Coxarthrosis - degenerative disease that leads to destruction of the hip joint and has a chronic course. More common in older age groups. More common in women than men.
Onset is gradual and progresses slowly. Can affect a set or two. It is the most common type of osteoarthritis.
Why is the disease?
Osteoarthritis in some patients is accompanied by the natural aging process is the degeneration of the tissues of the hip joint. Its appearance is influenced by these factors:
- reduces tissue nutrition,
- anomaly, congenital, of the hip joint, in particular, dysplasia;
- trauma pelvic;
- post-infectious hip;
- aseptic necrosis of the head of the hip joint;
- The disease of Perthes (osteochondropathy).
Unfortunately, in order to determine the cause of the disease is not always possible, and pathology of the hip joint is called idiopathic coxarthrosis - that is so, the cause of which has not been established. This is the incentive for continuous study of the problem. Scientific papers in this field and the doctors came to the conclusion that an increased risk of osteoporosis observed in the following patients:
- Hereditary predisposition to the disease. Patients whose parents suffered from diseases of cartilage and bone, in most cases, also have this type of problems.
- The excess of weight. Important body weight is the load on the joints that are regularly subjected to mechanical work;
- Metabolic disorders, diabetes. This leads to poor supply of oxygen and nutrients in the joint tissues, causing them to lose their properties.
Know the main risk factors of the disease, and to plan the preventive measures to avoid it.
How to recognize the pathology of the hip joint?
The symptoms of osteoarthritis depends on the anatomical characteristics of the musculoskeletal system, the causes of the pathology and the stage of the process. Consider the main clinical manifestations:
- pain in the joints;
- irradiation of pain in the knee, thigh, groin;
- the stiffness of the movement;
- limitation of the mobility;
- violations walk, limp;
- the decrease in the mass of thigh muscles;
- shortening of the limb affected.
The clinical picture corresponds with the internal changes in the tissues of the joint. The symptoms increase gradually and in the early stages, the patient does not pay them enough attention. This is dangerous, because in the beginning of the treatment process involves a greater effect.
The clinical and radiological grade of osteoarthritis
Listed below are the specific symptoms for each grade.
- 1 degree. The patient experiences intermittent pain and discomfort. Discomfort bother after exercise, a long position in a stance static. Pain localized to the area of the joint and then passes the rest. At this stage of the process is to not hinder the motion and no shortening of the leg. The changes observed on radiographs - joint space narrowing, there are osteophytes (bony growths).
- 2 of the degree. Increase the intensity of the pain, that occur during the rest and radiates to nearby areas of the body. Appears limp after the man had walked or the swell. Limited range of motion of the joint. In parallel, a change of the x-ray images: displaced head of the femur, osteophytes grow on the inside and the outside of the edges of the acetabulum.
- Stage 3. The pain becomes permanent, appears day and night. Much worse up there appears a permanent limp. Drastically reduced motor function, atrophy of the muscles of the legs. changing the muscle tissue causes the leg a bit he stopped and becomes shorter. This leads to a deformation of the posture and the curvature of the body. The radiograph at this stage of the process: the total of the reduction of the gap between the surfaces of the joint, deformity of the femoral head, a significant growth of osteophytes.
Diagnostic program when the disease
The main method of diagnosis - x-ray. Can be used to determine the presence of the disease and its stage. In the x-ray to analyze the structure of the group on the topic of joint space narrowing, osteophytes, fracture of the head of the hip bone.
If there is a need to study the condition of the soft tissues of the magnetic RESONANCE is performed. It allows us to study in detail the state of the cartilage areas of the joints and muscles of the area of the region.
The modern methods and ways of treatment of coxarthrosis of the hip joint
Treatment of osteoarthritis can be conservative and surgical. Treatment of osteoarthritis is aimed at the following objectives:
- reduce the symptoms of pain;
- restoration of motor activity;
- the rehabilitation and the rehabilitation;
- prevention of complications;
- the improvement of the quality of life of the patient.
Initiation of treatment is the modification of risk factors. To do so, the doctor recommends the following actions:
- the normalization of body weight;
- avoid habits that are harmful;
- nutrition;
- the standardization of the physical activity;
- balanced drinking regime;
- a healthy sleep.
The conservative treatment are: pharmacological and non-pharmacological. Drug treatment includes nonsteroidal anti-inflammatory drugs, analgesics, chondroprotectors. They reduce the inflammation in the tissue, eliminates swelling and soreness, restore range of motion and improve the condition of cartilage.
Non-drug treatment includes, among other things, massage to the affected area. It stimulates the muscles that are opposed to its degeneration and the prevention of the shortening of the limb. Full and professional massage stimulates the flow of blood to the area of the joint, and this, in turn, leads to the normalization of metabolism in the tissues. Please keep in mind that massage is not always useful when coxarthrosis - is conducted only between the exacerbations and at certain stages of the process. Assign it to your doctor may, recommend the massage techniques, the multiplicity of treatments and the duration of the course.
Obligatory condition of treatment of physiotherapy. Is the prevention of contractures and progression of the disease. Exercises should be performed daily, only then have an effect. Exercises are chosen individually, and is prescribed by a doctor. Exercises to improve general health, reduce the risk of emotional disorders, strengthen the powers of the body.
Physical therapy is another method that is applied in coxarthrosis. Can be mud, medical baths and showers, magnetotherapy. The use of electro - and phonophoresis of medicinal substances.
If these methods of treatment did not lead to the effect or which must be applied to the final surgical treatment is necessary.
Surgical intervention with coxarthrosis
Surgical treatment is used with the ineffectiveness of conservative methods. This is especially true for a late diagnosis. Modern operational techniques and equipment of high quality operating permit to restore the structure and function of the joint, to restore human range of motion and a normal quality of life. The most effective method of surgical treatment is arthroplasty.
Indications of surgery are:
- coxarthrosis 2-3 degrees;
- the lack of effect of the therapy;
- total restriction of movement, walking.
Contraindications, which do not allow to perform the operation:
- decompensated renal, heart, liver;
- mental illness;
- the acute phase of the inflammatory process in the body.
For this purpose, the diagnosis preoperative. However, if it is possible to adjust the condition of the patient, preparation for surgery and after the intervention.
The operation consists in the removal of the affected tissue and the prosthesis. There are different models of implants. Different methods of fixation of the bone – cement and cement-free, the material from which the endoprosthesis. Of all the characteristics of the prosthesis and the complexity of the surgical procedure can I get information on consultation with the attending physician.
The recovery period after a surgical treatment
From the first day after surgery, rehabilitation is carried out under the supervision of a doctor. First, she is to carry out passive movements, then the load is increased gradually. Walking in the first time is allowed only with crutches, was allowed on the seat and squat.
Of course, the first time after the operation, there are restrictions on the loads. Don't be afraid - because without functioning of these limits should be preserved to the end of life. A decrease in physical activity after a surgical treatment, it is necessary to strengthen the position of the prosthesis, the restoration of the integrity of the bones, the healing of the wounds. Within 2 months should be excluded from the sporting activities physical exercise on the joint, a long walk and a bit of exercise. After complete recovery, the person returns to normal life, you can do sports and outdoor activities.
The service life of the prosthesis: the majority of the companies indicates a survival rate of about 90% for observation periods of up to 15 years.