Coxarthrosis of the hip joint: symptoms, treatment, causes, diagnosis
Coxarthrosis refers to a non-inflammatory disease, in which degenerative-dystrophic changes occur first in the articular cartilage lining the articulating bone surfaces, later the bones themselves change.
As a result of this progressively progressive course, the normal function of the joint is disrupted, which leads to the suffering of the entire musculoskeletal system.
The disease develops in people of the older age group. Started in the early stages of treatment can stop the destruction of cartilage, but in its late stages to prevent complete disability can only prosthetic joint.
Depending on the causes of the disease, arthrosis of the hip joint is:
1) Primary, the cause of which is unclear.
2) Secondary, the causes of which are:
The hip joint is represented by two bones: the head of the femur, which rolls along the acetabulum( the latter is similar to a shallow pial or a pocket).
Above, they are covered with a special articular cartilage. It resembles a spongy substance: it breaks down when there is no motion in the joint and is compressed during movements. When it is squeezed into the joint, a special liquid is squeezed out, which is the lubricant for the joints that are braced. In addition, the cartilage itself damages the movements perfectly, evenly distributing the load to the entire joint.
In coxarthrosis, the nutrition of the cartilage itself is disrupted. It is thinned, and then disappears islets. If the process is not stopped, in places of cartilage atrophy, a bone grows, which tries to "fill" the void. As a result, bone spines develop-osteophytes. This leads to a disruption of the congruence of the articulating bones, the "erasure" of the remaining parts of the healthy cartilage.
The first symptoms of coxarthrosis depend on the stage of the disease, as well as the degree of hip joint damage.
The main ones are:
Coxarthrosis of the 2nd degree - symptoms. More painful than before, the pain syndrome is felt not only in the hip joint, it radiates into the groin. Because of muscle atrophy, the knee begins to bother, which often hurts more than the ileo- femoral joint. Pain sometimes appears in a state of rest, and after a physical load, a long rest is needed to stop it. With long walking or running, a person begins to limp. The volume of movements in the joint is reduced;Muscle strength in all groups of femoral muscles is reduced.
Coxarthrosis of the third degree - symptoms. Hip joint hurts constantly. The painful syndrome affects the entire leg completely, which is felt not only when walking, but even at night. Develops insomnia, sleep disorders. The volume of joint movements is minimal. The muscles of the buttocks, thighs and tibia atrophy. When walking, a person is forced to use auxiliary means( a cane).
If arthrosis develops only in one hip joint, the weak muscles of this thigh stimulate lateral displacement of the pelvis, which causes the length of the affected leg to decrease.
Preliminary diagnosis can be made on the basis of complaints, examination of the patient, during which the tone and strength of the gluteus, thigh muscles and muscles of the shin are determined, and the volume of movements performed in the joint is measured.
An accurate diagnosis can be made on the basis of a joint radiograph made in two projections:
Key moments of coxarthrosis therapy depend on several factors:
1) Eliminate prolonged walking, lifting weights, running.
2) Of the medicines used:
4) LFK with an instructor for the course individually selected set of exercises.
5) Physiotherapy:
1) Drug therapy includes:
3) Exercise therapy.
4) Hydrocinesitherapy.
5) Classic and underwater massage.
In some cases, the function of the joint can only be restored with the use of hip replacement, when a metal joint of intact materials is replaced instead of the damaged one.
After such an operation from the first days you need to perform a set of exercises in which the muscles of the foot, shin and hips will participate. Walking without support is allowed from the 14th day after the operation. Partly load the joint can be a month after the intervention, the full load is allowed in six months. Then it is recommended to have a sanatorium treatment.
Coxarthrosis of the hip joint can be avoided if:
As a result of this progressively progressive course, the normal function of the joint is disrupted, which leads to the suffering of the entire musculoskeletal system.
The disease develops in people of the older age group. Started in the early stages of treatment can stop the destruction of cartilage, but in its late stages to prevent complete disability can only prosthetic joint.
Causes of coxarthrosis of the hip
Depending on the causes of the disease, arthrosis of the hip joint is:
1) Primary, the cause of which is unclear.
2) Secondary, the causes of which are:
- violations of blood supply to the joint or outflow of blood from it;
- hip dysplasia;
- of Perthes disease;
- diseases of the spine, which increase the load on the joint( kyphosis, scoliosis);
- overweight;
- congenital defect in the structure of cartilaginous tissue;
- injuries of the lower extremities( bruises, dislocations, fractures);
- arthritis( inflammation) of the hip joint;
- aseptic necrosis of the femoral head;
- bone tumors;
- surgical interventions performed on the joint.
Mechanism of development of coxarthrosis
The hip joint is represented by two bones: the head of the femur, which rolls along the acetabulum( the latter is similar to a shallow pial or a pocket).
Above, they are covered with a special articular cartilage. It resembles a spongy substance: it breaks down when there is no motion in the joint and is compressed during movements. When it is squeezed into the joint, a special liquid is squeezed out, which is the lubricant for the joints that are braced. In addition, the cartilage itself damages the movements perfectly, evenly distributing the load to the entire joint.
In coxarthrosis, the nutrition of the cartilage itself is disrupted. It is thinned, and then disappears islets. If the process is not stopped, in places of cartilage atrophy, a bone grows, which tries to "fill" the void. As a result, bone spines develop-osteophytes. This leads to a disruption of the congruence of the articulating bones, the "erasure" of the remaining parts of the healthy cartilage.
Symptoms of coxarthrosis of the hip
The first symptoms of coxarthrosis depend on the stage of the disease, as well as the degree of hip joint damage.
The main ones are:
- pain in the hip joint, which is amplified by movement, disappears at rest;
- lameness;
- stiffness in the femoral joint;
- progressive reduction in hip movement;
- decrease in volume and weakness of the thigh muscles( because of this and develop severe pain in the knee).
Coxarthrosis of the 2nd degree - symptoms. More painful than before, the pain syndrome is felt not only in the hip joint, it radiates into the groin. Because of muscle atrophy, the knee begins to bother, which often hurts more than the ileo- femoral joint. Pain sometimes appears in a state of rest, and after a physical load, a long rest is needed to stop it. With long walking or running, a person begins to limp. The volume of movements in the joint is reduced;Muscle strength in all groups of femoral muscles is reduced.
Coxarthrosis of the third degree - symptoms. Hip joint hurts constantly. The painful syndrome affects the entire leg completely, which is felt not only when walking, but even at night. Develops insomnia, sleep disorders. The volume of joint movements is minimal. The muscles of the buttocks, thighs and tibia atrophy. When walking, a person is forced to use auxiliary means( a cane).
If arthrosis develops only in one hip joint, the weak muscles of this thigh stimulate lateral displacement of the pelvis, which causes the length of the affected leg to decrease.
Diagnosis of coxarthrosis
Preliminary diagnosis can be made on the basis of complaints, examination of the patient, during which the tone and strength of the gluteus, thigh muscles and muscles of the shin are determined, and the volume of movements performed in the joint is measured.
An accurate diagnosis can be made on the basis of a joint radiograph made in two projections:
- 1) At the I stage, the hyperplastic process( growth of) the bone is insignificant, the bony projections are localized in the acetabulum only on one side around its articular surface. The femur is intact. The distance between the articulating bones is slight and unevenly narrowed.
- 2) II stage: productive process is observed on both edges of the acetabulum. Developed already, and small deformities of the head, as well as thickening of the neck of the femur. The distance between the head of the femur and the acetabulum is much less than the norm, uneven.
- 3) At stage III, bone hyperplasia is already observed from the femoral and from the iliac component of the joint. The cervix of the femur is considerably thickened, and the articulation gap, on the contrary, is considerably narrowed.
Treatment of coxarthrosis of the hip joint
Key moments of coxarthrosis therapy depend on several factors:
- of the patient's age;
- state of his health;
- of the stage of coxarthrosis.
1) Eliminate prolonged walking, lifting weights, running.
2) Of the medicines used:
- anti-inflammatory drugs in the form of ointments and tablets: Movalis, Indomethacin, Diclofenac, Reopirin, Celebrex;
- for improving tissue repair intramuscularly and in the form of tablets: "Milgamma", "Neurorubin", "Vitreous Body", "Aloe";
- chondroprotectors: "Artra", "Dona", "Structum";
- preparations for improvement of microcirculation in the joint: "Pentoxifylline", "Cinnarizine";
- preparations that eliminate muscle spasm: "Sirdalud", "Midokalm".
4) LFK with an instructor for the course individually selected set of exercises.
5) Physiotherapy:
- electrophoresis with Novocaine solution;
- laser therapy;
- magnetotherapy;
- ultrasound therapy.
- 1) Medications of the same groups are used, but preference is given to intramuscular or intravenous administration. In the joint 2-3 times can be administered hormones( "Kenalog", "Solumedrol") with severe pain.
- 2) LFK - it is obligatory.
- 3) Extension of the joint on the bed or on a special table, using a 5-7 kg load for several hours a day.
- 4) Massage of the thigh muscles.
- 5) Underwater massage of the thigh with water jet.
- 6) Electrostimulation of gluteal muscles.
- 7) Swimming.
- 8) Walking on skis - at stihanii pains.
1) Drug therapy includes:
- oral or intramuscular application of painkillers: Celebrex, Rofica, Diclofenac, Ibuprofen;
- to take chondroprotectors already usually does not make sense, since the articular cartilage is almost not there;
- hormones are injected into the joint: "Kenalog", "Hydrocortisone";
- in the joint cavity are introduced synthetic analogues of the joint "lubricant" - hyaluronic acid.
3) Exercise therapy.
4) Hydrocinesitherapy.
5) Classic and underwater massage.
In some cases, the function of the joint can only be restored with the use of hip replacement, when a metal joint of intact materials is replaced instead of the damaged one.
After such an operation from the first days you need to perform a set of exercises in which the muscles of the foot, shin and hips will participate. Walking without support is allowed from the 14th day after the operation. Partly load the joint can be a month after the intervention, the full load is allowed in six months. Then it is recommended to have a sanatorium treatment.
Prophylaxis of coxarthrosis
Coxarthrosis of the hip joint can be avoided if:
- treatment of inflammatory joint diseases;
- timely therapy of joint dysplasia;
- correct physical load: it should be, but squats, especially with a load, must be performed correctly;
- control of body weight;
- avoiding joint injuries.