Treatment of osteoarthritis of the hip joint.

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 a persistent loss of joint function.

The disease quickly leads to a decrease in physical activity.

Osteoarthritis of the hip joints is one of the most serious 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. 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 among young and middle-aged patients, 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, have a disability, and need joint replacement surgery.

The disease occurs after 20-25 years, the average age of onset of symptoms is 37-39 years, it 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 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 that lead to the development of osteoarthritis of the hip joint have different meanings depending on the age and general health of each patient:

  • Congenital disorder of the normal anatomical shape of the joints: femoral neck deformities, 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, joint loads;
  • Causes
  • 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. Its severity and the addition of other manifestations of coxarthrosis depend on many factors, particularly body weight, lifestyle, and age. In the initial stage, patients notice intermittent moderate pain in the hip joints, which occurs mainly during physical exertion and passes on its own. Then the pain begins with light loads, does not go away at rest, "shoots up" in the knee joint. The mobility of the joint or both joints is limited.

Patients are forced to limit physical activity, lameness appears, "duck gait". In the final stage, unbearable and constant pains are observed, mobility in the hip joints is very limited, it is only possible to walk with a cane or crutches, patients need 24-hour assistance, they 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 under the cartilage thickens. At this stage, pain appears after physical exertion.

In the second stage, cartilage destruction progresses. Marginal osteophytes appear: bone 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, there is a flattening and subluxation of the femoral head, the joint space practically disappears. Constant severe pain, joint mobility is significantly limited.

limited joint mobility

Coxarthrosis diagnosis

If you experience pain in the groin area, limitation of joint mobility and other symptoms mentioned above, you can consult a therapist, but the main medical specialist who diagnoses and treats osteoarthritis of the hip joint is a traumatologistorthopedic.

The main method of diagnosing coxarthrosis is radiography. This is an informative method that allows you to accurately assess structural changes in 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 in the pre-X-ray stage (when there are still 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 physiotherapy complex. Among the physiotherapeutic techniques that have proven their effectiveness, magnetotherapy can also be distinguished.

Magnetic therapy for coxarthrosis is used for several purposes. Under the influence of a magnetic field in the body, regeneration processes are activated, including in bone tissue, blood circulation is improved. This last point is especially important, since in osteoarthritis there is an insufficient supply of blood to the joints, and therefore 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 essential nutrients to the joints, activates metabolism in bone and cartilage tissue, which is the basis of the positive effect of magnetotherapy in coxarthrosis.

Furthermore, 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.

conservative methods using physical therapy exercise techniques

Diet therapy is recommended to normalize metabolism and reduce body weight. Along with a rational diet, it is possible to use auxiliary preparations (drugs and biologically active 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 relaxants and some others, are used in all stages of coxarthrosis to eliminate pain and inflammation. Its use must be strictly dosed, under supervision and as prescribed by a doctor.

In the second or third stage of the disease, depending on the symptoms and the patient's condition, it is recommended to continue with conservative treatment or surgery. Currently, various surgical methods are used, the best results (complete restoration of joint function and human mobility) are achieved with total arthroplasty - replacement of the hip joint.

Drug therapy, diet therapy and lifestyle changes, physical therapy and spa treatment are also recommended, both in the case of surgery and with a conservative approach. Physiotherapeutic techniques in complex treatments can reduce the amount of drugs and the load on the body, contribute to a faster recovery after surgery and improve the general condition of the patient. In particular, magnetic therapy shows good efficacy and tolerance, even in debilitated elderly patients and people with chronic diseases of the nervous and cardiovascular systems.

drug therapy

Prevention of osteoarthritis 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 should consult a doctor; You can visit a therapist first and then an orthopedic surgeon. The therapist may prescribe initial pain relief treatment, recommend chondroprotectors, and an 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 the timely treatment of diseases that can become one of the causes of the development of coxarthrosis (inflammatory diseases, infectious of the joints, congenital anatomical defects of the joints, degenerative dystrophic diseases).