Osteoarthritis is a degenerative disease of cartilage tissue that can affect the joints of the vertebrae and all bones of the skeleton.The hip joint (HJ) is the largest and most heavily used bone joint.Coxarthrosis (deforming osteoarthritis of the hip joint) is therefore a very common cause of disability in patients over 50 years old.
Coxarthrosis (osteoarthritis 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 several years.
- Congenital dysplasia.
- TJ's 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 joint surfaces of the hip are affected.
Symptoms of osteoarthritis of the hip joint
When diagnosing, the following symptoms of hip osteoarthritis are observed:
- As the cartilage thins, it becomes dry and rough.
- Thickening of the underlying bone, its growth on the sides.
- Fibrotization and inflammation of the joint capsule.
- The appearance of an inflammatory exudate in the capsule.
- Stiffness of the joint, appearance of contractures.
Outwardly, these changes are manifested by the following symptoms:
- Pain in the joint, radiating to the groin, hip and knee.
- The initial painful symptom (morning) which disappears after warming up.
- A stiff, uncertain and lame gait.
- By shortening the leg on the affected side (the reason is a contracture).
- Weakening and atrophy of the femoral muscle.
- A crack in the joint.
Stages of the disease
Based on the signs and symptoms, three stages of the disease can be distinguished:
First of all
- Discomfort and pain, usually improving with rest.
- Absence of external symptoms - lameness, stiffness, atrophy.
Such signs do not particularly alarm patients, and few people pay attention to episodic pain and even fewer begin to treat it.
But it is precisely at the initial stage that hip osteoarthritis 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:
- restrictions on hip abduction and internal rotation appear
- lameness is observed
- The x-rays show:
- marginal osteophytes;
- deformation of the head and change in its contour;
- reduction of joint space.
Third step
- The pain becomes constant and the most excruciating night pain also begins.
- The patient is forced to lean on a cane.
- There is severe restriction of movement and atrophy of the gluteal, thigh and calf muscles.
- There is noticeable shortening of the leg and lameness.
- Due to the proliferation of osteophytes, the joint space practically disappears, fusion and complete loss of function of the hip joint occurs.
It happens that the first attack occurs at a fairly young age - in the early forties.A person most likely forgets it and remembers it already at 50-60 years old, when joint deformities become significant, affecting the quality of life.
Diagnosis
Radiological and functional diagnostics are carried out.The orthopedist not only deciphers the image, but also turns, bends the femur in all directions and studies the symptoms that arise when walking.
However, increasingly, if there is a suspicion that a patient suffers from coxarthrosis of the hip joint, leading specialists turn to him for diagnosis using magnetic resonance imaging (MRI).The explanation for this is the absolute safety and high information content of the procedure.It is the MRI examination that makes it possible to detect the slightest changes in the hip joint at an early stage, which contributes to the development of the most effective treatment tactics.
Treatment of coxarthrosis of the hip joint
Treatment is carried out according to the principle “the sooner the better”.
Early coxarthrosis can be treated with:
- Chondroprotectors.
- Light physiotherapy - swimming, aerobics, walking and cycling.
- Regulation of admissible physical loads on the joint.
- Weight correction (down).
- Physiotherapeutic treatment
- Extraction procedures.
- Massage sessions.
- Compress on the painful area.
Painful symptoms may be relieved by NSAIDs.
Annual sanatorium treatment is also very effective.
Intra-articular injections of corticosteroid analgesics may be used to treat more severe pain in later stages.
Treatment of coxarthrosis in advanced stages is very difficult due to the complete effacement of the hip joint.Chondroprotectors in this case are absolutely useless.
All kinds of external remedies in the form of ointments and gels can relieve muscle spasms and pain, but, of course, will in no way affect the condition of the diseased immobilized joint.Therefore, you should take a judicious approach to all kinds of advertising that guarantees that by smearing the sore spot with ointment, you will soon be able to forget about the disease.
Hip replacement
The only option for complete restoration of the hip joint in the third stage of coxarthrosis is surgery - endoprostheses (atroplasty) of the hip joint.
The stent consists of two elements: a head and a cup.
This operation is not simple:
- After surgery, a long period of rehabilitation is necessary.
- Healing of the joint is painful (the pain can persist for a year).
- You will need to walk for a while using a walker or using a cane for support.