint;
muscle relaxants, which also should help to relieve muscle spasm and improve blood filling of the affected joint;
chondroprotectors. Such drugs are used to restore the cartilage tissue of the joint;
physiotherapy procedures. The task of this method is to improve the functioning of the joint. This effect can be achieved by improving blood supply and reducing the severity of inflammatory phenomena;
orthopedic treatment, which is aimed at reducing the burden on the joint and the removal of contractures of the joint.
Recently, joint diseases began to occur in people more and more often. Modern children are no exception. A disease called coxarthrosis is one of the leading diseases among the musculoskeletal system. This disease has a tendency to increase in all countries of the world and constitutes a significant weight in the structure of disability in general.
Coxarthrosis is a deforming arthrosis of the hip joint. Dystrophic process begins with articular cartilage. As a result, its thinning occurs and depreciation properties are lost.
Coxarthrosis may be an unclear etymology - it is a primary coxarthrosis, in which other joints( most often knees) and the spine are often affected. Secondary coxarthrosis may occur against a background of hip dysplasia or congenital hip dislocation, aseptic necrosis of the head of the femur, Perthes disease, inflammation or as a result of a traumatic injury( bruise, dislocation, fracture, microtrauma).Coxarthrosis can be unilateral or bilateral. Two-sided coxarthrosis affects both hip joints at once.
Most scientists hold the opinion that the main cause of coxarthrosis is a violation of blood circulation in the joint due to deterioration of venous outflow, and because of deterioration of the arterial inflow. But you can not forget about the mechanical factors that cause joint overload, various articular injuries, and biochemical changes in the cartilage itself.
Coxarthrosis in children develops due to congenital and degenerative-dystrophic diseases of the hip joint. Early diagnosis contributes to the appointment of an effective treatment to stop further disease progression.
At the doctor's office, patients most often complain of pain, the nature, intensity, duration and localization of which depend on the stage of coxarthrosis.
There are many pseudo-scientific theories that explain the development of coxarthrosis. And this is understandable - after all, when we get sick, we begin to look for the cause of our illness. And since we all have a desire to seek out the simplest explanations of any phenomena, here we also want to find one simple and understandable interpretation of the troubles that have happened to us. And there will always be a charlatan or amateur who will throw an "exclusive" idea about how your illness has arisen.
Thanks to such charlatans there are persistent myths about the fact that arthrosis is developing allegedly due to the deposition of salts in the joints( in fact, with rare exceptions, salts in the joints are not postponed - and certainly salt joints are not deposited in the joints);or myths about the fact that arthrosis allegedly arises from eating tomatoes, or even some nonsense, including "evil eye" and something in the same spirit.
However, in fact, there is no one, all explaining the causes of arthrosis. Coxarthrosis can develop for a variety of reasons, but most often arthrosis is provoked by a combination of a number of unfavorable circumstances for the joint. And now we'll talk about what these circumstances are.
1. In 10-20% - injuries and microtraumas of the joint.
2. 20-30% - joint overload, or prolonged excessive load on the joint.
3. 10% - heredity and congenital anomaly of the head of the femur.
4. Extra weight: 5-10%.
5. Inflammation of the joints( arthritis): 2-3%.
6. Hip joint infarction: 10 to 30% of cases.
7. Prolonged stress and prolonged excess experience: 30 to 50% of cases.
8. Hormonal changes in the period of the organism's age-related rearrangement( in the menopause period), diabetes mellitus, loss of sensation in the legs with a number of nervous diseases, congenital "looseness" of the ligaments and osteoporosis: all these circumstances, as a rule, also contribute to the development of arthrosisof the hip joint.