Coxarthrosis Of The Hip Joint - Causes, Symptoms, 2 And 3 Degrees, Treatment. Gymnastics And Massage

2024 Author: Josephine Shorter | [email protected]. Last modified: 2023-12-16 21:43

Symptoms, degrees and treatment of coxarthrosis of the hip joint

Coxarthrosis of the hip joint is a persistent change in the integrity of the articular surfaces, which are based on a violation of metabolic processes. As a rule, coxarthrosis is a slow-onset disease that gradually affects the cartilaginous tissue with subsequent deformation of the bones and impaired functionality of the articular system.

Coxarthrosis is the most common disease among all degenerative-dystrophic pathologies of the musculoskeletal system, which occurs at the age of 40 years.

Content:

• Symptoms of coxarthrosis of the hip joint
• Causes of coxarthrosis of the hip joint
• The degree of coxarthrosis of the hip joint
• Diagnosis of diseases of the osteoarticular system
• Treatment of coxarthrosis of the hip joint
• Nutrition for coxarthrosis of the hip joint
• Prevention of coxarthrosis

Symptoms of coxarthrosis of the hip joint

Symptoms at different stages of development of coxarthrosis differ slightly. However, there are a number of common signs by which you can determine the onset of the development of the disease and take all the necessary measures to restore health. Often, patients turn to doctors at the later stages of the pathology, which significantly reduces the chances of a full recovery.

General symptoms:

• severe pain in the area of the affected joint is the main sign of joint damage; at the first stage, the pain manifests itself during movement, at the next stage it is permanent;
• stiffness (restrictions on movement) - in the early stages, this condition is observed after waking up or heavy physical exertion;
• a change in the length of the legs is a sign of an advanced form of the disease accompanied by deformity of the pelvis;
• muscle atrophy is the most severe symptom that manifests itself in the late stages of coxarthrosis; in the early stages, there is a slight weakening of the muscles;
• lameness, a clear change in gait is a sign of deformation of the skeletal system;
• pronounced crunch in the area of the joints, which may indicate a pathological lesion.

Causes of coxarthrosis of the hip joint

The reasons for the development of this disease can be very different, consider the most common:

• Violation of blood circulation in the area of the affected joint. For a variety of reasons, a person experiences a malfunction of the circulatory system - a deterioration in venous outflow and arterial inflow. As a result of all these processes, metabolic products accumulate in the tissues surrounding the hip joint, which contribute to the production of enzymes that destroy cartilage.
• Injuries. The development of coxarthrosis is facilitated by chronic microtraumas that contribute to the thinning and damage of cartilage.
• Excessive stress on the joint. The development of degenerative processes is facilitated by constant heavy physical activity, often in combination with predisposing factors.
• Obesity. A large body weight overloads the joint, thereby causing an inflammatory process, and subsequently deformation of the joint itself.
• Genetic predisposition. The disease is not directly inherited, the structural features of the cartilage, bone tissue and joints are transmitted. Therefore, with a number of unfavorable factors, this reason can affect the development of coxarthrosis more than with others.
• Hormonal background. Frequent changes in hormone levels can affect metabolic processes in the human body, thereby contributing to the development of inflammation of the joint tissues.

• A sedentary lifestyle is one of the main reasons for the development of pathologies of the hip joint.
• Other diseases (necrosis of the femoral head, severe infections). In case of improper treatment or non-timely medical care, a number of diseases can further affect the development of coxarthrosis, as a complication or concomitant disease.
• Congenital pathologies (dysplasia, congenital dislocation of the hip).

The degree of coxarthrosis of the hip joint

Coxarthrosis of the hip joint of the first degree

Grade 1 is the mildest form of the disease, which may not bother the patient for a very long time, but if you do not orientate yourself and treat the disease in time, it will develop to more severe forms.

At the first stage of the disease, there are periodic pains in the area of the affected hip joint after prolonged and intense physical exertion. With bilateral joint damage, pain manifests itself in both joints, with one-sided - in one. This stage is not characterized by the appearance of lameness and severe muscle rigidity. The pain syndrome disappears immediately after the end of physical activity and is not permanent. On the X-ray, you can see a slight narrowing of the gap located between the joints.

Coxarthrosis of the hip joint of the second degree

Grade 2 is characterized by more significant joint damage - destruction of cartilage tissue. At this degree, all symptoms are worse.

The pain syndrome in the second stage of the lesion intensifies; pain irradiation to the groin area and thigh is often noted. The pain occurs not only after physical exertion, but also at rest. In the absence of restorative measures, the normal mechanism of movements is disrupted - the patient begins to limp, gait gradually changes. The strength of the muscles responsible for hip extension and abduction is reduced. Over time, morning stiffness syndrome occurs.

Coxarthrosis of the hip joint of the third degree

Grade 3 is one of the most severe forms of pathology, which is characterized by almost complete destruction of the articular cartilage. The radiographic image shows a filamentous narrowing of the joint space. The joint is severely deformed.

The pain syndrome with this condition is permanent, it can be eliminated only temporarily with the help of medications. It is difficult for the patient to move without a cane or other assistive devices, since the joint is constrained, its movements are limited. In the area of the joint, the development of edema is noted, the tissues atrophy.

Coxarthrosis of the hip joint of the fourth degree

This is the last stage of the disease, the most severe. This condition is characterized by complete fusion of the bones of the hip joint with each other. Constant pain, preventing a normal life, severe swelling of the surrounding tissues. Complete lack of movement in the hip joint.

Diagnosis of diseases of the osteoarticular system

At the first stage, the diagnosis of coxarthrosis includes a survey, collection of anamnesis of life and disease, patient complaints, examination of the joint and carrying out functional tests.

In the clinical analysis of blood with coxarthrosis, there is a slight increase in ESR (erythrocyte sedimentation rate) - up to 30 mm / h and higher.

In a biochemical blood test, the level of inflammation markers is significantly increased: c-reactive protein, globulins, immunoglobulins and seromucoid. This analysis provides significant assistance in the differential diagnosis of joint damage: arthritis or arthrosis?

Instrumental methods form the basis of all diagnostic measures.

The main method for detecting joint damage is x-ray, which shows:

• the presence of osteophytes - bone growths along the edges of the articular cartilage;
• narrowing of the gap between the joints;
• areas of ossification of the articular cartilage;
• osteoporosis (bone loss);
• compaction of bone tissue under the cartilage.

The disadvantage of carrying out an X-ray examination is that only bones are visible, the soft tissues of the joint (cartilage, joint capsule) are not visible in the images.

An equally informative diagnostic method is magnetic resonance imaging or computed tomography, which allows you to recognize the disease at the earliest stages of its development.

On the subject: Pain in the hip joint

Treatment of coxarthrosis of the hip joint

With such a pathology as coxarthrosis, treatment is provided for a rather complicated and long-term, consisting of many stages. The main condition for effective treatment is the early start of therapeutic measures, regardless of the stage of the disease.

To treat the initial stage of the development of pathology, it is enough to correct the lifestyle, nutrition, eliminate problems with blood circulation and metabolism. More severe forms of the disease require as much effort as possible to recover.

Drug treatment for destructive changes in the hip joint

Medication therapy mainly consists of symptomatic treatment. The main actions that are required from drugs are elimination of pain syndrome, removal of puffiness and inflammation, improvement of blood circulation, nutrition of cartilaginous tissue and muscle relaxation.

1. Non-steroidal anti-inflammatory drugs:

   • brufen;
   • piroxicam;
   • diclofenac;
   • indomethocin;
   • ketoprofen.

   These drugs are indicated for the reactive stage of the inflammatory process. They perfectly relieve swelling, inflammation, eliminate pain due to the strongest anti-inflammatory effect. The disadvantage of using this group of drugs is quick addiction, the cartilage tissue ceases to regenerate on its own, and a number of side effects negatively affect the internal organs.

   To date, the newest drug has been developed with a smaller list of side effects - movalis. Thanks to its refinement, addiction does not develop so quickly.

   Experts do not recommend taking several anti-inflammatory drugs at the same time, if the drug used does not bring the necessary effect, it is worth either increasing the dosage or changing it.

2. Vasodilator drugs:

   

   • nikoshpan;
   • theonicol;
   • cinnarizine;
   • trental.

   The purpose of these drugs is to relax the smooth muscles of the vessels and expand their lumen to ensure good blood circulation. When used correctly, drugs in this group have a minimum number of contraindications and complications. Vasodilator drugs have a very important effect - they relieve spasms, including night "vascular" pains, which bring maximum discomfort to patients.

   Before using these drugs, you should consult with your doctor, since one of the most common side effects is an allergic reaction to the ingredients. The effectiveness depends on this factor.

3. Muscle relaxants:

   • sirdalud;
   • midocalm.

   Preparations of this group for coxarthrosis should be taken with extreme caution. They are used to relieve painful muscle spasms and improve blood circulation. The danger when using muscle relaxants is that they affect the nervous system, manifested in the form of frequent dizziness, nausea, lethargy or intoxication.

4. Chondroprotectors:

   • rumalon;
   • glucosamine;
   • structure;
   • don;
   • chondraitin sulfate.

   This category of drugs is the most useful and effective, its actions are aimed at restoring the structure of the cartilage. Regular use of chondroprotectors can stop the development of coxarthrosis in the early stages. Contraindications for use are pregnancy, allergies and joint inflammation.

5. Hormonal drugs (injections):

   • kenagol;
   • mitelpred;
   • hydrocortisone.

   This kind of therapy has a positive effect in the absence of inflammatory processes affecting the tendons of the femur. Injections are not recommended to be done more often than once every two weeks and no more than three injections in one joint.

6. Local medicines (ointments, lotions, compresses)

Such therapy is not fundamental in the treatment of coxarthrosis, since the likelihood that all the necessary substances will penetrate the skin, fat layer and muscles is very small, therefore, the rubbing process itself has a positive effect, increasing blood circulation in the affected area.

On the subject: List of modern drugs and drugs for joints

Operation for coxarthrosis of the hip joint

Surgical intervention is performed at the last stage of the development of the disease, when the functional capabilities of the joint are completely impaired.

Types of operations:

1. Endoprosthetics - joint replacement. This is the most difficult of all hip joint surgeries, its success rate is almost 70% of all surgeries performed. When choosing a prosthesis, the patient's age, gender, weight and anatomical features of the body are taken into account, the amount of time that the implant will serve depends on this. This is often the only way to restore the patient's ability to walk.

   Outwardly, a conventional endoprosthesis is identical to a conventional joint; it is designed for the same functions and is able to withstand the same loads as a natural joint.

   By the type of prosthetics, the following joints are distinguished:

   • unipolar (only the head of the hip joint is prosthetic);
   • bipolar (all anatomical elements of the joint are replaced).
2. Arthrodesis - the bones of the joint are fastened with special screws and plates to restore functionality. The disadvantage of this technique is that the joint, as before, is constrained in movement. This surgery is prescribed only in cases where other types of treatment do not give any result.
3. Arthroplasty is the modeling of a destroyed surface - cartilage.
4. Osteotomy is a specific dissection of bones to eliminate deformation. Unlike arthrodesis, this surgery restores not only support function, but also motor function.

Gymnastics for coxarthrosis of the hip joint

Therapeutic gymnastics for this disease is one of the most effective therapeutic methods of treatment that bring a positive result. In the initial stages, exercises aimed at strengthening the muscles surrounding the joint can prevent the further development of coxarthrosis.

It is very important that therapeutic exercises are carried out under the supervision of a highly qualified specialist, since there are a number of exercises that can both benefit and harm the patient.

Exercises for the treatment of coxarthrosis of the hip joint have a specific mechanism. Training of the gluteal and peri-femoral muscles helps to improve blood circulation, fixation and cartilage nutrition. Stretching exercises allow you to align shortened limbs by specifically stretching the joint capsule.

Statistical exercises, rational dynamic loading and stretching are excellent for treatment. A set of the most rational exercises:

• in the supine position, it is necessary to raise and tighten the gluteal muscles as much as possible;
• without getting up, in the same position - bend your knee and gradually put it out;
• while remaining in the prone position, straighten your legs and try to raise them as high as possible while simultaneously not raising the upper end of the body;
• while sitting on a chair, squeeze the fitness ball between your legs and try to squeeze it with maximum force;
• in a sitting position, straightening your legs, try to wrap your hands around your toes.

All exercises must be performed regularly and correctly. To relieve tension, you can take a relaxing oil bath.

Contraindications for medical gymnastics:

• increased body temperature (over 37);
• inguinal hernia, hernia of the abdomen and back;
• the rehabilitation period after surgery;
• acute inflammatory processes affecting internal organs;
• heart and lung failure;
• hypertensive crisis;
• severe pain syndrome;
• exacerbation of joint diseases;
• menstruation;
• high blood pressure.

Watch a visual video:

Before you start doing exercises at home, you need to consult with your doctor and get all the necessary recommendations regarding the methodology for performing certain exercises.

Physiotherapy procedures

Physiotherapy for coxarthrosis is not the main method of treatment, rather an auxiliary one. Physiotherapeutic procedures can bring a positive result only in the early stages of the development of the disease; they are prescribed to relieve spasm and improve blood circulation.

Most often used:

• mud therapy - spa treatment;
• cryotherapy;
• thermal procedures - electrophoresis;
• ultrasound therapy;
• phototherapy;
• magnetotherapy;
• inductothermy;
• the use of lasers;
• aeroionotherapy.

• Massage for pathology of the hip joint:

  • Massage is prescribed for any of the 4 stages of the disease, regardless of the treatment: conservative or surgical. It is absolutely safe, relieves tension, swelling, spasm and strengthens muscles. It is recommended to conduct it as often as possible. In addition, any massage procedures improve blood circulation, which contributes to the restoration of cartilage tissue.
  • At the first stage of the disease, massage is prescribed only after the use of drugs that restore cartilage tissue, vasodilators and anti-inflammatory. Before the start of the massage, the patient is recommended to reduce the load on the affected joint as much as possible, walk less, lie more.
  • The massage is performed manually on the hip joint, lower back and thighs. It is recommended to combine it with medical gymnastics and water procedures, ideal for visiting the pool 3-4 times a week.
  • In specially equipped sanatoriums, water jet massage (hydrokinesis therapy) is performed. You can also stretch the joint using manual massage.
  • In the third - fourth stages, coxarthrosis is treated with surgery. Therefore, massage procedures are prescribed after removing the stitches. During this period, massage is simply necessary, it helps to improve blood circulation, relieves muscle tension and thus ensures a speedy recovery.

On the subject: Other recipes for traditional medicine

Nutrition for coxarthrosis of the hip joint

Since the development of the disease depends directly on metabolism, nutrition, with coxarthrosis, should be aimed at excluding all possible factors that cause this pathology.

Diet

A balanced diet, the correct approach to the distribution of food intake are the most important factors influencing the recovery of the patient's health. Nutrition for coxarthrosis of the joints should be fractional, up to 5-6 times a day, while the portions should be small, but nutritious.

Thanks to the correct establishment of a meal schedule, you can achieve the following results:

• restoration of cartilage tissue;
• the formation of new tissues.

The diet for coxarthrosis should exclude the following foods:

• fatty meat broths;
• products containing a large amount of fat in their composition (mayonnaise, chocolate, red fish, sour cream and cottage cheese with a high fat content, cream);
• meat and fish semi-finished products;
• a large amount of salt (more than 1 tablespoon per day);
• food products with a high content of preservatives (chips, canned food, sausages, caviar, sauces, some types of cheese, nuts).

Useful foods for coxarthrosis

Fermented milk products are quite useful for the restoration of joints, since the human body easily assimilates milk protein, which is necessary for tissue regeneration. In addition, dairy products, namely cottage cheese (low in fat) and cheese, are rich in calcium, which strengthens the skeletal system.

Part of the required protein can be obtained from some types of meat and fish products, a very important aspect is that these products should be low-fat. In addition to animal protein, it is imperative to include vegetable protein in the daily diet, which is contained in lentils and buckwheat.

Collagen is needed to restore bone tissue and cartilage. It is found in jellied fish or aspic.

As for desserts, the ideal option for restoring normal joint function is fruit jelly, rich in vitamin complexes and gelatin. Also, foods rich in phosphorus and phospholipids have a positive effect on the restoration of joints and cartilage.

A separate role in proper nutrition in the treatment of joint coxarthrosis is played by carbohydrates, which provide the body with the necessary supply of energy. Energy potential is the basis of all processes of human life. It is better to give preference to complex carbohydrates - polysaccharides and monosaccharides. As a result, it is better to replace ordinary sugar with natural honey.

Cereals that are also rich in complex carbohydrates and essential elements that feed the brain are no less useful and necessary for recovery.

Are fats good for you?

When considering all the advantages and disadvantages of eating fats, it is best to use vegetable fats for nutrition with coxarthrosis.

Meals should be organized so as to affect the following factors:

• decrease in total body weight;
• normalization of metabolic processes.

A diet for destructive changes in the hip joint is one of the important steps towards a speedy recovery.

On the subject: Modern dietary supplements for the restoration of joints

Prevention of coxarthrosis

The main and most important method for the prevention of coxarthrosis of the hip and other joints is early diagnosis, as well as such measures as:

• swimming;
• physiotherapy;
• skiing, with sticks;
• Spa treatment;
• self-massage with ointments;
• specialized massage;
• weight control;
• regular intake of chondroprotectors.

Physical activity in the treatment of coxarthrosis should be aimed at the following properties:

• restoration of the functionality of the joint;
• strengthening the muscular system;
• improving the blood supply to the joint and the area around it;
• increased stability of the lumbar spine;
• prevention of severe complications.

Prevention and self-medication are two big differences, therefore, before starting any measures aimed at restoring joints, you need to consult with specialists.

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.