Coxarthrosis (osteoarthritis of the hip joint) is a degenerative-dystrophic disease of the hip joints, accompanied by damage to articular cartilage, bone tissue and periarticular structures, leading to persistent loss of joint function.
Arthrosis of the hip joints is one of the most serious dystrophic pathologies assisted by money from the musculoskeletal system. The disease quickly leads to a decrease in physical activity, a change in the nature of a person's movements, often - to the impossibility of independent movement and disability. Several decades earlier, coxarthrosis was considered one of the "diseases of old age", but since the beginning of this century there has been a high incidence in young and middle-aged patients, associated with several reasons.
Statistics
Osteoarthritis is the most common pathology of the musculoskeletal system and occurs in 70% of adults; coxarthrosis - in 25% of patients with orthopedic profile. Up to 30% of patients diagnosed with coxarthrosis are disabled, have a disability and need joint replacement surgery.
The disease occurs from 20 to 25 years, the average age of onset of symptoms is 37 to 39 years, progresses with age, which is associated with the presence of concomitant pathologies of the musculoskeletal system, bone loss, etc. In middle-aged patients, the prevalence of coxarthrosis is 11%, in people over 85 years old - 35%. In children and adolescents, coxarthrosis is a consequence of congenital dysplasia of the joints, which occurs in 1% of newborns.
Reasons for development
The reasons that lead to the development of arthrosis of the hip joint have different meanings depending on the age and general health of each patient:
- congenital disease of the normal anatomical shape of the joints - deformities of the femoral neck, congenital dislocation of the hip;
- deformation of the femoral head due to dystrophic (age-related) processes in the joint;
- traumatic injuries - fractures, dislocations, non-physiological, including sports, joint loads;
- infectious and inflammatory diseases - tuberculosis, osteomyelitis and others;
- rheumatoid arthritis and other systemic diseases (allergic, metabolic);
- if the exact cause of the disease has not been established, and it has developed on its own, the term "idiopathic coxarthrosis" is used.
Symptoms of coxarthrosis of the hip joint
Pain is the main symptom. Its severity and the addition of other manifestations of coxarthrosis depend on many factors, in particular body weight, lifestyle and age. In the initial stage, patients notice moderate and intermittent pain in the hip joints, which occurs mainly during physical exertion and goes on its own. So the pain starts with light loads, it doesn't go away at rest, it "shoots" in the knee joint. The mobility of the joint or both joints is limited.
Patients are forced to limit physical activity, lameness, "duck walking" appears. In the final stage, constant and excruciating pain is observed, mobility in the hip joints is severely limited, walking is only possible with a cane or crutches, patients need assistance 24 hours a day, they are disabled.
Development
As the disease progresses, the hip joint gradually collapses and completely loses its function.
There is a narrowing of the articular cartilage and a slight narrowing of the joint space. The bone tissue located under the cartilage becomes more dense. At this stage, the pain appears after physical exertion.
In the second stage, the destruction of the cartilage progresses. Marginal osteophytes appear - bone growths. The narrowing of the joint space progresses. Pain occurs when walking, limiting joint mobility (contracture).
In the final stage of coxarthrosis, bone growth is extensive, flattening and subluxation of the femoral head occurs, the joint space practically disappears. Constant severe pain, joint mobility is significantly limited.
Diagnosis of Coxarthrosis
If you experience pain in the groin area, limited joint mobility and other symptoms listed above, you can see a therapist, but the primary medical specialist who diagnoses and treats osteoarthritis of the hip joint is an orthopedic traumatologist.
The main method of diagnosing coxarthrosis is radiography. This is an informative method that allows to accurately assess the structural changes in the affected joints. Due to its cost-benefit and accessibility, joint radiography is still widely used. X-ray computed tomography is a more informative (but expensive) method. Magnetic resonance imaging (MRI) of the joints is also used. It is performed to detect coxarthrosis in the pre-radiological phase (when there are no changes on the radiographs), as well as for the differential diagnosis.
Treatment of coxarthrosis of the hip joint
In the early stages of coxarthrosis, with a favorable course of the disease, conservative methods using physiotherapy techniques, including kinesiotherapy, massage and physiotherapy, in particular, water and mud therapy, a physiotherapy complex are preferred. Among the physiotherapeutic techniques that have shown themselves well, magnetotherapy can also stand out.
Magnetic therapy for coxarthrosis is used for several purposes. Under the influence of a magnetic field in the body, regeneration processes are activated, including in bone tissue, blood circulation is improved. This last point is especially important, as in osteoarthritis there is an insufficient supply of blood to the joints and, therefore, a deficiency of nutrients to maintain the normal state of cartilage and bone tissue, which can aggravate pathological changes in the joint. Improving blood circulation in the area of the hip joints helps to restore the flow of essential nutrients to the joints, activates the metabolism in bone and cartilage tissue, which is the basis for the positive effect of magnetotherapy on coxarthrosis.
In addition, due to the increase in metabolic processes and the release of certain biologically active substances, the anti-inflammatory and analgesic effect of magnetotherapy is observed.
Diet therapy is recommended to normalize metabolism and reduce body weight. Along with a rational diet, it is possible to use auxiliary drugs (biologically active drugs and pharmaceutical additives) that affect the metabolic and recovery processes of the musculoskeletal system - based on glucosamine and chondroitin (chondroprotectors), minerals and vitamins, standardized plant extracts.
Preparations with anesthetic and anti-inflammatory effect, namely NSAIDs, GCS, muscle relaxants and some others, are used in all stages of coxarthrosis to eliminate pain and inflammation. Its use must be strictly dosed, under the supervision and prescription of a doctor.
In the second or third stage of the disease, depending on the patient's symptoms and condition, it is recommended to continue conservative treatment or surgery. Currently, several surgical methods are used, the best results (complete restoration of joint functions and human mobility) are achieved with total arthroplasty - replacement of the hip joint.
Drug therapy, diet therapy and lifestyle changes, physiotherapy and spa treatment are also recommended, both in the case of surgery and in a conservative approach. Physiotherapy techniques in complex treatments can reduce the amount of medication and the load on the body, promote a faster recovery after surgery and improve the general condition of the patient. In particular, magnetotherapy shows good efficacy and tolerance, even in debilitated elderly patients and people with chronic diseases of the nervous and cardiovascular systems.
Prevention of hip arthrosis
As a preventive measure, the early detection of coxarthrosis at an early stage is very important. If you find symptoms (pain, mobility problems) in the area of the hip joints, you need to see a doctor - you can first visit a therapist and then an orthopedic surgeon. The therapist can prescribe the initial pain treatment, recommend chondroprotectants and the orthopedist will prescribe special treatment.
Absence of overweight and normal physical activity, correction of working conditions and lifestyle in general, as well as the timely treatment of diseases that can become one of the causes of the development of coxarthrosis (inflammatory, infectious diseases of the joints, congenital anatomical defects of the joints, degenerative dystrophic diseases).