Osteoarthritis of the hip joints is one of the most severe pre-dystrophic pathologies assisted by 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 inability to move independently and disability. Decades ago, 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, receive a disability, and require joint surgery.The disease occurs from 20-25 years, the average age of onset of symptoms is 37-39 years, 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 persons over 85 years - 35%. In children and adolescents, coxarthrosis is a consequence of congenital joint dysplasia, which is observed in 1% of newborns.
Reasons for development
The reasons that lead to the development of osteoarthritis of the hip joints have different meanings depending on the age and general level of health of each patient:
- congenital disorder of the normal anatomical shape of the joints - femoral neck deformities, congenital displacement of the hip;
- deformity of the femoral head due to degenerative (age-related) processes in the joint;
- traumatic injuries - fractures, dislocations, non-physiological, including sports, joint loads;
- 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 has developed spontaneously, the term "idiopathic coxarthrosis" is used.
Pain is the main symptom. Their severity and the increase of other manifestations of coxarthrosis depends on many factors, in particular on body weight, lifestyle, age. In the initial stage, patients note moderate, permanent pain in the hip joints, which occurs mainly during physical exertion and passes on its own. Then the pain starts in light loads, does not pass at rest, "shoot" at the knee joint. The mobility of the wrist or both joints is limited.
Patients are forced to limit physical activity, lameness, "duck walking" appears. In the final stage, constant dull pain is observed, mobility in the hip joints is significantly limited, walking is possible only with a cane or crutches, patients need help throughout the day, 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 wrist space. The bone tissue located under the cartilage becomes denser. At this stage, the pain appears after exercise.
In the second stage, cartilage destruction progresses. Marginal osteophytes appear - bone growths. Narrowing of common space progresses. Pain occurs when walking, restriction of joint mobility (contractures).
In the last stage of coxarthrosis, the bone growths are extensive, flattening and subluxation of the femoral head occurs, the joint space practically disappears. Persistent severe pain, joint mobility is severely limited.
Diagnosis of coxarthrosis
If you experience pain in the groin area, restricted joint mobility, and other symptoms listed above, you may want to consult a therapist, but the leading medical specialist who diagnoses and treats hip osteoarthritis is an orthopedic traumatologist.
The main method for diagnosing coxarthrosis is radiography. This is an informative method that allows you to accurately assess structural changes in affected nodes. 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 no X-ray changes), as well as for the differential diagnosis.
Treatment of coxarthrosis of the thigh 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. Among the physiotherapeutic techniques that have proven themselves well, magnetotherapy can also be distinguished.
Magnetic therapy for coxarthrosis is used for various purposes. Under the influence of a magnetic field in the body, regeneration processes are activated, including in bone tissue, blood circulation is improved. The last point is especially important, since in osteoarthritis, there is an insufficient blood supply to the joints, and thus a lack of nutrients to maintain the normal state of cartilage and bone tissue, and this can exacerbate pathological changes injoints. Improving blood circulation in the hip joint area helps restore the flow of essential nutrients to the joints, activates metabolism in bone and cartilage tissue, which is the basis for the positive effect of magnetotherapy on coxarthrosis.
Also, 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.
Diet therapy is recommended to normalize metabolism and reduce body weight. Along with a rational diet, it is possible to use ancillary preparations (biologically active pharmaceutical drugs and additives) that affect metabolic processes and recovery in the musculoskeletal system - based on glucosamine and chondroitin (chondroprotectors), minerals and vitamins, plant extractsstandardized.
Drugs 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. Their use should be done in strict dosage, under supervision and as prescribed by a doctor.
In the second or third stage of the disease, depending on the symptoms and condition of the patient, it is recommended to continue 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 - hip joint replacement.
Medication therapy, dietary therapy and lifestyle changes, physiotherapy and spa treatment are also recommended, both in the case of surgery and in a conservative approach. Physiotherapy techniques in complex treatment can reduce the amount of medication and load on the body, promote faster recovery after surgery, and improve the overall condition of the patient. In particular, magnetotherapy shows good efficacy and tolerance, even in debilitated elderly patients, and people with chronic diseases of the nervous and cardiovascular systems.
Prevention of osteoarthritis of the thigh joint
As a preventative measure, early detection of coxarthrosis at an early stage is very important. If you find symptoms (pain, limited mobility) in the hip joint area, you should consult a doctor - you can first visit a therapist, then an orthopedic surgeon. The therapist may prescribe an initial treatment for pain relief, recommend chondroprotectors, and an orthopedist may prescribe a special treatment.
Lack of excess weight and normal physical activity, correction of working conditions and lifestyle in general, as well as timely treatment of diseases that can become one of the causes of the development of coxarthrosis (inflammatory diseases, infectious diseases of the joints, congenital anatomical defects of joints, degenerative dystrophic diseases).