Arthrosis 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 loaded bony joint.Therefore, coxarthrosis (deforming arthrosis of the hip joint) is a very common cause of disability in patients over 50 years of age.
Coxarthrosis (arthrosis of the hip joint): symptoms
Reasons
The causes of coxarthrosis are different.This pathology can lead to:
- Age-related dystrophic changes in cartilage.
- Constant physical activity among athletes and carrying heavy loads over a number of 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 surfaces of the hip are affected.
Symptoms of arthrosis of the hip joint
When diagnosed, the following symptoms of hip arthrosis are observed:
- Condition of the cartilage, it becomes dry and rough.
- Thickening of the lower bone, its growth to the sides.
- Fibrotization and inflammation of the joint capsule.
- Appearance of inflammatory exudate in the capsule.
- Joint stiffness, occurrence of contractures.
Externally, these changes are manifested by the following symptoms:
- Pain in the joint, spreading to the groin, hip and knee.
- Initial (morning) symptom of pain that disappears after warming up.
- A stiff, unsteady, limping gait.
- By shortening the leg on the affected side (contracture is the reason).
- Weakening and atrophy of the femoral muscle.
- Crackling in the wrist.
Stages of the disease
Based on the signs and symptoms, three stages of the disease can be distinguished:
First
- Discomfort and pain usually disappear with rest.
- Absence of external symptoms - lameness, stiffness, atrophy.
Such signs do not particularly disturb patients, and few people pay attention to episodic pain, and even fewer begin to treat it.
But just in 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 are reduced:
- limitations in hip abduction and internal rotation appear
- lameness is observed
- X-rays show:
- marginal osteophytes;
- deformation of the head and change of its contour;
- reduction of joint space.
The third phase
- The pain becomes constant, and the worst night pain begins.
- The patient is forced to lean on a stick.
- There is a sharp restriction of movement and atrophy of the gluteal, thigh and calf muscles.
- Leg shortening and lameness are noticeable.
- Due to overgrown 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 the age of 50-60, when deformations in the joint become significant, which affects the quality of life.
Diagnostics
X-ray and functional diagnostics are performed.The orthopedist not only deciphers the image, but also rotates, bends the femur in all directions and studies the symptoms that occur when walking.
However, more and more often, if a patient is suspected of having coxarthrosis of the hip joint, leading experts refer to diagnostics using magnetic resonance imaging (MRI).The explanation for that is the absolute safety and high informativeness of the procedure.It is the MRI examination that makes it possible to detect even the smallest 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:
- Chondroprotectors.
- Light physical therapy - swimming, aerobics, walking and cycling.
- Regulation of permitted physical loads on the joint.
- Weight correction (downward).
- Physiotherapy treatment
- Extraction procedures.
- Massage sessions.
- Poultices on the area of pain.
Painful symptoms can be alleviated with NSAIDs.
Annual sanatorium treatment is also very effective.
Pain-relieving 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 complete obliteration of the hip joint.Chondroprotectors are absolutely useless in this case.
All kinds of external medicines in the form of ointments and gels can relieve muscle spasms and pain, but, of course, they will not affect the condition of the diseased immobilized joint in any way.Therefore, you must sensibly approach all types of advertising that ensure that by smearing a sore spot with ointment, you can 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 - endoprosthetics (arthroplasty) of the hip joint.
The endoprosthesis consists of two components: the head and the cup.
This operation is not easy:
- After surgery, a long period of rehabilitation is required.
- Joint healing is painful (pain can last for a year).
- You will have to walk for a while with the help of a walker or using a cane as support.