Arthrosis of the hip joint is a complex disease with specific symptoms and complex treatment.The disease occurs against the background of metabolic disorders in the cartilaginous tissue of the joint cavity and head of the femur.
Arthrosis of the hip joint or coksartrosis is more common in the elderly.It is generally accepted that an inflammatory reaction plays the main role in the pathogenesis of the disease.After a large number of studies, it was proved that arthrosis occurs with atherosclerosis and diseases with metabolic disorders.
The essence of the disease
Coksartrosis is a disease based on metabolic disorders with atrophic and degenerative changes in the cartilage tissue of the hip joint.
You can not confuse arthrosis with arthritis.Unlike arthritis with arthrosis, non -infectious (aseptic) inflammation occurs, which develops and progresses for many years.
Pathogenesis of development:
- Violation of metabolic processes in cartilage.Cartilage tissue receives nutrients using diffusion.The slightest inflammation or edema leads to a lack of trace elements and minerals.
- Against the background of nutriental impaired processes, atrophic changes begin, cartilage tissue is refined, the amount of joint fluid and chondroblasts decreases.
- Due to the insanity and destruction of the cartilage, severe pain begins, there is a decrease in the amplitude of movements in the joints.
- The cartilage fabric is very much sophisticated, the fabulous slit is narrowing, the joint dystrophy occurs.
Until the onset of dystrophy, for more than one year takes place.The disease can only be stopped at the first stages, with the development of the third stage of osteoarthrosis, treatment is aimed at reducing symptoms and alleging the patient’s life, an alternative to medicines - endoprosthetics.
Reasons
The disease is polyetiological, there are many conditions and factors that can lead to arthrosis or provoke its progression.If the causes of arthrosis of the hip joint are not detected, such a disease is called idiopathic arthrosis.
The disease is not hereditary, but genetic pathologies in which cartilage dysplasia occurs can cause arthrosis of the hip joint.
Also, the cause of coksartrosis can be such diseases:
- Pertes syndrome - a characteristic sign of the disease is a violation of the delivery of nutrients to the cartilage tissue of the joint and the femoral head.It occurs in childhood, mainly boys are sick.
- Congenital dislocations and subluxation of the femur.In the process of injury, an inflammatory reaction and aseptic melting of the cartilage tissue and the femoral head may occur.
- Necrosis of the femoral head.It occurs due to damage to the upper artery, which is attached to the top of the head.
- Rheumatoid and juvenile arthritis.Against the background of the action of toxins or own antibodies, exudative inflammation develops in the joint.
Given the fact that the disease progresses slowly, the ailment can be on one side and two.
There are many factors contributing to the occurrence of arthrosis, they include:
- spine diseases (kyphosis, lordosis, scoliosis);
- metabolic diseases of the connective tissue;
- violation of the blood supply to the joint;
- atherosclerosis of large vessels;
- stress states;
- hip dysplasia;
- congenital deformations of the lower extremities;
- infectious diseases;
- inactive lifestyle;
- intake of alcohol, smoking;
- elderly age.
Do not forget that people who are engaged in stretching have a great risk of developing arthrosis in adulthood.
Also, one of the reasons may be traumatic damage to the components of the joint.After tissue damage occurs, an inflammatory reaction occurs, as a result of which cartilage can be replaced by connective.
Symptoms
Due to the fact that the disease is slowly progressing, the patient does not always pay attention to its first signs.It should be noted that with early diagnosis, the chances of remission of the disease increase.It is very important to start the treatment earlier, since in this way it is possible to avoid the occurrence of ankylosis and complete osteoarthrosis.
With arthrosis of the hip joint, symptoms can occur with different intensities depending on the loads and degree of the disease.
Clinical picture of osteoarthritis of the hip joint:
- Painful sensations that grow into severe pain on the front and lateral part of the thigh.Patients complain that the thigh hurts greatly during the turn or the load on the joint.
- The unpleasant sensations arising in the groin when walking, sometimes they are combined with pain in the thigh.
- The stiffness and limitation of the mobility of the limb in the hip joint.First, the function of leaving aside suffers, and then everyone else.
- Unpleasant sounds when walking, the joint can click or crunch.Constant pathological sounds can be the only sign of the disease.
- Morning stiffness, which passes in a couple of hours or before dinner.
Sometimes ignoring the possible consequences, people begin to take drugs for symptomatic therapy and thereby mask the progression of the destruction process in cartilage.
Degree of disease
The clinical picture depends on the degree of arthrosis of the hip joint and reactivity of the patient's body.If symptoms occur, as a rule, changes occur in x -rays.In medical practice, it is customary to distinguish three radiological stages, each of which has its own characteristics.
The degree of arthrosis regarding changes in x -rays:
1st degree arthrosis
It proceeds with minimal clinical manifestations, and therefore patients rarely seek help from a doctor.With an early diagnosis of the disease, the patient increases the chances of complete recovery.The initial period of the disease is characterized by small pains in the pelvis and thigh, pain increases against the background of physical exertion or prolonged walking.In second place in terms of frequency of manifestation comes a symptom of pain in the groin.At 1 degree, the pain is pulling and rarely occurs.The volume of movements is fully preserved.In an X -ray, minor changes are visualized.
2nd degree
In the event of a second degree, the patient begins to bother more acute and frequent pains that can occur at rest.Symptoms, as a rule, manifest itself in evening hours, and morning stiffness does not pass until dinner.During prolonged transitions, a symptom of lameness occurs, a person cannot fully load the diseased joint.Discomfort occurs during flexion or squats, degenerative processes progress in cartilage.Against the background of such changes, the leg can shorten, atrophy of the hip muscles and pelvis occurs.On the radiographs, a narrowing of the joint gap is visible, a periostal reaction grows.A large number of osteophytes are found in the lumen of the joint.
Final or diffuse 3rd stage of arthrosis
The third stage is characterized by the occurrence of motor dysfunction of the lower extremities.The patient complains of constant pain, which occurs for no reason.There is a shortening of the limb more than 5%, ankylosis occurs, the joint loses the ability to mobility.The radiograph shows the full closing of the joint gap and a large number of osteophytes against the background of bone deformation.Treatment of the 3rd degree is carried out only by an operational way.
Methods of treatment
The choice of methodology for treatment depends on the degree of osteoarthritis.In the first stages, comprehensive conservative treatment is used.The most difficult is the second stage, since conservative therapy is ineffective, and the indications for the operation are not enough.It is completely possible to cure arthrosis only with the development of the first degree of the disease.
After making a diagnosis of arthrosis of the hip joint, the doctor chooses treatment methods.The most commonly used:
- conservative treatment with drugs;
- surgical treatment;
- Exercise therapy and massage.
Each of the methods of treatment has its own characteristics, variations and specific goals.Conservative therapy is used for such purposes:
- The fight against the etiological factor.For example, metabolic or hormonal disorders can be corrected.
- Symptomatic treatment aimed at alleviating the patient's life and relieving aliteration symptoms.For this purpose, non -steroidal anti -inflammatory drugs are used.Most often, sodium diclofenac, nimesulide, ibuprofen are used from NSAIDs.
To get rid of constant pain, NSAIDs are taken almost every day, and this can affect the patient’s gastrointestinal tract and cause the development of peptic ulcer.
Surgical intervention is indicated with the third degree of arthrosis and is the only method for restoring walking function.The essence of the methodology is the complete or partial replacement of the joints of the joint with titanium endoprostheses.
Media physical education is an integral part of any rehabilitation measures.Exercise therapy and massage are aimed at improving blood flow in the joint.Also, exercise therapy is used to reduce the risk of ankylosis.
You should be careful when performing exercises, since you can damage the joint osteophytes.Tactics and exercises should be selected by a doctor based on your individual characteristics and clinical picture of the disease.