Arthrosis is a degenerative disease of the cartilage tissue that can affect the joints of the vertebrae and all the bones of the skeleton.The hip joint (HJ) is the largest and most stressed bone joint.Therefore, coxarthrosis (deforming hip joint arthrosis) is a very common cause of disability among patients over 50 years of age.
Coxarthrosis (arthrosis of the hip joint): symptoms
Reasons
The causes of coxarthrosis are varied.This pathology can lead to:
- Age-related dystrophic changes in cartilage.
- Constant physical activity among athletes and carrying heavy loads for many years.
- Congenital dysplasia.
- TJ injuries.
- Necrosis of the femoral head (Perthes disease).
The head of the femur, covered with elastic cartilage, is located in the acetabulum of the pelvic bones.
There are unilateral lesions (when the disease affects one joint) and bilateral lesions - when both articular hip surfaces are affected.
Symptoms of arthrosis of the hip joint
When diagnosed, the following symptoms of hip arthrosis are observed:
- The cartilage becomes thinner, dry and rough.
- Thickening of the underlying bone, growth to the side.
- Fibrotization and inflammation of the joint capsule.
- Appearance of inflammatory discharge in the capsule.
- Stiffness of the joint, occurrence of contractures.
Externally, these changes are manifested by the following symptoms:
- Pain in the joint that radiates to the groin, hip and knee.
- Initial (morning) pain is a symptom that goes away after warming up.
- Stiff, unsteady, limping gait.
- By shortening the leg on the affected side (this is due to the contracture).
- Weakening and atrophy of the hamstrings.
- Crackling in the joint.
Stages of the disease
Based on the signs and symptoms, three stages of the disease can be distinguished:
First of all
- Unpleasant feeling and pain, usually relieved by rest.
- Absence of external symptoms - lameness, stiffness, atrophy.
Such signs do not particularly alarm patients, and few pay attention to episodic pain, and even less begin to treat it.
But precisely at the initial stage, arthrosis of the hip joint is still a reversible disease.
Second degree
- Painful symptoms become more intense and may persist even at rest.
- The functional characteristics of the hip joint decrease:
- limitations of hip abduction and internal rotation appear
- lameness is observed
- X-rays show:
- marginal osteophytes;
- deformation and change of the contour of the head;
- joint gap reduction.
Third stage
- The pain becomes constant and the most excruciating night pain begins.
- The patient is forced to rely on a cane.
- There is a sharp restriction and atrophy of the movement of the gluteal, thigh and calf muscles.
- Leg shortening and lameness can be felt.
- Due to the overgrown osteophytes, the joint gap practically disappears, the fusion of the hip joint and complete loss of function occurs.
It happens that the first attack occurs at a fairly young age - in the early forties.Most likely, a person forgets about it and remembers it already at the age of 50-60, when the deformations of the joint become significant and affect the quality of life.
Diagnostics
X-ray and functional diagnostics are performed.The orthopedist not only deciphers the image, but also rotates it, bends the femur in all directions, and studies the symptoms that occur while walking.
However, more and more often, if the patient suspects coxarthrosis of the hip joint, leading specialists refer to diagnostics using magnetic resonance imaging (MRI).This is explained by the absolute safety and high information content of the procedure.The MRI examination enables early detection of the smallest changes in the hip joint, which contributes to the development of the most effective treatment tactics.
Treatment of coxarthrosis of the hip joint
The treatment is carried out according to the "the sooner the better" principle.
Early coxarthrosis can be treated with the following methods:
- Chondroprotectors.
- Light physiotherapy - swimming, aerobics, walking and cycling.
- Regulation of permissible physical loads of the joint.
- Weight correction (down).
- Physiotherapy treatment
- Withdrawal procedures.
- Massage sessions.
- It compresses the painful area.
Painful symptoms can be alleviated with NSAIDs.
The annual sanatorium treatment is also very effective.
Analgesic intra-articular corticosteroid injections can be used to treat more intense pain in the later stages.
Treatment of coxarthrosis in the late stage is very difficult due to the complete obliteration of the hip joint.Chondroprotectors are completely useless in this case.
All kinds of external remedies in the form of ointments and gels can relieve muscle spasms and pain, but of course they do not affect the condition of the patient's immobilized joint in any way.That's why you need to have a reasonable approach to all kinds of advertising, which assures that by applying ointment to the painful place, you will soon forget about the disease.
Hip replacement
The only option for complete restoration of the hip joint in the third stage of coxarthrosis is surgery - endoprosthesis of the hip joint (arthroplasty).
The endoprosthesis consists of two parts: a head and a cup.
This operation is not easy:
- After surgery, a long rehabilitation period is required.
- The healing of the joint is painful (pain can last up to a year).
- You will need to walk for a while with the help of a walker or a cane.