Osteoarthritis (arthrosis) of the hip joint is a chronic, progressive pathology in which degenerative-dystrophic processes occur in the area of the pelvic joints. More precisely, the hyaline cartilage that covers the head of the femur and the acetabulum, the surfaces of the pelvic bones that are in contact with each other, are destroyed.
Another name for the pathology is coxarthrosis of the hip joints.
Osteoarthritis of the hip joints: characteristics of the disease
The most common first-hand knowledge of what coxarthrosis is is for the elderly, mostly women, who are at risk of developing pathology after the age of 45. This selective appearance of pathology arises from the specific structure of female pelvic bones, as well as from their direct participation in the birth process. In men, osteoarthritis of the hip (coxarthrosis) occurs mainly after the age of 65.
An important role in the pathogenesis of coxarthrosis is played by the natural aging of the organism, when the joints of the bones that are under the greatest stress begin to collapse.
Also, the disease can be caused by a number of infectious, traumatic, non-inflammatory diseases, their combination. Initially, osteoarthritis is manifested by pain and decreased movement activity in the pelvic area, but then its consequences become more serious - the affected limb is shortened.
Classification of diseases
The types of osteoarthritis of the hip joint depend on the characteristics of its development and the cause. There is often post-traumatic osteoarthritis of the hip joint - it occurs after an injury. The classification also includes the following types of osteoarthritis:
- Dysplastic - due to dysplasia that occurred in childhood but was not cured;
- Static - associated with uneven load in the pelvic area, which occurs with pathologies of the feet, knees, ankles;
- Postinfectious - occurs after various inflammatory diseases;
- Primary chronic - develops in older people due to aging.
Any type of disease can be called "deforming arthrosis of the hip joint", because the pathology leads to a violation of the shape and appearance of the pelvic articulation of the bones.
In addition, the disease is divided into 3 degrees according to the severity of the changes, the symptoms of which are described below.
Reasons for the development of osteoarthritis
Signs of coxarthrosis can occur even in the absence of obvious preconditions, which is a consequence of natural degenerative processes in the joint. It has a narrow gap, and can withstand large and constant loads, so it wears out earlier than the others. Initially, the blood circulation in the tissues is disturbed, so the nutrients are delivered to the hyaline cartilage to a lesser extent. Metabolic processes are disturbed, cartilage dries, cracks are formed on it. Furthermore, the joint surfaces wear out quickly, they are destroyed - the arthrosis of the hip joint progresses. Symptoms can appear even faster if the body is affected by a number of provoking factors:
- Any injury;
- Physical work, heavy sports;
- Diseases of the spine, including curvature;
- flat feet;
- Arthritis on the background of the infectious process;
- Childhood dysplasia transmitted in childhood;
- Metabolic diseases;
- Excess weight;
- Rheumatism and other autoimmune pathologies.
Against the background of the influence of such factors, the disease can develop much faster - after 30-40 years.
Symptoms of coxarthrosis
The signs of osteoarthritis of the hip joint largely depend on its degree. There are three stages during the pathology:
- First degree. There are pains during physical overload - after a long walk, running, in connection with which there are pains, dull feelings in the pelvic area (they pass after a short rest). The pain does not spread to other parts of the leg. Deforming arthrosis of the hip joint of the 1st degree does not cause changes in gait, the muscles function completely. By the end of the stage, small limitations in leg movement may occur;
- Second degree.The pain of osteoarthritis of the hip joint in this case becomes more pronounced. The pain occurs with minimal effort, discomfort is present in the evening after the working day. Pain occurs at night, at rest. Crunching, feeling of friction in the joint. If a person walks for a long time, then rocking movements can be noticed while walking. It becomes difficult to put on shoes, pull your foot to the side;
- Third degree.The work of the pelvic bones is seriously disturbed (in primary arthrosis both joints are affected, in other types usually only one). The pain in the groin is constant, painful, giving in the knee. The thigh muscles are atrophied. The leg becomes shorter, so the person uses crutches and a walking stick.
Later, ankylosis occurs in which movement becomes impossible at all.
Diagnosis of the disease
What is coxarthrosis of the hip joint, what is its degree and how to treat the disease? All problems should be resolved after diagnosis. Despite the fact that the main method for diagnosis is radiography, the patient needs consultation with a number of narrow specialists and testing. This will help to discover the cause of the disease and act on it. Thus, coxarthrosis can be caused by osteochondrosis, flat feet, urological and gynecological infections, and their treatment will help stop the destruction of the bone joint.
As for making an accurate diagnosis and determining the degree of arthrosis, all changes are perfectly visualized on the image - X-ray or CT (MRI):
- The first degree is a slight narrowing of the gap, the appearance of marginal osteophytes;
- Second degree - narrowing of the joint space by 50% of the norm, the appearance of osteophytes on the outside and inside of the gap, deformation of the femoral head, often - the presence of inflammatory changes in the tissues near the bone joint;
- The third degree is a sharp deformity of the joint, the presence of large osteophytes, sclerosis zones.
Treatment of osteoarthritis
Conservative treatment
Ointments, creams, tablets for osteoarthritis of the hip help only in the first phase of the disease. Medications can completely restore cartilage, and it is important to start therapy at an early stage. NSAIDs, corticosteroids, chondroprotectors, hyaluronic acid-based drugs, and muscle relaxants are commonly used. They also deal with massage, exercise therapy and therapeutic exercises.
In the second phase, it is necessary to connect physiotherapy and mechanical methods of impact on the joint. These include aspirator, UHF, magnetotherapy, shock wave therapy, ultrasound, laser, inductothermy, electrophoresis. Folk remedies for osteoarthritis of the hip, as well as local remedies, are of only secondary importance, and the main method of therapy should be drugs.
Be sure to apply a diet for coxarthrosis of the hip joint, it is needed to normalize metabolism and improve cartilage nutrition.
Endoprosthetics for osteoarthritis
The third stage of the disease can only be treated surgically. The patient is recommended joint replacement surgery, ie arthroplasty. The surgeon cuts off the head of the femoral bone, inserts a metal needle into the incision to which the artificial head is attached. After the operation, a long rehabilitation and exercise therapy is performed, but then the hip joint will be fully functional, and the doctor will be able to answer the patient in the affirmative to the question of whether squatting is possible with osteoarthritis of the hip joint.
Disease prevention
To prevent osteoarthritis of the hip joint, sports and a healthy lifestyle must come to the fore. It is impossible to overload the joints, but it is necessary to eliminate hypodynamics. Suitable for walking, swimming, skiing, elliptical trainer. It is also important to lose weight and eat properly.
Prevention of osteoarthritis of the hip joint is also based on the early treatment of all bruises, injuries that affect the pelvis and spine. All congenital pathologies of the joints should also be eliminated in childhood.
Answer popular questions
- Who to contact with arthritis? The question of which doctor treats coxarthrosis of the hip joint has no definitive answer. Of course, it is initially advisable to contact a surgeon, traumatologist or orthopedist, depending on the capabilities of the clinic. An arthrologist deals with pelvic joint problems in specialized centers, but it is not always possible to find such a narrow specialist.
Depending on the cause of the disease, in the future you will have to report and treat in parallel under the supervision of a rheumatologist, neurologist, infectologist and a number of other doctors;
- Can Arthritis Be Cured? This disease is chronic and impossible to completely eliminate, especially since the main cause is aging. But if you go to the doctor when there is arthrosis of the 1st degree of the hip joint, you can cure all the existing changes, and then prevent rapid progression. In the following phases, it is possible to stop and correct all existing pathological changes, and live normally with regular courses of therapy. Only arthroplasty can save the joint from arthrosis, but it also has a number of disadvantages - from the need for periodic replacement of dentures to postoperative complications - pain, thrombosis, infection;
- When are local therapies sufficient, and in which cases can a visit to the doctor be avoided? Any ointment can only slightly improve the microcirculation of blood in the joint area, and also relieve pain, but they have no therapeutic effect. In addition, this joint is located very deep, which makes it difficult to penetrate the active substances. Therefore, it is necessary to consult a doctor at any stage of the disease, regardless of the severity of the manifestations. Only in the early phase can the disease be stopped with "a little blood" without surgery.
Osteoarthritis of the hip joint is a disabling pathology that makes a person crippled, preventing him from walking.
The only way to prevent the development of such problems is to start conservative therapy in stages 1-2 of the disease, not forgetting to conduct regular and full-fledged courses.