Osteoarthritis (arthrosis) of the hip joint is a chronic, progressive pathology in which degenerative-dystrophic processes occur in the area of the joints of the pelvic bones. To be more precise, there is a destruction of the hyaline cartilage lining the femoral head and acetabulum, the surfaces of the pelvic bones that are in contact with each other.
The second name of the pathology is coxarthrosis of the hip joints.
Arthrosis of the hip joints: features of the disease
Most often, firsthand knowledge of what coxarthrosis is is for older people, mainly women, who have a risk of developing pathology after 45 years. Such a selective appearance of pathology comes from the specifics of the structure of the female pelvic bones, as well as from their direct participation in the process of childbirth. In men, arthrosis of the hip joints (coxarthrosis) occurs mainly after 65 years of age.
An important role in the pathogenesis of coxarthrosis is played by the natural aging of the body, when the most stressed joints of the bones begin to collapse.
Also, the disease can be triggered by a number of infectious, traumatic, non-inflammatory diseases, their combination. Initially, arthrosis manifests itself as pain and a decrease in the activity of movements in the pelvic area, but then its consequences become more serious - the affected limb is shortened.
Disease classification
Types of arthrosis of the hip joint depend on the characteristics of its development and the cause of occurrence. Often there is post-traumatic arthrosis of the hip joint - it appears after an injury. The classification also includes the following types of arthrosis:
- Dysplastic - due to dysplasia that arose in childhood, but was not cured;
- Static - associated with an uneven load on the pelvic area, which happens with pathologies of the foot, knee, ankle;
- Post-infectious - appears after various inflammatory diseases;
- Primary chronic - develops in older people due to aging of the body.
Any type of disease can be referred to as "deforming arthrosis of the hip joint", because the pathology leads to a violation of the shape and appearance of the pelvic articulation of the bones.
In addition, the disease is divided into 3 degrees according to the severity of changes, the symptoms of which are described below in the text.
Reasons for the development of arthrosis
Signs of coxarthrosis can appear even in the absence of obvious prerequisites, which is due to natural degenerative processes in the joint. It has a narrow gap, while enduring huge and constant loads, so it wears out earlier than others. Initially, blood circulation is disturbed in the tissues, so nutrients are delivered to the hyaline cartilage to a lesser extent. Metabolic processes are disturbed, the cartilage dries out, cracks form on it. Further, the articular surfaces are quickly worn out, destroyed - arthrosis of the hip joint progresses. Symptoms can appear even more quickly if the body is affected by a number of provoking factors:
- Any injury;
- Physical work, heavy sports;
- Diseases of the spine, including curvature;
- flat feet;
- Arthritis against the background of an infectious process;
- Joint dysplasia transferred in childhood;
- Metabolic diseases;
- Excess weight;
- Rheumatism and other autoimmune pathologies.
Against the background of the influence of such factors, the disease can develop much faster - after 30-40 years.
Symptoms of coxarthrosis
Signs of arthrosis of the hip joint largely depend on its degree. During the pathology, three degrees (stages) are distinguished:
- First degree. There are pains during physical overload - after a long walk, running, in connection with which there are aching, dull sensations in the pelvic area (pass after a short rest). The pain does not radiate to other parts of the leg. Deforming arthrosis of the hip joint of the 1st degree does not cause changes in gait, the muscles function in full. By the end of the stage, slight restrictions on leg movement may appear;
- Second degree.Pain in arthrosis of the hip joint in this case becomes more pronounced. Pain appears with minimal exertion, discomfort is present in the evening after a working day. There are pains at night, at rest. A crunch, a feeling of friction in the joint join. If a person walks for a long time, then swaying movements can be noticed in the gait. It becomes difficult to put on shoes, take your foot to the side;
- Third degree.The work of the pelvic bones is seriously impaired (with primary arthrosis, both joints are affected, with other types, usually only one). The pain in the groin is constant, excruciating, it gives to the knee. The thigh muscles are atrophied. The leg becomes shorter, so a person uses crutches and a cane to move.
Later, ankylosis occurs, in which movement becomes impossible at all.
Diagnosis of the disease
What is coxarthrosis of the hip joint, what is its degree and how to treat the disease? All issues should be resolved after the diagnosis. Despite the fact that the main method for making a diagnosis is radiography, the patient needs consultations of a number of narrow specialists and testing. This will help to find the cause of the disease and act on it. So, coxarthrosis can be triggered by osteochondrosis, flat feet, urological and gynecological infections, and their treatment will help stop the destruction of the articulation of the bones.
As for making an accurate diagnosis and setting the degree of arthrosis, all changes are perfectly visualized in a picture - X-ray or CT (MRI):
- The first degree is a slight narrowing of the gap, the appearance of marginal osteophytes;
- Second degree - narrowing of the joint space by 50% of the norm, the appearance of osteophytes on the outer and inner sides of the gap, deformity of the femoral head, often - the presence of inflammatory changes in the tissues near the articulation of the bones;
- The third degree is a sharp deformity of the joint, the presence of large osteophytes, sclerosis zones.
Treatment of arthrosis
Conservative treatment
Ointments, creams, tablets for arthrosis of the hip joint help only in the first stage of the disease. The drugs can completely restore the cartilage, and it is important to start therapy at an early stage. Usually used NSAIDs, corticosteroids, chondroprotectors, drugs based on hyaluronic acid, muscle relaxants. They also practice massage, exercise therapy and therapeutic exercises.
At the second stage, it is necessary to connect physiotherapy and mechanical methods of influencing the joint. These include extractor hood, UHF, magnetotherapy, shock wave therapy, ultrasound, laser, inductothermy, electrophoresis. Folk remedies for arthrosis of the hip joint, like local drugs, are only of secondary importance, and the main method of therapy should be drugs.
Be sure to apply a diet for coxarthrosis of the hip joint, it is required to normalize metabolism and improve cartilage nutrition.
Endoprosthetics for arthrosis
The third stage of the disease can only be treated surgically. The patient is recommended an operation to replace the joint, or arthroplasty. The surgeon cuts off the head of the femoral bone, inserts a metal pin into the cut, on which the artificial head is attached. After the operation, a long rehabilitation and exercise therapy is carried out, but then the hip joint will function fully, and the doctor will be able to answer the patient in the affirmative to the question whether it is possible to squat with arthrosis of the hip joint.
Disease prevention
To prevent arthrosis of the hip joint, sports and a healthy lifestyle must come to the fore. It is impossible to overload the joints, but it is necessary to eliminate hypodynamia. Good for walking, swimming, skiing, elliptical trainer. It is also important to lose weight, eat right.
Prevention of arthrosis of the hip joint is also based on the early treatment of any bruises, injuries that affect the pelvis and spine. In childhood, all congenital joint pathologies should also be eliminated.
Answers to popular questions
- Who to contact with arthritis? The question of which doctor treats coxarthrosis of the hip joint does not have a definite answer. Of course, it is initially recommended to contact a surgeon, traumatologist or orthopedist, which depends on the capabilities of the clinic. In specialized centers, an arthrologist deals with problems of the pelvic joints, but it is not always possible to find such a narrow specialist.
Depending on the cause of the disease, in the future, in parallel, you will have to apply and undergo treatment under the supervision of a rheumatologist, neurologist, infectious disease specialist and a number of other doctors;
- Can arthritis be cured? This disease is chronic, and it is impossible to completely eliminate it, especially since the main cause is aging. But if you see a doctor when there is arthrosis of the 1st degree of the hip joint, you can cure all the existing changes, and then prevent rapid progression. At subsequent stages, it is possible to stop and fix all the existing pathological changes, and live normally due to regular courses of therapy. Only arthroplasty can save the joint from arthrosis, but it also has a number of disadvantages - from the need for periodic replacement of the prosthesis to postoperative complications - pain, thrombosis, infection;
- When are local therapies sufficient, and in what cases can a visit to the doctor be avoided? Any ointments can only slightly improve blood microcirculation in the joint area, and also relieve pain, but do not have a therapeutic effect. In addition, this joint is located very deep, which makes it difficult for active substances to penetrate. Therefore, it is necessary to consult a doctor at any stage of the disease, regardless of the severity of the manifestations. Only at an early stage can the disease be stopped with "little blood" without surgery.
Arthrosis of the hip joint is a disabling pathology that makes a person crippled, preventing him from walking.
The only way to prevent such problems from developing is to start conservative therapy at stages 1-2 of the disease, not forgetting to conduct regular and full-fledged courses.