Causes of development of dysplastic coxarthrosis of the hip joint and its treatment
Dysplastic coxarthrosis is a serious pathological condition characterized by hypoplasia of the hip joint.
Etiology of deforming arthrosis
The trigger mechanism of structural deformation of articular components:
- Hereditary factor.
- Deformation of the joint elements.
- Pelvic presentation of the fetus.
- Health problems of pregnant women.
- Congenital inferiority of the hip joint.
- Hormonal imbalance.
- Prolonged physical overload of the joint.
- Women are more susceptible to this disease.
Pathogenesis of dysplastic coxarthrosis:
- The disease develops gradually.
- Normally, the hip joint is spherical. The acetabular acetabulum corresponds to the size and shape of the head of the femur, and covers it. Durable and resilient cartilage lining their surface.
- With dysplastic coxarthrosis, the anatomy of the hip joint is impaired. The head of the femur due to incorrect development is not located in its typical place. It slips out of the joint cavity. A certain amount of articular cartilage increases the pressure.
- At some point the body's compensatory forces become insufficient.
- Against the background of hormonal changes with the onset of maturity, there is increased wear of the cartilage. The destruction of hyaline cartilage, which can not withstand increased pressure, is developing.
- Arthrosis may develop in the joint.
Symptoms of clinical dysplastic hip joint syndrome
The severity of the manifestation of the pathology varies with the degree of severity:
- The uncomfortable sensation of the aching character in the joint area.
- Strongly swollen feet, feet.
- Appears limp.
- During the movement, there is a characteristic crunch in the patient's joint.
- The leg changes its length( a limb shortens).
- Pain syndrome in the joint cavity.
- Limitation of limb mobility. Difficulties during the implementation of leads, bends, rotations( active turns).The expressed restriction of passive hip removal from the side of joint damage.
- If a pathological bilateral dysplastic process occurs, the patient often can not walk.
Complications of the pathology:
- In very neglected cases, patients in adulthood will need the endoprosthesis of a powerful joint.
- Bilateral dysplastic arthrosis often leads to disability of the patient.
Diagnosis of congenital disease:
- Diagnostic procedures are necessary.
- X-ray data play an important role.
Treatment of degenerative-dystrophic disease
Treat pathology in early childhood. After the diagnosis is established, the doctor gives recommendations. The patient needs active dispensary observation.
Conservative treatment has important tasks:
- Increased stability of articulation.
- Activation of blood flow in the legs.
- Improved tissue respiration.
- Reducing pain intensity.
On an outpatient basis, treatment is performed in the early stages of the disease. Inpatient medical care is provided to a patient with dysplastic coxarthrosis in advanced stages of the painful process. To cure completely dysplastic coxarthrosis with special medicines is almost impossible. However, effective medication, massage, and exercise therapy help alleviate the symptoms of the disease.
During the period of exacerbation, the doctor may prescribe conservative treatment:
- Admission of analgesics, preparations from the class of nonsteroidal: diclofenac, ibuprofen.
- For pain, OTC analgesic paracetamol can be taken on a doctor's recommendation on a regular basis.
- Capsaicin is an ointment that, when used regularly, helps block pain signals in the nerve fibers of tissues.
- The use of compresses with dimexide is shown. Time-tested rumalon, preparations of aloe. Vitamin complexes are prescribed.
- Intra-articular injections of corticosteroids will help to significantly alleviate the condition of the patient. They are performed only in the acute period of the disease.
- Therapeutic exercise in this disease should be regular.
- Treated by folk remedies for dysplastic coxarthrosis can only be after consultation with a doctor.
Radical surgical treatment
At the last stage of the disease:
- The patient needs an operative intervention that helps to maintain joint mobility. The ability to function normally returns to the muscles.
- Corrective osteotomy is performed to restore the normal structure of the hip joint. To have a more even load on the articular cartilage, the pelvic bones or hips are sawed. Then they are fixed at different angles using metal structures.
- Endoprosthetics of the hip joint( replacement for artificial) is performed in neglected cases, when the articular cartilage is completely destroyed, there are violations of joint functions and severe pain. The life of the joint prosthesis is limited, so it is not recommended to replace the joint with an artificial implant too soon. It is important that for all the remaining years of life the life of such a prosthesis is sufficient.
- However, surgeons do not recommend too tightening with surgery, as in this case there is a threat of muscle atrophy and significant bone destruction. The operation will be technically more complicated. The terms of rehabilitation increase, complications burden the disease.
If symptoms of dysplastic coxarthrosis appear, you should contact .
Complex multi-level therapy in accordance with medical recommendations will help to maintain leg health for many years.
The success of the treatment largely depends on the stage of development of the degenerative process in the hip joint.
Dysplastic coxarthrosis is a deforming arthrosis of the hip joint. The disease can manifest not only on one side, but also be bilateral. When untimely treatment or late diagnosis of the pathology, complete destruction of the hip occurs, which will inevitably lead to disability of the person suffering from the disease.
Dysplastic coxarthrosis: symptoms of
Symptoms of dysplastic coxarthrosis
Severity of symptomatic pattern of dysplastic coxarthrosis depends on the stage of the disease. In the initial period, the pain does not have a high intensity, and therefore does not cause much concern. A person does not yet see the need for medical advice.
Then the pain impulses increase, especially with increasing loads on the hip joint - climbing the stairs, while running or jumping on straight legs with a slight height, slopes, squats. The pain impulses are acute, spreading from the femoral region to the knee, less often to the shin. Sometimes pain gives in the groin, knee joint, and its intensity only a little subsides in rest.
Very fast joins the joint in the joint, especially the rotational movements in the lower limb are beginning to be given. This is a very serious sign that manifests the progression of the disease. Toughness leads to visible changes in gait. And this is not just a cosmetic defect. Over time, the leg is shortened, and as a result of shortening of the limb, a strong atrophy of the hip muscles is observed.
The efficiency, the quality of life of a person suffering from dysplastic coxarthrosis of a person deteriorates sharply, his disability comes.
Treatment of dysplastic coxarthrosis
Dysplastic coxarthrosis requires timely, quality treatment, because it will be impossible to restore the destroyed joint structure. As medicamental treatment appoint:
- short courses of anti-inflammatory drugs, most often a non-steroidal group;
- analgesics. But do not be addicted to them. Despite the fact that after the use of medicines, the pain syndrome will decrease, but this will not prevent the destruction of the entire joint;
- chondroprotectors and substances that stimulate the production of synovial( intra-articular) fluid. These drugs only work on a funded scheme, so their effect is not so noticeable. You should take only continuous long-term courses several times a year. Relief can come a few months later.
- complexes of vitamins;
- antispasmodic means for relaxing the muscles of the thigh;
- means to improve blood microcirculation.
Dysplastic coxarthrosis: surgical treatment
Surgical treatment is an extreme treatment for dysplastic coxarthrosis. It can go through several schemes that the doctor will choose for you. It is possible to replace the head of the femur, but if there is a serious destruction of the joint structure, then an endoprosthesis is shown - a complete replacement of the joint with a metal prosthesis.
All over the world, such surgical interventions are quite common, they do not represent special complexity. The doctors have accumulated experience in conducting the operation itself and the postoperative period. The patient quickly returns to a normal lifestyle.
Other methods of treatment
Physiotherapy for dysplastic coxarthrosis
Therapeutic massage of the thigh, lower limb and lumbar region is able to activate blood circulation, improve innervation and increase the rate of metabolic processes in the periarticular tissues. All this will lead to slower degradation of the joint structure. Massage courses are useful to combine with magnetotherapy and acupuncture. These procedures mutually improve their therapeutic actions on the joint. Do not forget about dietary rules for dysplastic coxarthrosis. Excess weight, especially in elderly patients, is the main enemy in the treatment of pathology. The food should be balanced, with moderate caloric content. We list the most useful products for dysplastic coxarthrosis:
Home / Diseases / Coxarthrosis / Dysplastic coxarthrosis Dysplastic coxarthrosis, also called deforming arthrosis, occurs in the hip joint. This disease is typical for people after the age of forty, leading either not a very lively lifestyle, or exposed to excessive stresses, as a result of which the hip joint is exposed to microtrauma. At first the person does not attach importance to these injuries, but over time progressive processes respond to the person with constant pain, which indicates the onset of this disease.
Dysplastic coxarthrosis: symptomatology of
The main symptom of dysplastic coxarthrosis is painful sensations, most often occurring at the end of the day or with long walks. The pain is not strong, so few do not attach importance until it goes below, into the groin area, and will not become pulling and intolerable. Therefore, it is better to consult a specialist when the first signs of a possible disease appear - perhaps an early visit to the doctor can speed up the treatment process and prevent the sad consequences for the patient.
Dysplastic coxarthrosis of the hip joint has three degrees of severity. At the first, the pain has a periodic character and passes, usually, at high loads and after a short rest. Two other degrees of the disease are much more problematic and require serious medical intervention.
Dysplastic coxarthrosis of 2nd degree
It is characterized by more intense pain sensations giving off to the groin and hip area. Pain occurs even when the patient is at rest. As a result of a violation of the function of the joint, a person becomes limp when walking. The strength of the muscles that drive the hip decreases. The roentgenogram allows you to see cysts and bony growths of impressive size.
Unfortunately, it is impossible to completely get rid of this disease at the moment. The whole problem is that with dysplastic coxarthrosis the deformation of the bone itself occurs, in the restoration of the form of which the doctors are currently powerless. Treatment is reduced to improving the condition of the affected joint, which in turn allows you to return the patient's former mobility when walking and reduce pain.
Produce orthopedic treatment aimed at reducing the burden on the affected joint and the removal of joint contractures. Chondroprotectors restore the cartilaginous tissue of the joint.
When medicamental treatment, non-hormonal anti-inflammatory drugs - diclofenac, ibuklin and others - are used. Good results can be achieved with the use of magnetic, ultrasound and laser therapy, electrophoresis, massage and physiotherapy exercises. All these measures stop dysplastic coxarthrosis, but do not treat until complete recovery.
Dysplastic coxarthrosis of the third degree
If the diagnosis is dysplastic coxarthrosis of the third degree, then there are two ways out: either an operation or a conservative method of treatment. Very often resort to the first option, in which an osteotomy of the femur with fixation of bone fragments is carried out. In the case of conservative treatment of this disease, analgesics and non-steroidal anti-inflammatory drugs are used. Only in this case they are administered intravenously, intramuscularly, and directly into the patient's joint itself. Pain relief is performed by intraarticular blockades.
They are used, as in the case of second-degree coxarthrosis, electrophoresis, magnetic and laser therapy methods, physiotherapy exercises. With unsuccessful conservative treatment, the only way for a patient to remain is to undergo an arthroplasty in which the prosthesis replaces damaged areas. The advantage of such an operation is the complete restoration of the joint support functions and the complete disappearance of pain, which positively affects the quality of life of the patient.
At the first and second degree of the disease, treatment is most often prescribed at home, and it consists, for the most part, in performing physical exercises, applying compresses and performing massage procedures. A prerequisite for the treatment of dysplastic coxarthrosis at home is compliance with all the conditions of the doctor. In no case should one resort to self-medication - it may not give an effective result, and this, in turn, will lead to the loss of precious time needed for treatment.
In the period of exacerbations of the disease it is desirable to reduce the load on the limb with the affected joint. The transfer of weights, running and prolonged walking adversely affects the patient's condition. If necessary, you can use the walking stick when walking. Periodic administration of analgesics will reduce pain in the hip joint.
Coxarthrosis of the hip joint( cont.)
This stage of the disease is characterized by pain in the joint and thigh, sometimes in the knee that arise after physical exertion and subsiding after rest. The mobility of the joint is not limited and there are no abnormalities of the gait. Coxarthrosis of the 1st degree is the initial stage of the disease, after the treatment of which, you can still stop the process of destruction and deformation of the joint and keep its functions in full. But, unfortunately, many do not consider it necessary to consult a doctor because of weak joint pains, and the disease progresses in the meantime.
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At the 2nd stage of the pain the pain is already manifested much more seriously, they intensify and take an intense character. In this case, pain can occur even in the period of rest, give in the thigh and inguinal region. The functioning of the joint is already disrupted, with prolonged walking, lameness begins to appear, the hip extraction and internal rotation of the thigh are severely limited. Expanding and hip flexing muscles begin to lose strength.
Changes in the roentgenogram become very noticeable. Bony growths become very noticeable, while they can go beyond the cartilaginous lip. The head of the femur also deforms, its contour is distorted and the volume increases. Cyst formation is possible in the most loaded parts of the joint. The slit of the hip joint strongly and unevenly narrows, losing up to 2/3 of the initial height.
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The final stage of development of this disease before necrosis of the joint. Most doctors believe that at this stage, there is a need for surgical intervention. But nevertheless, some doctors prescribe first a classical therapeutic treatment, in case of failure of which they switch to surgical intervention.
If you do not consult a doctor on time, coxarthrosis of grade 3 may develop until necrosis of the hip joint. Some doctors call necrosis 4 the stage of the disease. With necrosis, therapeutic treatment is no longer prescribed, as tissue death begins, and only the operation can help the patient.
There are such causes of the disease:
a long load on the joint, its overload. This can occur in athletes or during long walking, often occurs in full people;running or walking gives a big load on the hip joints. In people with age, the elasticity of the cartilage decreases, and the joints begin to wear out more quickly;injury of the joint. Even in young people, traumas can lead to the development of coxarthrosis of the hip joint, as the joint accumulates damages that have a poor effect on its function;arthritis( inflammation of the joints) is often the cause of coxarthrosis;diabetes mellitus, metabolic disorders, osteoporosis, hormonal changes can also cause coxarthrosis;
One of the most important reasons why coxarthrosis appears is now considered chronic stress in the patient. In combination with the above reasons, stress can be very bad for the joints, and all this leads to coxarthrosis.
Coxarthrosis, like any other arthrosis, is a progressive disease. Therefore, in most cases, clinical symptoms develop as gradually, allowing the patient to adapt, get used to it. The most characteristic 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.
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.
By this time patients are most often already observed in doctors, many of them have been repeatedly treated by neurologists, manual therapists, etc. Pain with coxarthrosis "makes" the patient adjust, patients notice that with less stress on the joint less pain, they begin to "unload "a sick leg when walking - there is lameness. A smaller load on the injured leg promotes the development of muscle hypotrophy, which is manifested by a visual decrease in volume compared to a healthy limb.
Patients with coxarthrosis also intuitively to reduce pain in the joint and reduce the amount of movement in it - they are afraid to "disturb" it, which subsequently leads to permanent changes in the form of development of joint contractures. Often, with the development of coxarthrosis, shortening of the diseased limb occurs, which further disrupts the gait and intensifies the lameness.
Thus, as coxarthrosis develops, the so-called "vicious circle" is formed, when some pathological manifestations contribute to the development of others, and those in turn contribute to the progression of the first pathological manifestations. So the pain when walking leads to disruption of gait, lameness and restriction of the load on the aching leg, which leads to muscle hypotrophy, joint contractures.
Disturbance of gait with coxarthrosis leads to disruption of the biomechanics of all skeleton structures participating in the walking process - redistribution of the load on the joints of the spine and lower limbs, which is manifested by pain in the lower back, curvature of the spine, skewing of the pelvis, which again disrupts the walking function and promotes the progression of the disease.
Thus, with a prolonged course of coxarthrosis, there is a sharp disruption of the hip joint function, which in turn leads to a sharp decrease in the quality of life of the patient, limiting the possibility of full-fledged self-movement and self-service.
Diagnosis is established using x-ray photographs of the hip joint. It is possible to detect congenital abnormalities of the development of the hip joint with the help of special measurements of the angles of the location of the femur and its neck. Establish the degree of coxarthrosis, the condition of the head of the femur and the expected possibilities of treatment.
There are three X-ray stages of coxarthrosis
• The joint slit of the hip joint is narrowed only in the upper-external areas, small bony overgrowth around the articular surface of the acetabulum, a small compaction of the subchondral plate of the pelvic bones.
• Uneven joint narrowing. Strengthening of marginal bony growths with the formation of "beaks", "canopies".Sometimes a subluxation of the head of the femur, a shortening of the neck of the femur, a violation of the symmetry of the location of the head of the femur in the articular cavity.
• Articular cleft in the upper-external part is practically not determined. Bony growths are extensive, covering the entire hip joint. The head of the femur is deformed.
For the treatment of coxarthrosis of the hip joint, it is very important to identify the disease at the earliest possible stage of development, when it is possible to achieve any results with conservative treatment and slow the pathological process. In general, conservative treatment of coxarthrosis is the same as for all arthrosis. It is necessary to correct the lifestyle, change the professional load, taking into account the sparing of the patient's joint. Patients should be under supervision with obligatory X-ray control of hip joint condition 1-2 times a year.
The diagnosis of coxarthrosis is made on the basis of clinical signs and additional research data, the main one of which is radiography. In many cases, X-rays provide an opportunity to establish not only the degree of coxarthrosis, but also the cause of its occurrence. For example, an increase in the neck-diaphyseal angle, slanting and flattening of the acetabulum indicate dysplasia, and changes in the shape of the proximal femur suggest that coxarthrosis is a consequence of Perthes disease or juvenile epiphysiolysis. On the X-ray patterns of patients with coxarthrosis, there may also be changes that indicate trauma.
CT and MRI can be used as other methods of instrumental diagnosis of coxarthrosis. Computed tomography allows us to examine in detail the pathological changes from the side of the bone structures, and magnetic resonance imaging provides an opportunity to assess violations from soft tissues.
To prevent the development of coxarthrosis, you need to monitor the weight, eat right, protect yourself from joint injuries, and timely treat infectious and inflammatory diseases. You need to play sports, but do not overload the body, excessive loads can be harmful. For the prevention of coxarthrosis, outdoor walks are good.
The main method of preventing coxarthrosis is early diagnosis of the disease, as well as such measures as:
exercise physiotherapy;self-massage with ointments that have anti-inflammatory effect;reception of chondroprotectors;