Hip Arthrosis

Osteoarthritis of the hip joint is a very complex disease in which the destruction of the hyaline cartilage, which is lined with the surface of the femoral head (has a spherical shape), and the acetabulum. Arthrosis is a degenerative-dystrophic disease that most often develops in people of advanced age.

In specialized periodicals, the results of surveys and medical studies are often published, according to which the female half of the population who has reached the age of 40 is most susceptible to arthrosis of the hip joint. This is primarily due to the anatomical features of the female hip joint, which has a different shape and position than that of men. Such differences can be explained by the fact that the hip joint plays an important role in the process of procreation. The bones of the female pelvis are under heavy stress every day, as a result of which they are more often susceptible to various diseases. Male representatives at a later age (by the age of 60) may experience arthrosis.

According to the available statistics, in patients who underwent surgical treatment of arthrosis of the hip joint, various complications may develop:

blood loss during surgery,

thromboembolism (pulmonary artery) - 0.05% of cases,

the development of infection (after surgery) - 0.5% -2% of cases.

Most often, in this category of patients, infection occurs in the area of ​​the joint replacement prosthesis. In this case, the doctors perform a second operation, during which the endoprosthesis is removed, and then a course of antibiotics is prescribed.

During a patient's thrombolysis, a blockage in the pulmonary artery occurs. This type of complication often results in death, especially for those patients who are prone to blood clots. To prevent such a complication after surgery, patients are administered special drugs that reduce blood viscosity.

Severe bleeding during surgery is a frequent complication of the surgical treatment of arthrosis of the hip joint. In modern medical centers, there is a large supply of blood and blood substitutes, so that specialists can easily cope with this complication.

Causes of Arthrosis of the Hip Joint

Modern medicine divides this disease into the following categories:

Primary arthrosis, develops for no apparent reason.

Secondary arthrosis, develops against the background of injuries of the hip joint.

To date, the following causes for the development of arthrosis of the hip joint have been identified:

depression, as well as prolonged stressful periods,

excess weight (even an insignificant set of excess weight can cause the development of this disease, as additional stress will be placed on the joints),

past injuries: sprains, bruises, bumps, fractures, etc.,

damage to cartilage in the joint,

diseases of the endocrine system (in particular diabetes mellitus) that have a negative effect on the work of the adrenal glands,

poor heredity, against the background of which joint deformity may develop (a genetic predisposition to arthrosis is the most common cause of this disease),

displacement or curvature of the femur,

hip dysplasia (most often diagnosed in newborns)

acetabular protrusion,

sedentary (sedentary) lifestyle,

change in the structure of blood vessels,

metabolic disorders in the body,

high concentration of uric acid in the patient’s blood (determined by laboratory blood tests),

gout, osteoradionecrosis, bone tuberculosis, Perthes disease, rheumatoid arthritis and other diseases in which the hip joint is infected with bacteria,

degeneration of the synovial membrane of the joint into cartilage,

circulatory disorders in the hip joint,

hormonal disorders in the body,

strong physical exertion on the hip joint when playing sports,

difficult working conditions

advanced age, etc.

Symptoms of Arthrosis of the Hip Joint

With arthrosis of the hip joint, the following symptoms are observed in patients:

severe pain in the hip and knee joints, as well as in the groin (pain syndrome accompanies this disease constantly, and with the progression of arthrosis can integrate into the region of the lower extremities),

impaired motor function (due to excruciating pains, patients cannot move independently, because of which they are forced to use special devices: crutches, canes),

shortening of the lower (affected by arthrosis) limb,

a crunch in the joint that occurs with any movement,

lameness and gait disturbance,

stiffness and limitation of limb movements,

when conducting x-rays in this category of patients revealed atrophy of muscle tissue located in the thigh,

when conducting hardware diagnostics in patients, bone growths can be detected,

at the 2nd stage of arthrosis in patients, deformation occurs, and the displacement of the femoral head upwards (it increases significantly in size and acquires uneven outlines),

with a third degree of arthrosis in patients, the head of the femur bone enlarges, as a result of which the narrowing of the joint gap begins

Signs characterizing arthrosis of the hip joint of 1 degree

At the first stage of this disease, patients do not have pronounced symptoms, as a result of which people rarely go to a medical institution.

With the development of arthrosis of the hip joint of the 1st degree, the following occurs:

the liquid begins to lose its properties,

the consistency of the liquid becomes more viscous,

fluid is not able to provide unhindered movement of the joint.

At the first stage of this disease, the structure of the cartilage tissue begins to collapse, microcracks form in it. Over time, in the process of arthrosis progression, cartilage tissue thinning is observed. In many patients, replacement processes begin to occur, against the background of which bone growths form at the location of the cartilage.

At the first stage, arthrosis of the hip joint is very easy to completely cure. The problem is that patients, due to untimely access to specialists, cannot receive medical care. That is why doctors strongly recommend that people who discover any of the symptoms of arthrosis have an immediate visit to the nearest clinic and undergo a comprehensive diagnosis.

Signs characterizing arthrosis of the hip joint 2 degrees

Osteoarthritis of the hip joint of the 2nd degree is accompanied by a strong pain syndrome that can integrate from the hip and pelvis into the knee. At this stage of the disease, patients suffer from severe cartilage damage.

All damage can be seen thanks to radiography:

cartilage thinning,

narrowing of the lumen between the parts of the joint,

a change in the structure of the femoral head,

the appearance of various neoplasms,

displacement of the head of the hip joint,

the number of bone growths (osteophytes) increases.

When conducting diagnostic measures in this category of patients, inflammation of the periosteum is detected. If this disease is not treated, patients will begin to intensify pain, motor functions will be impaired, and dystrophy of muscle tissues in the lower extremities will develop. Such patients will experience unbearable pain, even when at rest.

Signs characterizing grade 3 arthrosis of the hip joint

With the transition of arthrosis of the hip joint to the third stage in patients observed:

almost complete destruction of hyaline cartilage,

impaired motor function (patients are limited in movement),

shortening of the lower limb

severe narrowing of the joint space

the spread of bone formations (spike-shaped), etc.

At the 3rd stage, the treatment of this disease is possible only surgically, since no medications can restore the cartilage and restore mobility to the person. Currently, this category of patients undergoes gentle operations, during which they replace the damaged hip joint with an artificial prosthesis. Thanks to endoprosthetics, patients after a long rehabilitation can return to normal life.

Deforming Arthrosis of the Hip

Deforming arthrosis of the hip joint (coxarthrosis) is a severe form of osteoarthrosis. This form of the disease is most often (in 40% of cases) diagnosed to patients who visited a medical institution for problems with the musculoskeletal system. Both women and men who have reached the age of 40 suffer from deforming coxarthrosis. According to world statistics, deforming arthrosis of the hip joint is more often diagnosed in representatives of the female half of the population.

There are a large number of factors that provoke the development of coxarthrosis. The most important cause of this disease is a violation of blood circulation in the pelvic organs. As a result, harmful enzymes begin to accumulate in the body of patients, which have a negative effect on cartilage, leading to their gradual destruction.

The causes of coxarthrosis include physical and mechanical effects on the hip joint. Most often, this disease manifests itself in people who are professionally involved in sports. Being overweight also puts stress on both the patient's joints and his body as a whole. Deforming arthrosis of the hip joint is usually accompanied by severe pain and limited mobility of the lower extremities. These symptoms should alert the patient and encourage him to go to a specialized medical institution. At the reception, the patient will be examined and assigned a radiography, which will determine the degree of damage and the type of arthrosis.

Diagnostics

Many people who develop arthrosis of the hip joint may be bothered by movement pain or any other physical exertion. Initially, the pain syndrome occurs only with physical overwork, but later patients begin to experience pain even during rest. Pain sensations are often integrated from the hip joint into the lower back, knee, hip, etc. Against the background of the occurrence of pain, some people begin to self-medicate, which often leads to irreversible consequences. That is why it is necessary, when such a primary symptom of arthrosis appears, turn to highly qualified specialists who will conduct the diagnosis.

When visiting a medical institution, patients who are suspected of arthritis of the hip joint should receive the advice of the following narrowly specialized specialists:

Therapist. This specialist will evaluate the general health of the patient and determine the cause of the pain syndrome (sometimes pain occurs due to the progression of various chronic diseases).

Neurologist. Very often, pain in the hip joint is a consequence of the formation of intervertebral hernias, therefore, when such symptoms appear, consultation of this specialist is important.

Urologist. In the male half of the population, pain in the hip joint occurs as a result of inflammatory processes in the prostate gland. A consultation with a urologist will confirm or refute such a suspicion.

Gynecologist. All women are referred to this specialist who have contacted a medical institution with complaints of pain in the hip joint. This is due to the fact that during the development of adhesions in the pelvic organs, patients often experience pain, therefore, when diagnosing arthrosis, it is important to obtain the conclusion of this narrow-profile specialist.

Rheumatologist or arthrologist. These specialists can diagnose arthrosis of the hip joint in the early stages of its development. With timely access to a rheumatologist or arthrologist, the patient will be guaranteed a successful cure for this disease.

Orthopedist and surgeon. Patients with advanced stage of arthrosis of the hip joint are referred to these specialists.

When carrying out diagnostic measures, the specialist will first of all conduct a personal examination of the patient and collect a medical history. During palpation, he will be able to probe the upper third of the lateral surface of the thigh and reveal serious damage to it.

A specialist can carry out a number of simple manipulations, thanks to which it will be possible to make a preliminary diagnosis - arthrosis of the hip joint:

flexion and extension of the lower extremities,

turns of the lower extremities in and out, etc.

To make an accurate diagnosis, patients are assigned a hardware and laboratory examination:

X-ray examination (an X-ray will reveal any damage to the hip joint),

pelvic ultrasound,

magnetic resonance or computed tomography (this diagnostic method allows you to identify arthrosis at the very initial stage of development, when it is not yet accompanied by pronounced symptoms),

laboratory tests of blood and urine (clinical, biochemical) will reveal any inflammatory processes in the patient’s body.

The main task of hardware diagnostics is to identify arthrosis of the hip joint, as well as determine the degree of this disease. It is very important to determine the cause of arthrosis, since the method of treatment of this disease will depend on this.

There are diseases (for example, bone tuberculosis) that provoke the development of arthrosis, in which traditional treatment can not be carried out (such diseases can reveal laboratory tests of urine and blood):

use ointments and gels with a warming effect,

physiotherapeutic procedures carried out at high temperature conditions,

physiotherapy exercises, etc.

Hip Arthrosis Treatment

At the first stage, arthrosis of the hip joint lends itself well to conservative treatment. The first task of the attending physician is to relieve pain, which prevents the patient from moving.

In the process of drug treatment is performed:

repair damaged cartilage

restoration of nutrition and blood circulation in muscle and cartilage tissues,

physical activity on the damaged joint is reduced,

activation of hidden reserves of the human body, which will contribute to tissue regeneration at the microcellular level,

joint space enlargement,

restoration of joint mobility, etc.

During drug treatment of arthrosis of the hip joint, in this category of patients, the following drugs are prescribed:

anti-inflammatory drugs (non-steroidal),

muscle relaxants that restore blood circulation in muscle and cartilage tissues,

chondroprotectors that can restore joint function and stop their destruction,

steroids are prescribed to patients as injections during an exacerbation of the disease to eliminate the pain syndrome,

medications that can dilate blood vessels, etc.

During conservative treatment, patients should adhere to a diet specially designed for patients with arthrosis of the hip joint. The course of therapeutic therapy includes therapeutic massage, which is indicated for patients with stages 1 and 2 of arthrosis.

At the 3rd stage of arthrosis of the hip joint, patients undergo surgical treatment of this disease.

Before surgery, each patient must undergo mandatory training:

take blood and urine tests,

undergo a hardware examination (ultrasound, X-ray, cardiogram fluorography, EEG, etc.),

get advice from narrow-profile specialists who will give admission to the operation (therapist, rheumatologist, arthrologist, orthopedist, etc.).

The day before surgery, the patient must stop consuming solid food. Mandatory bowel cleansing is performed (this can be done either through special medications or with an enema). In the evening, the patient will be given a sedative injection that will help him fall asleep. Before surgery, the patient should empty his bladder into which a catheter will be inserted (he will remove urine during surgery). The patient, in the operating room, will have to lie on his side, after which the surgeon will make the markup.

Endoprosthetics is performed under general anesthesia (the type of which the anesthetist chooses based on the patient’s cardiovascular system), after which the patient will recover within a few hours. To prevent the appearance of a gag reflex after anesthesia for 5-6 hours, fluid intake should be limited. If the patient is tormented by severe thirst, he should moisten his lips with a gauze or cotton pad.

In order to exclude the formation of blood clots in the lower extremities, each patient is wrapped with elastic bandages around his legs (to the knees). Such a tight bandage should be worn for 3-5 days after surgery, especially when moving (if the patient is in bed, in a lying position, he can remove elastic bandages).

During endoprosthetics, the surgeon performs the following actions:

cuts off the femoral head

a pin made of a special metal used in the medical industry inserts into the bone cut

the endoprosthesis is tightly fixed on the installed pin (it has an exact copy of the femoral head).

During surgery, the surgeon partially removes the surface of the pelvic bone. Instead, a bed made of polymer materials is installed. This bed is firmly connected to the titanium head, so that the joint will be able to function fully in the future for 20 years. At the final stage of surgical intervention, the wound is sutured and after that a sterile dressing treated with antiseptic agents is applied to its surface.

Currently, surgeons perform fixation of the endoprosthesis in two ways:

using a fragment of the cancellous bone (a prosthesis is driven in),

using special medical cement (it is used in the surgical treatment of bones).

Many specialists prefer to use bone cement during endoprosthetics, which fixes the prosthesis very firmly and allows patients to move independently after the healing of the postoperative scar. This method is ideal for patients in advanced age. After such endoprosthetics, the need for a second operation disappears, the purpose of which is to replace the endoprosthesis.

Recommended Exercises for Arthrosis of the Hip

After undergoing treatment for arthrosis of the hip joint, patients need to gradually return to their usual rhythm of life. Much attention should be paid to the restoration of motor functions of the joint and lower extremities. For this, experts recommend undergoing rehabilitation, which includes both a special course of physiotherapeutic procedures and therapeutic exercises.

Hip arthrosis is a very dangerous disease that is difficult to treat. That is why, when choosing the level of physical exertion for patients, specialists take into account their age, severity of the disease, characteristics of their body, etc. Physical therapy classes should be carried out in the walls of special medical institutions in which there are rooms equipped for these purposes. During daily training, the orthopedic surgeon monitors the patients, who will immediately come to the rescue if necessary.

So that physical activity does not entail a deterioration in the patient's condition, the following must be remembered:

physical activity must be given gradually,

each exercise should be performed carefully, without sudden movements,

before starting classes, you need to warm up all the muscles (this can be done using a regular warm-up),

in case of pain in the hip joint at the time of exercise, you should temporarily stop the training, etc.

Many experts recommend this category of patients to combine therapeutic exercises and other sports:

skiing etc.

Great benefit to the recovering hip joint will be daily walks in the fresh air, during which strong physical activity does not appear at the site of damage. After the rehabilitation carried out in a medical institution, the patient can perform a course of therapeutic exercises at home. During training with an instructor, each patient learns to correctly perform each exercise, as a result of which the possible injury during independent physical education is almost completely eliminated.

For daily exercise, it is best to use special mats (orthopedic). During training, one should not forget about proper breathing, which, if necessary, should be immediately corrected. After completing the last exercise from the treatment complex, the patient should undergo a small self-massage. For these purposes, you can use special massagers, thanks to which additional load will be exerted on weakened muscles.

If the patient finds the following symptoms, he needs to stop daily classes for a while and contact a medical institution for advice:

exacerbation of chronic diseases,

increase in temperature,

hernias, cysts and other neoplasms, etc.

Prevention

To prevent the development of arthrosis in the hip joint, it is necessary to prevent this disease in a timely manner:

timely receipt of qualified medical care for any injuries of the hip joint,

abandonment of a sedentary lifestyle,

normalization of body weight

timely correction of congenital or acquired defects of the hip joint,

giving up bad habits (smoking, alcohol, etc.),

water sports, etc.

Education: diploma in "General Medicine" was obtained in 2009 at the Medical Academy. I.M.Sechenova. In 2012, he completed postgraduate studies in the specialty "Traumatology and Orthopedics" at the City Clinical Hospital named after Botkin at the Department of Traumatology, Orthopedics and Disaster Surgery.

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Osteoarthritis is a disease of the joints that is considered dystrophic and associated with the slow destruction of cartilage inside the joint. With arthrosis over time, changes occur, restructuring of the articular ends of the bones, inflammatory processes and degeneration of the periarticular tissues occur.

Osteoarthritis of the knee joint is the deformation and destruction of cartilage tissue. The disease has a chronic degenerative nature, accompanied by pain of various strengths. It can lead to its complete immobilization, loss of functionality. The disease develops more often in women than in men.

Arthrosis of the shoulder joint is a fairly common problem that most older people face. This chronic and rapidly progressive degenerative disease affects both men and women. As a result of the development of arthrosis, not only cartilaginous tissue is affected, but also bone.

Arthrosis of the ankle joint is a disease in which the development of degenerative processes in cartilage tissues occurs. With the progression of arthrosis in the cartilage of the joint, irreversible processes begin to occur, which cause serious consequences. Today, modern medicine classifies ankle arthrosis as follows.

Proteins and carbohydrates can not be combined in one dish. Moreover, you can not eat fruit after meat. The speed of fruit digestion is 15–20 minutes. The speed of digestion of animal proteins is about 2 hours. Therefore, the digested fruits are not evacuated from the stomach until the meat is digested.

Another real life story. One, a woman who lived alone, suffered from arthrosis, rheumatism and polyarthritis and there was no one to help her. She could not even get to work, because the pain of the knee joints brought her to fainting. Doctors told her that they could no longer help at this stage of the disease.

Risk Factors and Causes of Hip Arthrosis

In the pathological mechanism of the development of arthrosis of the hip joint, the main role belongs to the change in the physicochemical characteristics of the synovial (intraarticular) fluid, as a result of which it becomes more thick and viscous. This degrades its lubricity. When moving, the articular cartilage surfaces begin to rub against each other, become rough, become covered with cracks. Small particles of hyaline cartilage break off and enter the joint cavity, causing the development of aseptic (non-infectious) inflammation in it. As the disease progresses, the bone tissue is drawn into the inflammatory process, which leads to aseptic necrosis of the areas of the femoral head and acetabular surface, the formation of osteophytes (bone growths), which increase inflammation and cause severe pain during movement.

In a late stage of arthrosis of the hip joint, the inflammation spreads to the surrounding tissue joint (vessels, nerves, ligaments, muscles), which leads to the appearance of signs of periarthritis. As a result, the hip joint is completely destroyed, its functions are lost, the movement in it stops. This condition is called ankylosis.

Causes of arthrosis of the hip joint:

  • congenital dislocation of the hip,
  • hip dysplasia,
  • aseptic necrosis of the femoral head,
  • peters disease
  • hip joint injuries
  • infectious arthritis of the hip joint
  • gonarthrosis (deforming osteoarthrosis of the knee joint),
  • osteochondrosis,
  • excess weight,
  • professional sports,
  • flat feet
  • rachiocampsis,
  • sedentary lifestyle.

Pathology is not inherited, but the child inherits from his parents the structural features of the musculoskeletal system, which can cause arthrosis of the hip joint in the conditions conducive to this. This explains the fact of the existence of families whose incidence is higher than in the general population.

Forms of the disease

Depending on the etiology, arthrosis of the hip joint is divided into primary and secondary. Secondary arthrosis develops against the background of other diseases of the hip joint or its injuries. The primary form is not associated with previous pathology, the reason for its development is often not possible to establish, in this case they talk about idiopathic arthrosis.

Coxarthrosis is single or double-sided.

During arthrosis of the hip joint, three stages (degrees) are distinguished:

  1. Initial - pathological changes are slightly expressed, provided that they are treated promptly and adequately, they are reversible.
  2. Progressive coxarthrosis - characterized by a gradual increase in symptoms (joint pain and impaired mobility), changes in articular tissues are already irreversible, but therapy can slow down degenerative processes.
  3. Final - movement in the joint is lost, ankylosis is formed. Treatment is possible only surgically (replacement of the joint with an artificial one).

Joint replacement surgery in 95% of cases provides a complete restoration of limb mobility, restores the patient's performance.

Possible consequences and complications

The most serious complication of progressive arthrosis of the hip joint is disability due to loss of movement in the joint. With bilateral coxarthrosis, the patient loses the ability to move independently and needs constant outside care. A prolonged stay in bed in one pose creates the prerequisites for the occurrence of congestive (hypostatic) pneumonia, which is difficult to treat and can lead to death.

Pathology is not inherited, however, the child inherits from his parents the structural features of the musculoskeletal system, which can cause arthrosis of the hip joint.

Arthrosis of the hip joints is a progressive chronic disease that can only be completely cured in the early stages, provided that the cause of the disease is eliminated. In other cases, therapy can slow down its course, but over time, there is a need for implantation of endoprostheses of the hip joint. Such operations in 95% of cases provide a complete restoration of limb mobility, restore the patient's performance. The service life of modern prostheses is 15-20 years, after which they must be replaced.

Causes of occurrence

Why arthrosis of the hip joint occurs, and what is it? 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 becomes thinner and loses its ability to absorb loads. The body compensates for the stratification of cartilage tissue by the formation of bone growths along the edge of the articular surfaces, which leads to the deformation of joints and bones of varying degrees.

The main causes of this joint disease:

  1. Injuries. Such a cause may not be some major lesion, but in many cases the development of the disease is affected by chronic microtraumas that contribute to the cracking and thinning of cartilage. They also affect the tear of the joint capsule, leading to the accumulation of many injuries. Often recurring microtraumas are the forerunner of the appearance of such a disease.
  2. Excessive stresses leading to systematic microtrauma, as well as joint injury.Most often this occurs in people engaged in heavy physical labor or professional athletes. In this case, treatment without changing lifestyle or limiting stress is also ineffective and often accompanied by relapse.
  3. Hereditary predisposition. This may include abnormalities in the development of the femoral head itself, underdevelopment of the elements of the joint, etc. In this case, the so-called dysplastic arthrosis of the hip joint arises.
  4. Diseases For example, arthritis, in the absence of proper treatment, can degenerate into arthrosis over time. This is due to the fact that during arthritis the properties of cartilage tissue change, there is a violation of blood circulation. Gradually, this leads to the development of a degenerative process.
  5. Excess body weight. Overweight, even when walking, exerts a load on the joints that exceeds their physiological strength limits.

Depending on the cause of the development of the disease and its pathogenesis, 2 main types of arthrosis of the hip joint are distinguished.

  1. Primary coxarthrosis. In this case, the disease develops very slowly and begins with a violation of the blood supply to the tissues. The reasons for the development of this type of arthrosis are rooted in metabolic disorders, which is more common for people over 50 years old. Primary arthrosis of the hip joint is the most commonly diagnosed.
  2. Secondary coxarthrosis. In this case, the disease develops against the background of a systemic inflammatory lesion of many joints in the body. Inflammation can be of either an infectious or an autoimmune nature.

At the initial stage of coxarthrosis, patients are only concerned about minor pain or a feeling of discomfort in the joint area. Often, such symptoms are ignored, resulting in the disease progressing.

Hip arthrosis of the 1st degree

This stage of the disease is characterized by pain in the joint and thigh, sometimes in the knee, arising after exercise and subsiding after rest. Joint mobility is unlimited and there is no gait disturbance.

Coxarthrosis of the 1st degree is the initial stage of the disease, starting treatment of which, you can still stop the process of destruction and deformation of the joint and maintain its functions in full. But, unfortunately, many do not consider it necessary to consult a doctor because of mild pain in the joint, and the disease, meanwhile, is progressing.

Osteoarthritis of the hip joint 2 degrees

It manifests itself more vividly - the intensity of pain increases, it occurs not only after exercise, but also at rest, there is a limitation of motor functions. In particular, coxarthrosis is characterized by difficulty in pronation (hip rotation inward) and abduction, contracture is formed.

During X-ray examination, we see a narrowing of the joint space and the appearance of bone growths on the surfaces. The acetabulum and the femoral head are deformed. The hip muscles begin to atrophy on the affected side, and the pain syndrome spreads lower, capturing both the knee joint and the inguinal region (it is important to understand that this will not be accompanied by dystrophic changes in the knee joint).

Hip Arthrosis, Grade 3

Signs of the disease are pronounced and are permanent. Pain overtakes at night. When walking, the patient uses support. The muscles of the lower leg and thighs gradually atrophy, and the diseased leg of the sick person becomes much shorter.

Often, to the 3rd degree, the joint gap completely disappears, and the joints grow together into a single bone structure, this shows a picture. As a result of this comes complete immobility of the joint.

On radiographs, extensive bone growths from the roof of the acetabulum and the head of the femur, a sharp narrowing of the joint space are determined. The femoral neck is significantly widened and shortened.

Non-drug methods

In addition to the use of drugs, doctors recommend non-drug methods of combating the disease. These include the following methods of treatment for this disease:

The following types of treatment are referred to physiotherapy used for arthrosis:

  • magnetic therapy
  • UHF and ultrasound therapy,
  • aeroionic and electrotherapy,
  • inductothermy,
  • phototherapy,
  • the use of laser technology.

All these methods can only be used to improve blood supply to the joints and relieve spasms.

Drug therapy

The combined treatment of hip arthrosis involves the appointment of the following groups of medicines:

  1. Nonsteroidal anti-inflammatory drugs (these are diclofenac, ketoprofen, indomethocin, brufen, piroxicam, etc., they all eliminate pain, relieve inflammatory processes, but do not restore cartilage tissue).
  2. Chondroprotectors. Preparations for the nutrition of cartilage. Accelerate her recovery. Important in phase 1.2 of treatment for arthrosis. With grade 3 disease, the cartilage is already destroyed, these drugs will be useless. Take drugs for a long time, go through several courses.
  3. Muscle relaxants (sirdalud, midokalm, etc., they eliminate muscle spasms in the area of ​​diseased joints, help improve tissue blood supply).
  4. Ointments and creams. Medical ointments are ways to alleviate the condition of a sick person, but do not contribute to a full recovery. Warming ointments are well suited. They irritate the skin receptors, and thereby reduce pain. Warming ointments also work to restore increased circulation in the tissues and muscles around the diseased joint.
  5. Injections of steroids into the joint cavity (hydrocotisone, mitelpred, Kenalog, etc., injections of these drugs are prescribed to relieve exacerbation of the disease and eliminate severe pain).
  6. Vasodilating drugs (trental, cinaresin, teonikol, etc., dilate blood vessels inside and around the joint cavity, thereby improving the delivery of nutrients needed for tissue repair).

It is not necessary to count on folk remedies of treatment. But some healers recommend tincture of lemon, garlic, or celery root to treat joints and bones.

Massage in the treatment of coxarthrosis

With deforming arthrosis of the hip joint massage treatment gives good results. Massage with coxarthrosis is a very effective and useful method. It is advisable that the massage is carried out by a good specialist and as often as possible.

Its action is aimed at improving blood circulation, strengthening muscles, relieving painful spasm, swelling and muscle tension, as well as increasing diastasis between the joint elements of the joint.

In the absence of a professional massage therapist, you can do the massage yourself. Massage with arthrosis can be performed both manually and with the help of various massage devices and even a jet of water (hydrokinesitherapy).

Gymnastics

Treatment of arthrosis of the hip joint with physical education is to achieve two goals: increase leg mobility and prevent muscle atrophy. All standard complexes of exercise therapy for coxarthrosis also have a general strengthening character and a positive effect on the whole organism.

A set of gymnastic exercises is prescribed by a specialist. The first couple of physiotherapy exercises should be supervised by a doctor. He will show you how to perform each movement correctly, and will also monitor the proper load on the hip joints.

  1. Give preference to porridges on the water.
  2. Eat enough animal protein: fish (except salted), poultry, and beef.
  3. Eat at least 5 servings of vegetables per day (one serving - 100 grams, can be used as a side dish).
  4. Mandatory dairy products: cottage cheese, yogurt, fermented baked milk.
  5. Exclude alcohol, coffee, strong black tea.
  6. Exclude sweet, starchy foods.
  7. Eat a little, but often.

Diet will reduce the load on the hip joints and provide them with everything necessary for tissue repair.

Reasons and degrees of the course

The provoking factors that cause the development of arthritis include the following phenomena:

  • hereditary predisposition
  • muscle-joint corset weakness
  • anomalies in the structure of the skeleton,
  • history of injuries
  • inflammation,
  • autoimmune processes
  • purulent infections
  • heavy physical labor or playing sports,
  • old age.

There are 3 stages of the pathological process. Thus, arthrosis of the 1st degree of the hip joint is characterized by the appearance of pain only after physical exertion, and there are no other symptoms of the disease. The next stage is characterized by constant pain, including at rest. An X-ray examination shows a narrowing of the joint space. Grades 1 and 2, with proper and timely treatment, are reversible conditions, however, in the absence of therapy, they quickly develop into a more severe form. With further progression of arthrosis, the pain becomes excruciating and limits the mobility of the femur in the hip joint. The muscles of the lower limb atrophy and do not perform functions. The detection of osteophytic growths is characteristic of grade 3 severity of arthrosis of the hip joint.

Symptoms of pathology

Arthrosis of the hip joint is characterized by the occurrence of such manifestations:

  • pain syndrome, which provokes physical activity,
  • fever, while body temperature ranges from normal to subfebrile,
  • muscular-ligamentous corset atrophy,
  • lameness,
  • limb deformation, associated with massive edema and the formation of osteophytes,
  • limb length change
  • the sounds of a crunch when moving TBS.

Deforming arthrosis develops more often in the area of ​​the right than the left hip joint.

Signs are expressed depending on the stage of the process. Often, the patient’s entire leg hurts completely, which is associated with pinching or inflammation of the nerve endings that pass near the joint. In this case, degree 2 arthrosis of the hip joint is characterized by the appearance of pain at rest. And also there is a stiffness of movements, especially in the morning. This is caused by congestion around the neck and head of the intraarticular exudate.

Hyaline cartilage atrophies, therefore, the joint gap is significantly narrowed, which provokes the appearance of a characteristic crunch during movement, shortening the length of the limb. In this case, the hip bone is destroyed and the density of its tissues is lost. Osteopathy is progressive in nature and is associated with a violation of trophic tissue. The development of chronic inflammation is a provoking factor in the destruction of the hip joint. Therefore, foci of pathological ossification or osteophytes appear. This is characteristic of 2 3, and sometimes the first degree of the course of the disease.

How is the diagnosis carried out?

A traumatologist can determine the arthrosis of the hip joint during an external examination and questioning about the course of the disease in the patient. To confirm the diagnosis, an X-ray examination is used. In the picture, arthritis looks like compaction and deformation of the pelvic ends of the thigh. This significantly increases the size of the head. An important symptom of the disease is the formation of osteophytes, which is also well detected using this method.

What is dangerous?

The hip joint is a component of the musculoskeletal system of a person. Therefore, a violation of its functions causes immobilization of the patient, and eventually provokes the occurrence of disability. In addition, inflammation spreads to the pelvic bones, provoking dysfunction of urination and defecation. It is possible to infringe on the nerve endings that pass near the femoral head, which causes a violation of the tactile sensitivity of the limb.

Treatment for arthrosis of the hip joint

Therapy of joint diseases should be aimed at eliminating the cause of the process. It is necessary to be treated with the use of medications, and, if necessary, resort to surgical intervention. The complex effect also includes folk remedies in the form of herbal medicine, which should complement the main therapy. When an exacerbation of the disease was overcome, physiotherapy is used. They will also help if a beginning pathological process is present. Prevention of arthrosis consists in proper nutrition. Diet should limit salt-rich foods.

With significant severity of the lesion, replacement of the joint is recommended, including the pelvic joint.

Conservative treatment is able to remove the unpleasant symptoms that hip arthrosis causes in the early stages of development. It helps to anesthetize the soft tissues of the thigh and pelvis, as well as remove some other unpleasant manifestations. For this purpose, non-steroidal anti-inflammatory drugs based on "Diclofenac" or "Ibuprofen" are used. They must be administered intramuscularly, taken orally or smeared in the affected area. And also muscle relaxants that reduce muscle spasm of a sick limb are used. Drug treatment consists in the appointment of a long course of chondroprotectors and vitamin complexes.

Physiotherapy

It is possible to cure arthrosis of the hip joint in the initial stages of the course with the help of physiotherapy. It can also be used after prolonged drug exposure and the elimination of signs of an inflammatory process. This type of exposure can help reduce muscle spasm and restore the functional activity of the joint.

If the patient has an initial stage of pathology, then it will be useful to also do the following types of physiotherapy:

  • magnetic therapy
  • electrophoresis
  • paraffin baths,
  • mud therapy
  • baths with essential oils.

Folk remedies

Treatment of arthrosis of the hip joint with the use of alternative methods involves the use of various means. For this purpose, crushed mint and aloe leaves with the addition of petroleum jelly can also be used to impart viscosity and better application. Celandine soaked in olive oil for 2 weeks will be beneficial. Apply compresses from horseradish root or healing mud wraps.

Exercise therapy and massage

Hip arthrosis with a mild course is treated with these types of exposure. Manual therapy is indicated after the complete elimination of inflammation and pain. The doctor should perform the massage after reading the patient’s medical history. More often, a course of 15 receptions of a masseur is prescribed. Treatment at home involves the use of special gymnastic exercises that will help return the full functional activity of the joint.

Severe arthrosis is not treated using massage and exercise therapy.

Where is the hip joint

It is the largest in the human skeletal system connecting the femoral head to the pelvic acetabulum. Outside, it is strengthened by an articular bag, muscles and ligaments. The joint bag inside has a synovial membrane, due to which the synovial fluid is synthesized - the very biological lubricant that nourishes the joint and provides it with smooth, painless mobility.

All surfaces of the bones are lined with hyaline cartilaginous tissue, which performs shock-absorbing functions and softens the pressure of the hip joint during movement. They bear the main load during movement, in addition, the joint has a narrow inter-articular gap, which makes the bones vulnerable. If the joint structure is correct, there are no deformations, inflammations, then the movement will be without pain and restrictions.

Unfortunately, with age, changes occur in the bones: impaired intraarticular metabolism, blood circulation.Cartilage tissue loses water, become brittle, less elastic, prone to cracking. Particles of destructible cartilage settle in the joint cavity, causing aseptic (non-microbial) inflammation. With the progression of the disease, inflammation spreads to the bone tissue, provoking the occurrence of aseptic necrosis or necrosis of the areas of the femoral head and acetabulum.

Symptoms of coxarthrosis

Medicine knows a number of cumulative symptoms of coxarthrosis of the hip joint, which change in intensity as the disease progresses. The characteristic symptoms of arthrosis of the hip joint are as follows:

  1. Pain in the inguinal region with innervation in the knee. The patient may experience discomfort at any time of the day.
  2. There is contracture (stiffness) during movements.
  3. Limping.
  4. Limb shortening.
  5. Weakening or complete atrophy of the muscles.

Osteoarthritis 1 degree

In the early stages, the signs of coxarthrosis of the hip joint are fuzzy, passing. Therefore, people do not turn to the hospital for help, hoping "at random", and this only aggravates their condition. Full recovery is guaranteed only with timely detection of the disease at the 1st stage, when it can still be solved with the help of conservative therapy. Symptoms are characteristic for arthrosis of the hip joint of the 1st degree:

  1. Periodic aching, dull pain after exercise, which decreases after rest.
  2. Discomfort in the inguinal region (often this is the only symptom).
  3. Restrictions on movements have not yet been observed.
  4. On the x-ray revealed a slight narrowing of the interarticular gap.

Coxarthrosis 2 degrees

In the process of proliferation of the pathological process and in the absence of treatment, the pain increases, appears even with small loads, usually in the evening. If the structures are badly damaged, then it can hurt even during rest, especially at night. In addition to painful sensations, for coxarthrosis of the hip joint of the 2nd degree, the following symptoms are characteristic:

  1. Lameness or gait on the heels. As a result of inflammation and destruction of cartilage and periarticular tissues, the range of movements made by the limb is limited.
  2. Difficulties in bending the leg, taking it to the side, it is difficult to wear shoes on your own.
  3. Contracture after prolonged rest. Discomfort disappears when moving, and again after intense exertion, the pain returns.
  4. Shortening the legs, a decrease in the volume of the muscles of the buttocks and thighs from the pathological process.
  5. On x-rays revealed necrosis of the femoral head, ilium, narrowing of the interarticular cracks, the growth of osteophytes (growths).
  6. MRI or CT scan shows the presence of fragments of cartilage, an inflammatory process in nearby soft tissues.

Osteoarthritis 3 degrees

When the patient’s disease is so neglected that the limb stops moving, constant pain disrupts sleep, causes irritability, then we can talk about grade 3 arthrosis of the hip joint. In addition to the described symptoms, there are:

  1. Shortening or lengthening the legs - this may depend on the characteristics of the deformation.
  2. Ankylosis of the joint with the inability to produce any movement.
  3. Severe lameness.
  4. X-ray and tomography show that the cartilaginous layer is completely destroyed, the joint is noticeably destroyed, large osteophytes are formed.

At this stage, conservative treatment is not possible. Drug therapy is prescribed only for maintenance and analgesia. A joint replacement operation is recommended, after which therapeutic gymnastics is prescribed during the rehabilitation period to increase muscle tone and restore activity. Treatment may well have a good result if the diagnosis is carried out correctly, and therapy is started immediately.

Watch the video: Diagnosing an Arthritic Hip Joint (January 2020).