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 and resulting in persistent loss of joint function.
Osteoarthritis of the hip joints is one of the most serious silver-assisted dystrophic conditions of the musculoskeletal system. The disease quickly leads to a decrease in motor activity, a change in the nature of a person's movements, often - 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, a high incidence has been recorded in young and middle-aged patients, which is associated withvarious 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 old, the average age of onset of symptoms is 37-39 years, progresses with age, which is associated with the presence of concomitant pathologies of the musculo-skeletal, bone loss, etc. In middle-aged patients, the prevalence of coxarthrosis is 11%, in people over 85 years - 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 osteoarthritis 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 loads, including sports, on the 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 has 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 depend on many factors, in particular, body weight, lifestyle, age. At the initial stage, patients note moderate, intermittent pain in the hip joints, which mainly occurs during physical exertion and passes on their own. Then the pain begins at light loads, does not go away with rest, "pulls" in the knee joint. Mobility of the joint or both joints is limited.
Patients are forced to limit physical activity, lameness, "duck gait" appears. At the final stage, constant excruciating pain is observed, the mobility of the hip joints is severely limited, walking is only possible with a cane or crutches, patients need 24-hour assistance, aredisabled.
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 under the cartilage becomes denser. At this point, the pain appears after physical exertion.
In the second stage, the destruction of the cartilage progresses. Marginal osteophytes appear - bony growths. The narrowing of the joint space progresses. Pain occurs when walking, limitation of joint mobility (contracture).
In the final stage of coxarthrosis, the bone growths are extensive, flattening and subluxation of the femoral head occurs, the joint space practically disappears. Constant intense pain, joint mobility is considerably limited.
Diagnosis of coxarthrosis
In case of pain in the groin area, limitation of joint mobility and other symptoms listed above, you can consult a therapist, however, the main specialist doctor who diagnoses and treats osteoarthritisof the hip joint is an orthopedic traumatologist.
The main method of diagnosing hip osteoarthritis is an x-ray. This is an informative method that allows you to accurately assess structural changes in the affected joints. Due to its cost effectiveness and affordability, 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 at the pre-radiographic stage (when there is still no change on the radiographs), as well as for differential diagnosis.
Treatment of coxarthrosis of the hip joint
In the early stages of hip osteoarthritis, with a favorable course of the disease, conservative methods using physiotherapy techniques are preferred, including kinesiotherapy, massage and physiotherapy, especially water therapy andmud, a physiotherapy complex. Among the physiotherapeutic techniques which have proved their worth, there is also magnetotherapy.
Magnetic therapy for coxarthrosis is used for a variety of purposes. Under the influence of a magnetic field in the body, regenerative processes are activated, including in bone tissue, blood circulation improves. This last point is especially important, because in osteoarthritis there is an insufficient blood supply to the joints, and therefore a deficiency of nutrients to maintain the normal condition of cartilage and bone tissue, which can worsen the pathological changes ofthe joint. Improving blood circulation in the area of the hip joints helps restore the flow of necessary nutrients to the joints, activates metabolism in bone and cartilage tissue, which is the basis of the positive effect of magnetotherapyin coxarthrosis.
In addition, due to the improvement of metabolic processes and the release of certain biologically active substances, the anti-inflammatory and analgesic effect of magnetotherapy is observed.
A diet is recommended to normalize metabolism and reduce body weight. Along with a rational diet, it is possible to use auxiliary preparations (biologically active drugs and pharmaceutical additives) that affect the 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 relaxers and a few others, are used at all stages of coxarthrosis to eliminate pain and inflammation. Their use must 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 the patient's condition, it is recommended to continue conservative therapy 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 pharmacotherapy, diet and lifestyle changes, physiotherapy and spa treatments, both in case of surgery and in a conservative approach. Physiotherapy techniques as part of 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 efficiency and good tolerance, even in debilitated elderly patients and people with chronic diseases of the nervous and cardiovascular systems.
Prevention of osteoarthritis of the hip joint
As a preventive measure, the early detection of coxarthrosis at an early stage is very important. If you find any symptoms (pain, reduced mobility) in the area of the hip joints, you need to see a doctor - first you can see a therapist, then an orthopedic surgeon. The therapist may prescribe an initial analgesic treatment, recommend chondroprotectors, and the orthopedist will prescribe special treatment.
The absence of overweight and normal physical activity, the 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 and infectious diseases of the joints, congenital anatomical anomalies of the joints, degenerative dystrophic diseases).