Hip joint necrosis
The hip joint is a spherical joint, thanks to which the human body is able to move. It is formed by the pelvic acetabulum and the head of the femur. All existing ligaments of the cup-shaped joint allow performing various movements of the hip (up, down, left, right). The blood supply to the hip joint is provided by the branches of the arteries that bend around the femur.
Necrosis occurs in the tissues of the hip joint, gradually destroying it as a result of impaired blood supply. It has not yet been possible to accurately determine the causes of the development of a complex disease, but among the risk factors are: age 20-50 years, the presence of injuries (dislocations, hip fractures), alcohol consumption, the use of glucocorticoids, inflammatory processes in the joints (arthritis, arthrosis, rheumatism) …
After the past diseases, such as malignant proliferation of lymphocytes (lymphoproliferative diseases), chronic inflammation of the pancreas, granulomatous inflammation, systemic lupus erythematosus, the development of necrosis of the hip joints is also observed. The condition with necrotic phenomena can be accompanied by many symptoms.
The mobility in the joint is impaired, there are constant pains when walking. It is recommended that if you experience persistent pain in the hip joint, radiating towards the knee joint, consult a doctor. The destruction of the hip joint with necrosis can last for 2.5 years. Cessation of blood flow to part of the femoral head leads to cell death. In this case, the shape of the femoral head is disturbed, the articular cartilage is damaged.
The methods, intensity and result of treatment depend on the stage of changes in the joint.
For the diagnosis of necrosis, clinical studies are traditionally carried out using X-ray, magnetic resonance imaging of the hip joint. Decompression or bone grafting of the affected area is prescribed if the joint is affected by 20% and only a small fragment is affected by necrosis. If necrosis has covered a significant area of the femoral head, hip arthroplasty is required.
Hip necrosis or Perthes disease occurs in children. It is expressed by necrosis and partial destruction of the elements that form the hip joint. Treatment of necrosis in children is carried out with the help of potent drugs. The main reason for the appearance of the disease is improper blood supply after an injury, fracture, bruise, dislocation. Also, necrosis can form if the child has been taking medications for a long time that remove calcium from the body.
At the initial stages of the development of necrosis, cavities are formed, and when the body cannot eliminate them, the cysts that appear join and areas of necrosis appear. With the formation of connective tissue, the bone begins to crush into fragments, in which fragile beams are formed, they break under stress. During this period, there is constant pain, concavity of the leg inward and lameness. Only early treatment can prevent the development of necrosis and restore the impaired functions of the joint.
The complex of therapeutic measures should include unloading of the hip joint, which helps to maintain the shape of the femoral head: swimming in the pool, massage, mud treatments, vitamin therapy. It is known that intra-articular injuries contribute to the development of inflammatory-dystrophic processes in the articular surfaces. Old injuries that disrupt the physiological characteristics of the hip joint lead to serious diseases, one of which is necrosis. They should be treated with reconstructive surgery. This will avoid major health problems.
Surgical treatment is indicated for later and progressive stages. Among the operative methods, tunnelization of the femoral neck is distinguished by its effectiveness, which consists in drilling several tunnels in the neck and head of the femur with a drill so that the granulation tissue rich in vessels grows in them. The method of endoprosthetics is the replacement of a damaged hip joint with an artificial joint.
The determining factors in the prognosis of the disease are the size and location of the necrosis focus in the femoral head, early diagnosis of the disease and the appropriateness of the treatment measures, the correct choice of the place of treatment and the experience of a specialist. Personal seriousness to this issue, careful implementation of the doctor's recommendations is also important. All together provide a favorable outcome even in the most severe cases.
Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist
Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".
