Coxarthrosis (osteoarthritis of the hip joint) is a degenerative-dystrophic disease of the hip joints, accompanied by damage to the articular cartilage, bone tissue and periarticular structures and leading to persistent loss of joint function.
Osteoarthritis of the hip joints is one of the most severe money-assisted-dystrophic pathologies of 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. A few decades earlier, coxarthrosis was considered one of the "diseases of old age", but since the beginning of this century, a high incidence has been recorded among patients of young and middle age, which is associated with various reasons.
Statistics
Osteoarthritis is the most common pathology of the musculoskeletal system and occurs in 70% of adults; coxarthrosis - in 25% of patients with an orthopedic profile. Up to 30% of patients diagnosed with coxarthrosis are disabled, receive a disability and require joint replacement surgery.
The disease occurs from 20-25 years, the average age of the onset of symptoms is 37-39 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 persons over 85 years old - 35%. In children and adolescents, coxarthrosis is a consequence of congenital dysplasia of the joints, which is observed in 1% of newborns.
Development reasons
The reasons leading to the development of arthrosis of the hip joint have different meanings depending on the age and general level of health of each patient:
- congenital disorder 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, loads on joints;
- 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 developed on its own, the term "idiopathic coxarthrosis" is used.
Symptoms of coxarthrosis of the hip joint
Pain is the main symptom. Their severity and the addition of other manifestations of coxarthrosis depends on many factors, in particular on body weight, lifestyle, age. At the initial stage, patients note moderate, intermittent pain in the hip joints, which occurs mainly during physical exertion and passes on their own. Then the pain begins at light loads, does not go away at rest, "shoot" in the knee joint. The mobility of the joint or both joints is limited.
Patients are forced to limit physical activity, a lameness, "duck gait" appears. At the final stage, excruciating constant pains are observed, mobility in the hip joints is sharply limited, walking is possible only with a cane or crutches, patients need round-the-clock assistance, are disabled.
Development
As the disease progresses, the hip joint gradually collapses and completely loses its function.
There is a thinning of the articular cartilage and a slight narrowing of the joint space. The bone tissue located under the cartilage becomes denser. At this stage, pain appears after exercise.
In the second stage, the destruction of cartilage progresses. Marginal osteophytes appear - bone growths. The narrowing of the joint space progresses. Pain occurs when walking, limitation of joint mobility (contracture).
At the final stage of coxarthrosis, bone growths are extensive, flattening and subluxation of the femoral head occurs, the joint space practically disappears. Constant severe pain, joint mobility is significantly limited.
Coxarthrosis diagnostics
If you experience pain in the groin area, limitation of joint mobility and other symptoms listed above, you can consult a therapist, but the leading medical specialist who diagnoses and treats arthrosis of the hip joint is an orthopedic traumatologist.
Radiography is the main method for diagnosing coxarthrosis. This is an informative method that allows you to accurately assess the structural changes in the affected joints. Due to its cost-effectiveness and affordability, joint radiography is still very widely used. A more informative (but expensive) method is X-ray computed tomography. Magnetic resonance imaging (MRI) of the joints is also used. It is performed to detect coxarthrosis at the pre-X-ray stage (when there are no changes on the X-rays), as well as for 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 are preferred, including kinesiotherapy, massage, and physiotherapy, in particular, water and mud therapy, a complex of physiotherapy. Among the physiotherapeutic techniques that have proven themselves well, magnetotherapy can also be distinguished.
Magnetic therapy for coxarthrosis is used for various purposes. Under the influence of a magnetic field in the body, regeneration processes are activated, including in bone tissue, blood circulation is improved. The latter point is especially important, since in osteoarthritis, there is an insufficient supply of blood to the joints, and hence a deficiency of nutrients to maintain the normal state of cartilage and bone tissue, and this can aggravate pathological changes in the joint. Improving blood circulation in the area of the hip joints helps to restore the flow of necessary nutrients to the joints, activates metabolism in bone and cartilage tissue, which is the basis for the positive effect of magnetotherapy in coxarthrosis.
Also, due to the enhancement of 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 (medicines and biologically active pharmaceutical additives) that affect metabolic and recovery processes in 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 at all stages of coxarthrosis to eliminate pain and inflammation. Their use should be strictly dosed, under the supervision and prescription of a doctor.
At the second or third stage of the disease, depending on the symptoms and condition of the patient, it is recommended to continue conservative treatment or surgery. Currently, various 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.
Also recommended are drug therapy, diet therapy and lifestyle changes, physiotherapy and spa treatment, both in the case of surgery and in a conservative approach. Physiotherapy techniques in complex treatment can reduce the amount of drugs and the load on the body, promote faster recovery after surgery, 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 arthrosis of the hip joint
Early detection of coxarthrosis at an early stage is very important as a preventive measure. If you find symptoms (pain, limited mobility) in the area of the hip joints, you need to consult a doctor - first you can visit a therapist, then an orthopedic surgeon. The therapist can prescribe initial pain management, recommend chondroprotectors, and the orthopedist will prescribe special treatment.
The absence of excess weight and normal physical activity, correction of working conditions and lifestyle in general, as well as 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, degenerativedystrophic diseases).