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 stressed bone joint.Therefore, coxarthrosis (deforming arthrosis of the hip joint) 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 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 hip surfaces are affected.
Symptoms of arthrosis of the hip joint
When diagnosed, the following symptoms of hip arthrosis are observed:
- Thinning of the cartilage, it becomes dry and rough.
- Thickening of the underlying bone, its growth to the sides.
- Fibrotization and inflammation of the joint capsule.
- The appearance of inflammatory exudate in the capsule.
- Stiffness of the joint, the occurrence of contractures.
Externally, these changes are manifested by the following symptoms:
- Pain in the joint, radiating to the groin, hip and knee.
- The starting (morning) pain symptom that goes away after warming up.
- A stiff, uncertain, limping gait.
- By shortening the leg on the affected side (the reason for this is contracture).
- Weakening and atrophy of the femoral muscle.
- A crunch in the joint.
Stages of the disease
Based on the signs and symptoms, three stages of the disease can be distinguished:
First
- Discomfort and pain, usually subsiding with rest.
- Absence of external symptoms - lameness, stiffness, atrophy.
Such signs do not particularly alarm patients, and few people pay attention to episodic pain, much 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 can persist even at rest.
- The functional characteristics of the hip joint decrease:
- restrictions on hip abduction and internal rotation appear
- lameness is observed
- X-rays show:
- marginal osteophytes;
- deformation of the head and change in its contour;
- reduction of joint space.
Third stage
- The pain becomes constant, and the most excruciating night pain also begins.
- The patient is forced to rely on a cane.
- There is a sharp restriction of movements and atrophy of the gluteal, thigh and calf muscles.
- There is noticeable shortening of the leg and lameness.
- 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 about it and remembers it already at 50-60 years old, when deformations in the joint become significant, affecting the quality of life.
Diagnostics
X-ray and functional diagnostics are carried out.The orthopedist not only deciphers the image, but also rotates, bends the femur in all directions, and studies the symptoms that arise when walking.
However, increasingly, if a patient is suspected of having coxarthrosis of the hip joint, leading specialists refer for diagnostics 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 physical therapy - swimming, aerobics, walking and cycling.
- Regulation of permissible physical loads on the joint.
- Weight correction (downwards).
- Physiotherapeutic treatment
- Extraction procedures.
- Massage sessions.
- Compresses on the area of pain.
Painful symptoms can be relieved with NSAIDs.
Annual sanatorium treatment is also very effective.
Pain-relieving intra-articular corticosteroid injections may be used to treat more intense pain in the later stages.
Treatment of coxarthrosis at a late stage is very difficult due to the complete erasure of the hip joint.Chondroprotectors in this case are absolutely useless.
All sorts of external remedies in the form of ointments and gels can relieve muscle spasms and pain, but, of course, will not in any way affect the condition of the diseased immobilized joint.Therefore, you need to take a sensible approach to all kinds of advertising that assures that by smearing the 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 (atroplasty) of the hip joint.
The endoprosthesis consists of two components: a head and a cup.
This operation is not easy:
- After surgery, a long rehabilitation period is required.
- Healing of the joint is painful (pain may persist for a year).
- You will have to walk for some time with the help of a walker or using a cane as a support.