Osteoarthritis of the hip joint: symptoms, treatment, causes, complications

Osteoarthritis of the hip joint( medical name deforming osteoarthritis) is a degenerative and dystrophic disease of the musculoskeletal system.

It consists in the gradual destruction of cartilage with the proliferation of bone tissue, which leads to the formation of bone synostosis, completely limiting the mobility of the joint.

In some cases, because of bone osteophytes, reactive arthritis develops, which can easily be confused with rheumatoid arthritis. This explains the diagnostic errors.

The prevalence of the disease is 5-10%, and it increases with increasing age of the person. However, at present, this disease is found not only in elderly patients, but also in young people.

The relevance of arthrosis of the hip joint is due to the fact that in the absence of treatment after 10 years, a persistent impairment of joint mobility, leading to a person's disability, develops.

Causes of arthrosis of the hip joint

From the point of view of causative factors this disease must be classified into primary arthrosis and secondary. With the primary changes develop on the unchanged cartilage as opposed to the secondary. The main predisposing factors that increase the likelihood of developing hip arthrosis are as follows:

• increased joint strain as occupational hazard
  
• cartilage infringement violation
  
• microcirculation disorder in the cartilaginous tissue
  
• metabolic disorders that lead to accumulation in the joints of various chemicals that graduallydestroy
  
• autoimmune processes in the body that destroy cartilage
  
• long walking
  
• chondrodystrophy
  
• frombody weight
  
• hypermobility of joints, etc.

Symptoms of arthrosis of the hip joint

The main symptoms that characterize the deforming arthrosis of the hip are as follows:

1. 1) The pain that occurs with prolonged strain on the joint, for example, as a result of a long walk. These pains peak in the evening and become insignificant at rest and during sleep
   
2. 2) Pain "starting" nature. They are manifested by painful sensations arising at the beginning of the movement, but gradually they decrease after several movements of
   
3. . 3) Blockage pain or periodic jamming in the joint. It is associated with the presence of an articular mouse - pieces of necrotic cartilage, which falls between the articular surfaces. When the movement results in the removal of this piece, the pain is stopped
   
4. 4) The crunch in the joint
   
5. 5) The joint deformation that is associated with the bony growths
   
6. 6) The pronounced restriction of mobility in the joint - first the hip is rotated to the inside and its retraction, then the hip rotation suffersoutside and its reduction, at the last turn suffers flexion and extension of the hip joint
   
7. 7) Lame on the aching leg, and if the pathological process is bilateral, this leads to a duck walk( patient)
   
8. 9) First the pains appear in the inguinal region and then gradually irradiate to the knee
   
9. 10) Atrophic changes of the femur and gluteus muscles
   
10. 11) Over time, the flexion position developslimb, leading to its shortening.

In some cases, these symptoms change as a result of the appearance of reactive arthritis. It manifests itself with the following symptoms:

• joint reddening
  
• its defogging - change in shape due to inflammatory edema
  
• local skin temperature increase over the hip joint
  
• permanent joint pain.

And also, we recommend that you familiarize yourself with other forms of the disease:

• arthrosis of the knee joint
  
• arthrosis of the ankle
  
• arthrosis of the shoulder joint
  
• arthrosis of the foot

Diagnosis of arthrosis of the hip joint

Diagnostic search for suspected deforming arthrosis of the hip is primarily to conduct its radiographic examination.the main signs confirming the diagnosis are the following:

• narrowing of the gap between the articular surfaces of bones
  
• appearance of osteophytes - bony outgrowths
  
• gradual flattening of the femoral head
  
• calcification of the soft tissues that surround the joint.

Based on the results of the X-ray study, the stage of the disease is determined. The first stage of the disease is characterized by a change in bone structure, densification of the bone in the subchondral zone, the appearance of small osteophytes along the edge of the joint surface.


It is almost completely absent in the fourth stage of the disease, the epiphyseal ends of the bones have a sharply altered shape. In addition to the X-ray study, the following studies should be included in the diagnostic program:

• a general clinical blood test that does not detect abnormalities of the
  
• biochemical blood test that shows an increase in serumucoid, fibrinogen and sialic acids only in the development of reactive synovitis
  
• general clinical urine analysis without changes
  
• synovial biopsyshell and its histological examination
  
• puncture of the joint and the production of synovial fluid with its subsequentcytological study of
  
• biopsy of cartilaginous tissue and its histological examination.

However, for a reliable diagnosis, a thorough evaluation of the clinical picture and radiographic data is sufficient. All other studies are conducted according to the indications.

Possible complications of

The main complication that develops against the background of a steady progression of coxarthrosis is immobility of the patient with bilateral hip joint damage.

Against this background, a person can not move independently, and becomes disabled. And in the case of prolonged immobilization, the probability of hypostatic pneumonia increases dramatically, which has a high percentage of deaths.

Treatment of arthrosis of the hip joint

Treatment of deforming arthrosis of the hip follows such goals as:

1. 1) Deceleration of the progression of the pathological process
   
2. 2) Reduction of the pain syndrome
   
3. 3) Treatment of developed synovitis
   
4. 4) The maximum possible restoration of joint function.

To achieve these goals, both conservative therapy and orthopedic treatment can be conducted.

Conservative therapy includes:

• administration of drugs that improve cartilage regeneration processes( chondroprotectors)
  
• use of drugs that have anti-inflammatory properties( non-steroidal anti-inflammatory drugs or corticosteroids)
  
• use of drugs that improve microcirculation in cartilage and subchondral bone
  
• use of physiotherapy techniques
  
• massage and exercise therapy, which prevent the development of mantiplaque atrophy.

Orthopedic treatment of arthrosis also occupies an important place in the care of such patients. It may be different depending on the condition of the hip joint.

At the initial stages, the use of special fixative bandages, which limit the load on the joint and prevent additional traumatization of the cartilage, is shown. If the disease is more advanced, then the use of orthopedic walking sticks and crutches is shown to unload the patient's joint.

In some cases, it is necessary to resort to surgical intervention. Modern orthopedics has a large arsenal of artificial joints, which allow a sufficient volume to restore the function of the broken hip joint.

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