Coxarthrosis of the hip joint, a complex pathology of arthropathy, leads to severe changes in the joint.Unfortunately, adult disability and loss of ability to work are common.In fact, statistics on hip diseases account for almost half of all pathologies of the musculoskeletal system.I will give an example from the life of a case after surgical treatment and a rare complication during rehabilitation.
Coxarthrosis of the hip joint: a little about this disease
Osteoarthritis is a degenerative-dystrophic change that contributes to the complete destruction of cartilage leading to loss of joint function.
Coxarthrosis - here the hip joints are destroyed, in fact this is the same joint disease.
Mechanistically, the hip's connection to the pelvis is similar to a door hinge.The femoral head is connected to the femur like a hinge.There is a special anatomical formation - the acetabulum.This structure ensures maximum joint mobility.It performs a full range of movements, or rather, bending, stretching, rotation, etc.
Normally, the joint surface is smooth, with enough fluid inside, ensuring unhindered movement.As the disease progresses, the lubricant becomes thicker and more viscous, which immediately affects the condition of the cartilage.Synovial fluid no longer fully performs its functions.Because of this, the shock absorber pads dry out, crack and become rough.
- First.Due to the lack of necessary gliding ability, the friction of the bones increases, causing them to be injured.
- Monday.As the disease progresses, deformation of the bone surface is also associated with altered cartilage tissue.Therefore, the body tries to compensate for the increased load.
- Tuesday.Increased loads lead to complete atrophy of the femoral muscles and weakening of the ligaments.
Important: Hip osteoarthritis is a progressive disease.The changes can lead to a complete loss of physical activity.Ultimately leads to disability.And completely disrupt the usual lifestyle.This disease and its treatment are extremely important not only medically but also as a major social problem.
Causes of development of coxarthrosis and its types
At least there is no exact cause of coxarthrosis, which causes destruction of the hip joint.There are only assumptions.Most cases of developing hip pathology are associated with congenital hip dislocation and dysplasia (insufficiency) of the joint.
Therefore, there are 2 types of coxarthrosis;
- primary (originating from an unknown cause);
- secondary (associated with injury or illness).
Primary osteoarthritis is characterized by a combination of factors:
- hereditary;
- the influence of biological and mechanical processes;
- overweight;
- metabolic disorders;
- There is also the theory of pathological tissue recovery in response to damaging agents (inflammation, friction, infection).
Often this type of coxarthrosis is combined with damage to the spine and the phenomenon of knee arthritis (arthritis, arthritis).
In the secondary version, the reasons for development are clearer.These include:
- Dysplastic disorders.In half of cases of congenital pathology, grade 1 hip dysplasia occurs.
- Hip dislocation (congenital).
- Life trauma.Fractures of the pelvis, femoral neck, dislocation, dislocation.
- Legg-Calvé-Perthes disease.Osteochondropathy of the femoral head with its necrotic development.This disease occurs in children when the blood supply and nutrition to the joints is impaired.
In addition, pathology can affect both formations at the same time or one way.In addition to the direct causes of the disease, there are also favorable factors that stimulate the development of the disease.The disease often occurs when the load increases on the athlete's limbs.As well as people with difficult physical working conditions.Excess weight significantly increases the likelihood of developing arthritis.
Triggers also include:
- Disruption of metabolism, joint nutrition, hormonal imbalance.
- Adynamia.
- Bad posture.Especially scoliosis and hunchback leading to pelvic misalignment.
- Age after 40 years.It is estimated that after this date, every 10th patient was diagnosed with hip coxarthrosis, grade 1, 2. After 60, every 3rd person was observed.And when they reach the age of 70 or older, nearly 80% of applicants suffer from this disease.
There is no specific gene responsible for transmitting pathological changes in the joints.However, genetic factors can still be found.A person can receive from relatives structural features of cartilage tissue, altered metabolism and bone pathology.It is the combination of such genetic information that can cause the appearance of hip arthritis.
Classify
The main division of the disease is based on severity.There are 3 stages, differing not only in symptoms but also in radiographic changes.It is these indicators that are taken as the basis for diagnosis.
Degree |
Token |
|---|---|
I |
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II |
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III |
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This division is the most common.There are also Kellgren classification types.It includes 4 stages, plus grade 0 - equivalent to a healthy joint.
Symptom
The basis of all diseases of the musculoskeletal system is pain.Coxarthrosis of the hip joint 1-2 degrees has less pronounced symptoms than in the late stage 3. Initially, pain manifests itself when exercising.Especially after hiking or climbing stairs.Later, pain becomes a constant companion, making quality of life significantly worse.
Grade 1 coxarthrosis
Discomfort is concentrated only in the joint area (the groin and buttocks are practically not affected), rarely reflected in the hips or knees.The pain subsides with rest.
At this stage, no additional manifestations are detected - gait does not change, there are no movement disorders.In contrast, in dysplasia, mobility increases due to connective tissue changes;Often in the early stages of the disease, due to increased flexibility, the patient becomes interested in gymnastics and yoga.Movement problems only occur in stage 3.
For symptoms of stage 1 coxarthrosis in the hip joint, treatment can be done without surgery.Reasonable therapy allows you to eliminate unpleasant symptoms, stop progression.
Grade 2 disease
The pain, although not constant, manifests itself when resting.Radiation becomes noticeable - hips, groin, knees.Stiffness of the joints is observed - movement is limited when lifting, attempts to abduct to the side, difficulty moving the leg in a circle (especially the pain often increases).Limping becomes noticeable after intense walking or running.
When moving, one hears a crunching sound characteristic of joint disease - rough, dry.
Grade 3 osteoarthritis
The pain becomes constant and does not go away after rest and sleep.The feeling of discomfort does not leave the patient even at night.There are problems with walking;To facilitate movement, you must use a stick.The limp is constant.
At this stage, muscle atrophy of the limbs occurs and the legs become shorter.These changes force the patient to bend over to the affected side, adding to the load on the joint.Restrictions on mobility are observed in almost all directions.
Changes in bilateral coxarthrosis of the hip joint change the patient's gait, which is why all structures involved in the walking process are affected.Lower back pain appears, posture is disturbed, the axial position of the pelvis changes.
Diagnose
An important role in determining the disease is the examination of the orthopedic surgeon, as well as a thorough analysis of complaints.The patient's activity should be assessed - ability to climb stairs, comfort in boots and socks, ambulation, use of a cane.
It is recommended to check the general condition - blood tests, urine tests, biochemistry, ECG, identify signs of HIV and syphilis.
Grade 1 hip coxarthrosis has the most subtle symptoms.That is why it is necessary to conduct an X-ray examination to visualize changes in the joint space.This method not only allows to identify the disease.And also often find the cause of the appearance - dysplasia, Perthes disease.
Typically, knee pain is much more pronounced with grade 1 hip deformity, so it needs to be differentiated from gonorrhea.Differential diagnosis also includes examination of the spine to rule out nerve root syndrome (which causes pain that radiates to the hips and knees).
In doubtful cases, MRI (allows you to examine soft tissues in detail) and CT (to look at bone formation) are used.
Treatment
This disease cannot be completely cured, but modern medicine can restore lost mobility, helping you live a fulfilling life.
The use of physical therapy and medication is effective for grades 1-2 of the disease.In the final stages, only surgery can help.In other cases, surgery is performed if the conservative therapies used do not provide effective pain relief.
Level 1 treatment
Unfortunately, it is not possible to completely eliminate the pathology.In grade 1, treatment is aimed at stabilizing the condition.
During therapy, some general recommendations must be followed:
- Normalize physical activity - excessive stress should be reduced (hiking, running, jumping).
- Use shoes with good shock-absorbing soles and special insoles.
- Losing weight.
- Mandatory physical therapy.
Important: many patients completely refuse exercise and any exercises due to pain.This is often associated with increased fear of pain and the possibility of the situation getting worse.Practice proves that this opinion is wrong - regular exercise therapy helps strengthen muscles, protect them from atrophy, relieve pain and improve joint function.
Diet for grade 1 coxarthrosis of the hip joint is not prescribed;Moderate nutrition is prescribed for weight loss.It is also helpful to add gelatin products, canned fish with bones, and dairy products to your diet.
Conservative
Nonsteroidal anti-inflammatory drugs are used as a treatment.Because of its many side effects, it should be used when there is severe pain.You can combine their use with gastroprotective drugs.
Persistent pain is relieved by steroid injections into the joint and pain blockers can also be used.
For support, the following rules apply:
- Muscle relaxants – reduce stress, relieve pain in the legs.
- Chondroprotectors – improve the restoration of cartilage tissue.
- Vasodilator (nicotinic acid) - helps reduce blood vessel spasm and also increases tissue microcirculation.
Hot compresses are also used in combination (you can also use traditional treatments).They do not provide a cure but help reduce muscle spasms.
Be sure to use physiotherapy - UHF, magnetic field, induced current, massage.
Hip replacement surgery
To restore stage 3 freedom of movement and relieve severe pain, the patient is prepared for a planned laparoscopic surgery.This is a special operation to replace destroyed formations with artificial formations.The interventions completely restore the patient's mobility.Helps you completely return to your normal lifestyle.
Depending on the extent of the process, the prosthesis can be unipolar (only the worn end of the femur is replaced) or bipolar (the surface of the acetabulum is also changed).After surgery, rehabilitation is imperative for patients to return to an active life as quickly as possible.
For patients over 60 years of age, the recovery period is established even before surgical treatment, so that recovery takes place in a shorter period of time.The lifespan of an artificial joint is about 20 years, but it is important to follow the recommendations:
- Exclude running, long walks, jumping.
- Avoid lifting heavy objects.
- Avoid excessive exposure to a forced static position (this is especially true for people with standing jobs).
Life incidents
My friend's husband requested laparoscopic surgery.He was not diagnosed with coxarthrosis but had a successful resection of his lumbar hernia.The condition did not improve, the examination continued, and finally, when it was discovered that something was wrong, they sent me to the scheduled surgery.
After replacement, everything grew back safely, but the second hip also required surgical intervention.A year later, the quota for the operation was met again and was successful.And then, from the first minutes after anesthesia, it is necessary to restore function and strictly follow the doctor's recommendations.
What about our friends?On the way home from the hospital, I began to put stress on the prosthetic joint (sitting for a long time, stepping on my feet).I forgot how careful I was the first time.As a result, the ligaments and muscles do not have time to adapt to the implant, which cannot hold and it pops out.
Of course, they inserted it, put it in there and then everything seemed to be fine.But he complained that he couldn't move his leg sideways, had pain, and felt discomfort when walking.Although he exercises and does various exercises to develop both joints, it is also about work and the desire to move independently.
prevent
We discussed the symptoms and treatment of coxarthrosis of the hip joint, as well as their stages.
- Only daily exercise can help you avoid serious complications and live to old age without crutches.In Soviet times, serious work was done to prevent diseases of the musculoskeletal system and strengthen the immune system.Nowadays it is difficult to restore lost experiences, the mind is clear but lazy to do.
- Excess weight causes joints to wear down to an ugly level;Endoscopy is better but no more weight loss.My friend is sure of this without even trying to eat less sweets and starchy foods.Proper nutrition is a very important point.
- I consider lifting weights to be no less cruel to the entire skeleton.
- Bad habits (alcohol, smoking) remove calcium, magnesium and other beneficial substances from the body.
Just dig, everything is interconnected.
Take care of yourself and your joints by exercising every day!