Arthrosis Of The Hip Joint - Causes, Symptoms, Degrees And Treatment Of Deforming Arthrosis Of The Hip Joint

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Causes, symptoms, degrees and treatment of arthrosis of the hip joint

Content:

• What is arthrosis of the hip joint?
• Causes of arthrosis of the hip joint
• Symptoms of arthrosis of the hip joint
• The degree of arthrosis of the hip joint
• Deforming arthrosis of the hip joint
• Diagnostics
• Treatment of arthrosis of the hip joint
• Prevention

What is arthrosis of the hip joint?

Arthrosis of the hip joint is a very complex disease in which the destruction of the hyaline cartilage, which lines the surface of the femoral head (has a spherical shape), and the acetabulum occurs. Arthrosis is a degenerative-dystrophic disease that most often develops in the elderly.

In specialized periodicals, the results of surveys and medical studies are often published, according to which the female half of the population who has reached the age of 40 is most susceptible to arthrosis of the hip joint. This is primarily due to the anatomical features of the female hip joint, which has a different shape and position than that of men. Such differences can be explained by the fact that the hip joint plays an important role in the process of childbirth. The bones of the female pelvis are under heavy stress every day, as a result of which they are more likely to be susceptible to various diseases. Males at a later age (by the age of 60) may experience arthrosis.

According to available statistics, patients who have undergone surgical treatment of arthrosis of the hip joint may develop various complications:

• blood loss during surgery;
• thromboembolism (pulmonary artery) - 0.05% of cases;
• development of infection (after surgery) - 0.5% -2% of cases.

Most often, in this category of patients, infection occurs in the area of the endoprosthesis that performs the functions of the joint. In this case, doctors perform a second operation, during which the endoprosthesis is removed, and then a course of antibiotics is prescribed.

During thrombolism, the patient has a blockage of the pulmonary artery. This type of complication is often fatal, especially for those patients who have a predisposition to blood clots. To prevent such a complication, after surgery, patients are injected with special drugs that reduce blood viscosity.

Severe bleeding during surgery is a common complication of surgical treatment of arthrosis of the hip joint. In modern medical centers there is a large supply of blood and its substitutes, thanks to which specialists can easily cope with this complication.

Causes of arthrosis of the hip joint

Modern medicine divides this disease into the following categories:

1. Primary arthrosis develops for no apparent reason.
2. Secondary arthrosis develops against the background of previous injuries of the hip joint.

To date, the following reasons for the development of arthrosis of the hip joint have been identified:

• depression, as well as prolonged stressfulness;
• excess weight (even a slight set of excess weight can cause the development of this disease, since an additional load will be exerted on the joints);
• suffered injuries: sprains, bruises, blows, fractures, etc.;
• inflammatory processes;
• damage to the cartilage tissue in the joint;
• diseases of the endocrine system (in particular diabetes mellitus) that have a negative effect on the work of the adrenal glands;
• poor heredity, against the background of which joint deformation can develop (a genetic predisposition to arthrosis is the most common cause of this disease);
• displacement or curvature of the thigh bones;
• hip dysplasia (most often diagnosed in newborns);
• protrusion of the acetabulum;
• sedentary (sedentary) lifestyle;
• changes in the structure of blood vessels;
• necrosis of the femoral head;
• violation of metabolic processes in the body;
• high concentration of uric acid in the patient's blood (determined by laboratory blood tests);
• gout, osteoradionecrosis, bone tuberculosis, Perthes disease, rheumatoid arthritis and other diseases in which the hip joint is infected with bacteria;
• degeneration of the synovial membrane of the joint into cartilaginous;
• violation of blood circulation in the hip joint;
• various neoplasms;

• hormonal disorders in the body;
• strong physical exertion exerted on the hip joint during sports;
• difficult working conditions;
• old age, etc.

Symptoms of arthrosis of the hip joint

With arthrosis of the hip joint, the following symptoms are observed in patients:

• strong pain in the hip and knee joints, as well as in the groin (pain syndrome accompanies this disease constantly, and with the progression of arthrosis it can integrate into the lower extremities);
• violation of motor function (due to excruciating pain, patients cannot move independently, which is why they are forced to use special devices: crutches, walking sticks);
• shortening of the lower limb (affected by arthrosis);
• a crunch in the joint that occurs with any movement;
• lameness and gait disturbance;
• stiffness and limited limb movements;
• when performing X-ray in this category of patients, atrophy of muscle tissues located in the thigh area is revealed;
• when conducting hardware diagnostics in patients, bone growths can be detected;
• at the 2nd stage of arthrosis, patients experience deformation and upward displacement of the femoral head (it significantly increases in size and takes on uneven outlines);

• at the 3rd degree of arthrosis in patients, the femoral head expands, as a result of which a narrowing of the joint space begins, etc.

The degree of arthrosis of the hip joint

Today, medicine knows three degrees of arthrosis of the hip joint. They are accompanied by certain symptoms and directly depend on the stage of the disease.

Signs characterizing arthrosis of the hip joint 1 degree

At the first stage of this disease, patients do not have pronounced symptoms, as a result of which people rarely go to a medical institution.

With the development of arthrosis of the hip joint of the 1st degree, the following occurs:

• the liquid begins to lose its properties;
• the consistency of the liquid becomes more viscous;
• fluid is not able to provide unhindered movement of the joint.

At the first stage of this disease, the structure of cartilage tissue begins to collapse, microcracks form in it. Over time, in the process of progression of arthrosis, there is a thinning of the cartilage tissue. In many patients, replacement processes begin to occur, against the background of which bone growths are formed at the location of the cartilage.

At the first stage, arthrosis of the hip joint is very easy to treat completely. The problem lies in the fact that patients, due to untimely access to specialists, cannot receive medical care. That is why doctors strongly recommend people who have found any of the symptoms of arthrosis to immediately visit the nearest clinic and undergo a comprehensive diagnosis.

Signs characterizing arthrosis of the hip joint of the 2nd degree

Arthrosis of the hip joint of the 2nd degree is accompanied by severe pain syndrome, which can integrate from the hip and pelvis into the knee. At this stage of the disease, patients experience severe damage to the cartilage tissue.

All damage can be seen thanks to X-ray:

• thinning of cartilage tissue;
• narrowing of the lumen between parts of the joint;
• changes in the structure of the femoral head;
• the appearance of various neoplasms;
• displacement of the head of the hip joint;
• the number of bone growths (osteophytes) increases.

When carrying out diagnostic measures in this category of patients, inflammation of the periosteum is revealed. If this disease is not treated in patients, pain will begin to increase, motor functions will be impaired, and dystrophy of muscle tissues in the lower extremities will develop. Such patients will experience unbearable pain, even while at rest.

Signs characterizing arthrosis of the hip joint of grade 3

With the transition of arthrosis of the hip joint to the third stage, patients have:

• excruciating pain;
• almost complete destruction of hyaline cartilage tissue;
• violation of motor functions (patients are limited in movement);
• muscle tissue atrophy;
• change in gait;
• shortening of the lower limb;
• deformation of the joint;
• severe narrowing of the joint space;
• the spread of bone formations (spike-shaped), etc.

At the 3rd stage, the treatment of this disease is possible only surgically, since no medications can restore cartilage and restore mobility to a person. Currently, this category of patients undergo sparing surgeries, during which the replacement of the damaged hip joint with an artificial prosthesis is performed. Thanks to endoprosthetics, patients, after undergoing long-term rehabilitation, can return to normal life.

Deforming arthrosis of the hip joint

Deforming arthrosis of the hip joint (coxarthrosis) is a severe form of osteoarthritis. This form of the disease is most often (in 40% of cases) diagnosed in patients who have visited a medical facility for problems with the musculoskeletal system. Both women and men who have reached 40 years of age suffer from deforming coxarthrosis. According to world statistics, deforming arthrosis of the hip joint is more often diagnosed in the female half of the population.

There are a large number of factors that provoke the development of coxarthrosis. The most important reason for the appearance of this disease is circulatory disorders in the pelvic organs. As a result, harmful enzymes begin to accumulate in the body of patients, which have a negative effect on the cartilage, leading to their gradual destruction.

The reasons for the appearance of coxarthrosis can be considered both physical and mechanical effects on the hip joint. Most often, this disease manifests itself in people who are professionally involved in sports. Excess weight also puts a strain on the patient's joints and on his body as a whole. Deforming arthrosis of the hip joint is usually accompanied by severe pain and limited mobility of the lower limbs. These symptoms should alert the patient and encourage him to go to a specialized medical institution. At the reception, the patient will be examined and an X-ray will be prescribed, which will determine the degree of damage and the type of arthrosis.

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Diagnostics

Many people who develop arthrosis of the hip joint may be concerned about pain when walking or any other physical activity. Initially, the pain syndrome occurs only with physical overwork, but as a result, patients begin to experience torment even during rest. Pain is often integrated from the area of the hip joint into the lower back, knee, hip, etc. Against the background of pain, some people begin to self-medicate, which often leads to irreversible consequences. That is why it is necessary, when such a primary symptom of arthrosis appears, to contact highly qualified specialists who will diagnose.

When visiting a medical facility, patients who are suspected of having arthritis of the hip joint should seek the advice of the following highly specialized specialists:

1. Therapist. This specialist will assess the patient's general health and determine the cause of the pain syndrome (sometimes pain occurs due to the progression of various chronic diseases).
2. Neurologist. Very often, pain in the hip joint is a consequence of the formation of intervertebral hernias, therefore, when such symptoms appear, it is important to consult this specialist.
3. Urologist. In the male half of the population, pain in the hip joint occurs as a result of inflammatory processes in the prostate gland. A consultation with a urologist will confirm or deny such a suspicion.
4. Gynecologist. All women who have come to a medical institution with complaints of pain in the hip joint are referred to this specialist. This is due to the fact that during the development of the adhesive process in the pelvic organs, the patients often experience pain, therefore, when diagnosing arthrosis, it is important to obtain the conclusion of this narrow-profile specialist.
5. Rheumatologist or arthrologist. These specialists can diagnose arthrosis of the hip joint in the early stages of its development. With a timely appeal to a rheumatologist or arthrologist, the patient will be guaranteed a successful cure for this disease.
6. Orthopedist and surgeon. These specialists are referred to patients with advanced stage of arthrosis of the hip joint.

When carrying out diagnostic measures, the specialist will first of all conduct a personal examination of the patient and collect an anamnesis of the disease. During palpation, he will be able to feel the upper third of the lateral surface of the thigh and identify serious damage on it.

The specialist can carry out a number of simple manipulations, thanks to which it will be possible to make a preliminary diagnosis - arthrosis of the hip joint:

• flexion and extension of the lower limbs;
• turns of the lower limbs inward and outward, etc.

To make an accurate diagnosis, patients are assigned hardware and laboratory examinations:

• X-ray examination (an X-ray will reveal any damage to the hip joint);
• arthroscopy;
• ultrasound examination of the pelvic area;
• magnetic resonance imaging or computed tomography (this diagnostic method allows you to identify arthrosis at the very initial stage of development, when it is not yet accompanied by pronounced symptoms);
• laboratory analysis of blood and urine (clinical, biochemical) will reveal any inflammatory processes in the patient's body.

The main task of hardware diagnostics is to identify arthrosis of the hip joint, as well as to determine the degree of this disease. It is very important to determine the cause of arthrosis, since the method of treatment of this disease will depend on this.

There are diseases (for example, tuberculosis of the bones) that provoke the development of arthrosis, in which traditional treatment cannot be carried out (such diseases can be detected by laboratory tests of urine and blood):

• use ointments and gels that have a warming effect;
• physiotherapy procedures carried out at high temperature conditions;
• massage;
• physiotherapy exercises, etc.

Treatment of arthrosis of the hip joint

At the first stage, arthrosis of the hip joint responds well to conservative treatment. The first task of the attending physician is to relieve pain that interferes with the patient's movement.

In the process of drug treatment, the following is performed:

• restoration of damaged cartilage;
• restoration of nutrition and blood circulation in muscle and cartilage tissues;
• the physical load on the damaged joint decreases;
• activation of the hidden reserves of the human body, which will contribute to tissue regeneration at the microcellular level;
• an increase in the joint space;
• restoration of joint mobility, etc.

During the drug treatment of arthrosis of the hip joint, the following drugs are prescribed for this category of patients:

• drugs with anti-inflammatory effect (non-steroidal);
• pain relievers;
• muscle relaxants that restore blood circulation in muscle and cartilage tissues;
• chondroprotectors capable of restoring the function of joints and stopping their destruction;
• steroids are prescribed to patients in the form of injections during an exacerbation of the disease to eliminate pain;
• medicines that can dilate blood vessels, etc.

During conservative treatment, patients should adhere to a diet specially designed for patients with arthrosis of the hip joint. The course of therapeutic therapy includes therapeutic massage, which is indicated for patients with stages 1 and 2 of arthrosis.

At the 3rd stage of arthrosis of the hip joint, patients undergo surgical treatment of this disease.

Before the operation, each patient must undergo mandatory training:

• take blood and urine tests;
• undergo a hardware examination (ultrasound, X-ray, fluorography, cardiogram, EEG, etc.);
• get advice from narrowly specialized specialists who will give permission to the operation (therapist, rheumatologist, arthrologist, orthopedist, etc.).

The day before surgery, the patient must stop eating solid food. Bowel cleansing is mandatory (this can be done both with special medications and with an enema). In the evening, the patient will be given a sedative injection to help him fall asleep. Before surgery, the patient should empty his bladder, into which a catheter will be inserted (it will drain urine during the operation). The patient in the operating room will have to lie on their side, after which the surgeon will make the markings.

Endoprosthetics is performed under general anesthesia (the type of which is chosen by the anesthesiologist based on the state of the patient's cardiovascular system), after which the patient will recover within a few hours. To prevent the appearance of a gag reflex after anesthesia, fluid intake should be limited for 5-6 hours. If the patient is tormented by strong thirst, he should moisten his lips with a gauze or cotton pad.

In order to exclude the formation of blood clots in the lower extremities, each patient is wrapped around the legs (up to the knees) with elastic bandages. He should wear such a tight bandage for 3-5 days after the surgical intervention, especially when moving (if the patient is in bed, in a supine position, he can remove the elastic bandages).

During endoprosthetics, the surgeon performs the following actions:

• cuts off the head of the femur;
• a pin made of a special metal used in the medical industry is inserted into the bone cut;
• the endoprosthesis is tightly fixed on the installed pin (it has an exact copy of the femoral head).

In detail: Endoprosthetics (replacement) of the hip joint

During surgery, the surgeon partially removes the surface of the pelvic bone. Instead, a stock made of polymer materials is installed. This bed is firmly connected to the titanium head, thanks to which the joint will be able to fully function in the future for 20 years. At the final stage of surgery, the wound is sutured and then a sterile bandage treated with antiseptic agents is applied to its surface.

Currently, surgeons perform endoprosthesis fixation in two ways:

• with the help of a fragment of cancellous bone (the prosthesis is driven in);
• with the help of special medical cement (it is used in the surgical treatment of bones).

Many specialists prefer to use bone cement during endoprosthetics, which very firmly fixes the prosthesis and allows patients to move independently after healing of the postoperative scar. This method is ideal for elderly patients. After such arthroplasty, there is no need for a second operation, the purpose of which is to replace the endoprosthesis.

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Recommended exercises for arthrosis of the hip joint

After undergoing a course of treatment for arthrosis of the hip joint, patients need to gradually return to their usual rhythm of life. Much attention should be paid to the restoration of the motor functions of the joint and lower extremities. For this, experts recommend undergoing rehabilitation, which includes both a special course of physiotherapeutic procedures and therapeutic gymnastics.

Arthrosis of the hip joint is a very dangerous disease that is difficult to treat. That is why when choosing the level of physical activity for patients, specialists take into account their age, the severity of the disease, the characteristics of their body, etc. Physical therapy classes should be carried out within the walls of special medical institutions, which have rooms equipped for these purposes. During daily workouts, patients are monitored by an orthopedic surgeon who will immediately come to the rescue if necessary.

So that physical activity does not entail a deterioration in the patient's condition, the following must be remembered:

• physical activity should be given gradually;
• each exercise should be performed carefully, without sudden movements;
• before starting classes, you need to warm up all the muscles (this can be done using a regular warm-up);
• if pain occurs in the hip joint during the exercise, stop the exercise for a while, etc.

Many experts recommend this category of patients to combine therapeutic gymnastics and other sports:

• swimming;
• skiing, etc.

The healing hip joint will benefit greatly from daily walks in the fresh air, during which strong physical exertion does not appear at the site of the injury. After the end of rehabilitation, carried out in a medical institution, the patient can perform a course of therapeutic exercises at home. During training with an instructor, each patient learns to correctly perform each exercise, as a result of which possible injury during independent physical education is almost completely eliminated.

For daily training, it is best to use special mats (orthopedic). During training, one should not forget about correct breathing, which should be corrected immediately if necessary. After completing the last exercise from the treatment complex, the patient should perform a small self-massage. For these purposes, you can use special massagers, thanks to which an additional load will be exerted on the weakened muscles.

If the patient discovers the following symptoms, he needs to stop daily activities for a while and contact a medical institution for advice:

• exacerbation of chronic diseases;
• increasing the temperature regime;
• increased blood pressure;
• diseases of the heart and blood vessels;
• hernias, cysts and other neoplasms, etc.

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Prevention

To prevent the development of arthrosis in the hip joint, it is necessary to timely prevent this disease:

• timely receipt of qualified medical care for any injuries of the hip joint;
• rejection of a sedentary lifestyle;
• playing sports;
• leisure;
• normalization of body weight;
• timely correction of congenital or acquired defects of the hip joint;
• proper nutrition;
• giving up bad habits (smoking, alcohol, etc.);
• water sports, etc.

Author of the article: Kaplan Alexander Sergeevich | Orthopedist

Education: diploma in the specialty "General Medicine" received in 2009 at the Medical Academy. I. M. Sechenov. In 2012 completed postgraduate studies in Traumatology and Orthopedics at the City Clinical Hospital named after Botkin at the Department of Traumatology, Orthopedics and Disaster Surgery.