Deforming osteoarthritis of the hip joint is a disease of the elderly, which is caused by degenerative processes of cartilage tissue. The progression of arthrosis of the hip joint is accelerated by the mismatch of the articular surfaces, which leads to abnormal friction. In some patients, the disease develops due to ischemia of the femoral head after fractures of the femoral neck or direct damage to the articular cartilage; in 50% of cases, the cause of the disease is unknown. Doctors diagnose osteoarthritis of the hip joint using x-rays and computed tomography.
Treatment of deforming arthrosis of the hip joint is carried out with the latest drugs, which are highly effective and have minimal side effects. Doctors discuss severe cases of coxarthrosis and decide on the tactics of treating each patient. Rehabilitation therapists use innovative methods of restorative therapy to slow the progression of degeneration of the articular cartilage.
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Signs of arthrosis of the hip joint
Patients suffering from deforming arthrosis complain of sudden attacks of stiffness in the hip joint, which appear after a state of rest and disappear after some activity. At first, bouts of minor pain last for 1 to 2 days, intensifying after prolonged periods of weight bearing.
Often, defensive lameness occurs due to muscle spasm, which is accompanied by pain and a gradually increasing sensation of joint stiffness. Arthrosis of the left hip joint is manifested by the same symptoms as arthrosis of the right hip joint. Pain in arthrosis of the hip joint is localized along the antero-outer or posterior surface of the joint, depending on the site of inflammation. It radiates to the front and inner surfaces of the thigh and to the popliteal fossa. The pain syndrome intensifies after prolonged load on the limb and movements, especially in the direction of internal rotation, abduction, and extension. Patients often complain of increased pain in damp and cold weather and note relief in warmth and after taking acetylsalicylic acid preparations.
In the acute period of arthrosis-arthritis of the hip joint, patients note soreness over the site of inflammation of the capsule, which is accompanied by muscle spasm that engulfs the adductor muscles of the thigh. Orthopedists perform the Faber test: the patient places the heel of the affected limb on the back of the healthy foot and slides it up the skin of the tibial surface of the lower leg to the knee. It will be positive for any inflammatory process in the hip joint.
In the early stage of arthrosis of the hip joint, there are no changes on radiographs. Later, radiologists occasionally reveal subchondral sclerosis, which gradually leads to a narrowing of the joint space. An additional sign is the flattening of the head in its upper pole, which is accompanied by cystic changes in this area.
The degree of arthrosis of the hip joint
As it progresses, deforming arthrosis of the hip joints passes through several stages, respectively, which distinguish three degrees of the disease.
Deforming arthrosis of the 1st degree is the initial stage of the disease, when there are still no obvious changes in the structure of the joint tissues. Pain syndrome is often absent, if it does arise, then against the background of the inflammatory process. Patients may complain of stiffness and fatigue in the limb. Often the first degree of osteoarthritis of the hip joint is asymptomatic.
In grade 2 deforming arthrosis, morphological changes are obvious. The articular surfaces are uneven, with significant bone growths located on them. The bone tissue in the joint area becomes less strong. Due to the inflammatory process, the synovial membrane thickens greatly. The pain can be dull, aching in nature and last constantly, or it can occur sharply and abruptly.
In the case of grade 3 deforming arthrosis, the pain becomes so intense that it does not go away even after prolonged rest. The mobility in the diseased joint is reduced, the axis of the limb may be disturbed. Ulcers and areas of decay can form in the cartilaginous tissue that covers the articular surfaces.
How to treat arthrosis of the hip joint
Conservative treatment of arthrosis of the hip joint is carried out with exacerbation of the disease. It includes unloading the limb, traction, warmth and massage. To reduce the inflammatory process, salicylates are prescribed. Injections of glucocorticoids are performed for arthrosis of the hip joint of 1 and 2 degrees. In the third stage of deforming arthrosis of the hip joint, the only effective treatment is the planned replacement of the hip joint with an endoprosthesis.
Complex treatment of arthrosis of the hip joint is carried out using physiotherapy and kinesitherapy, diet correction. Effective therapy of the initial stages of the disease allows people with 1 and 2 degrees of arthrosis of the hip joint to avoid arthroplasty and limit the need for drugs.
Surgical treatment of deforming coxarthrosis
With coxarthrosis of the 3rd degree, when conservative treatment does not bring relief, only prosthetics helps to relieve the patient of pain and discomfort, restoring him the joy of movement. If there is fluid in the joint, it is pumped out after the puncture. Corticosteroid hormones are simultaneously injected into the hip joint.
With the help of arthroscopic debridement, the inner surface of the joint is cleaned from fragments of altered cartilaginous tissue and its cavity is rinsed with a therapeutic solution to relieve the inflammatory process. Periarticular osteotomy is an artificial fracture of the femur followed by its fusion at a different angle. Surgery can reduce the stress on the joint.
Rehabilitation methods for deforming arthrosis
For the treatment of patients with osteoarthritis of the hip joint, the following types of physiotherapy are used:
- shock wave therapy - exposure to sound waves that provide blood flow to the desired area of the body, which stimulates regeneration processes and speeds up metabolism;
- myostimulation, which restores the work of muscles weakened due to the forced limitation of movements in the joint;
- phonophoresis is a method that combines the advantages of ultrasonic and drug effects on the body (under the influence of the device, a drug in the form of an ointment or cream penetrates more effectively through the skin to the hip joint);
- ozone therapy - reduces discomfort and activates the growth of cartilage tissue due to the properties of the ozone-oxygen mixture.
Kinesitherapy is considered to be the basis for the successful treatment of arthrosis of any localization. Regular performance of a special system of gymnastic exercises strengthens the ligaments and muscles around the joint affected by the pathological process, which reduces discomfort during the usual daily stress. The exercise therapy instructor individually selects exercises for arthrosis of the hip joint of 1, 2 and 3 degrees. Rehabilitation clinic specialists perform various types of massage, including lymphatic drainage, use innovative manual therapy techniques aimed at passive work with muscles, ligaments and joints. Approaches used to help people with coxarthrosis reduce the need for pills and injections for deforming arthrosis, which reduces the pharmacological burden on the body.
Rehabilitation clinics are equipped with modern mechanical and computerized simulators from the world's leading manufacturers. They help to exercise the joint without significant physical effort, which is especially in demand among elderly people. Extension of the joints with the help of a special traction device or the hands of a chiropractor increases the space inside the joint, which "throws" the pathological process back a few steps, relieving symptoms and giving the body time to restore the function of the hip joint.
Diet therapy is necessary for all patients with osteoarthritis of the hip joint, but is most important for overweight people. Losing weight reduces the stress on the inflamed joint and improves metabolism. In combination with other conservative methods, a balanced diet allows you to forget about pain and other manifestations of arthrosis-arthritis of the hip joint.
Gymnastics for arthrosis of the hip joint
Gymnastic exercises for arthrosis of the hip joint are not prescribed in the following cases:
- with exacerbations of arthrosis-arthritis;
- after a recent major surgery;
- in the presence of a hernia, acute diseases of internal organs;
- during menstruation;
- with an increase in body temperature above more than 37. 50WITH.
The therapist selects all exercises individually. The exercise therapy instructor takes into account the patient's age, the severity of the pathological process and the presence of concomitant diseases. With deforming arthrosis, well-chosen gymnastics should give a useful load to the muscles and ligaments of the hip joint, but not to the joint, because it is already worn out.
The complex of gymnastic exercises for arthrosis of the hip joint consists of more static exercises than dynamic ones. Static exercises are those where you need to fix the position of the body for a few seconds. If such movements are sufficient, the muscles and ligaments of the legs receive the necessary load to restore the joint. The hip joint itself takes minimal part in such exercises and does not wear out.