Deforming osteoarthritis of the hip joint is a disease of the elderly that is caused by degenerative processes of cartilage tissue. The progression of osteoarthritis of the hip joint is accelerated by the incompatibility of the joint surfaces, which leads to abnormal friction. In some patients, the disease develops due to ischemia of the femoral head after a fracture 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 osteoarthritis 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 each patient's treatment tactics. Rehabilitation therapists use innovative methods of restorative therapy to slow the progression of articular cartilage degeneration.
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Signs of hip arthrosis
Patients suffering from deforming arthrosis complain of sudden attacks of hip joint stiffness, which appear after a state of rest and disappear after some activity. Initially, attacks of minor pain last 1 to 2 days, intensifying after prolonged weight bearing.
Defensive lameness often occurs due to muscle spasms, accompanied by pain and a gradually increasing feeling of joint stiffness. Osteoarthritis of the left hip joint is manifested by the same symptoms as osteoarthritis of the right hip joint. Pain in osteoarthritis of the hip joint is localized along the antero-outer or posterior surface of the joint, depending on the site of inflammation. It radiates towards the anterior and inner surface of the thigh and to the popliteal fossa. The pain syndrome intensifies after prolonged loading of limbs and movements, especially in the direction of internal rotation, abduction, and extension. Patients often complain of increased pain in wet and cold weather and notice relief from heat and after taking acetylsalicylic acid preparations.
In the acute period of arthrosis-arthritis of the hip joint, patients notice pain at the site of inflammation of the capsule, accompanied by muscle spasm that affects the adductor muscles of the thigh. Orthopedists perform the Faber test: the patient places the heel of the affected limb on the back of a healthy foot and slides it across 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 osteoarthritis of the hip joint there are no changes on the radiogram. Later, radiologists occasionally detect subchondral sclerosis, which gradually leads to 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.
Degree of hip arthrosis
As it progresses, deforming osteoarthritis of the hip joints goes through several stages, which distinguish three stages of the disease.
First-degree deforming arthrosis is the initial stage of the disease, when there are still no evident changes in the structure of joint tissues. The pain syndrome is often absent, if it occurs, then in the background of the inflammatory process. Patients may complain of stiffness and fatigue in the limbs. Often, first-degree osteoarthritis of the hip joint is asymptomatic.
In second-degree deforming arthrosis, morphological changes are evident. The articular surfaces are uneven, there are significant bony outgrowths on them. The bone tissue in the joint area becomes less firm. Due to the inflammatory process, the synovial membrane thickens greatly. The pain may be dull, painful in nature and last constantly, or it may appear sharp and sudden.
In the case of grade 3 deforming arthrosis, the pain becomes so intense that it does not disappear even after prolonged rest. Mobility in the diseased joint is reduced, the axis of the limbs can be disturbed. Ulcers and areas of putrefaction can form in the cartilaginous tissue that covers the joint surfaces.
How to treat hip osteoarthritis
Conservative treatment of hip arthrosis is carried out with exacerbation of the disease. Includes limb unloading, traction, warmth and massage. To reduce the inflammatory process, salicylates are prescribed. Glucocorticoid injections are performed for hip arthrosis of the 1st and 2nd degree. In the third stage of deforming osteoarthritis of the hip joint, the only effective treatment is the planned replacement of the hip joint with an endoprosthesis.
Complex treatment of osteoarthritis of the hip joint is carried out by physiotherapy and kinesitherapy, dietary correction. Effective therapy of the initial stages of the disease allows sick people with 1 and 2 degrees of arthrosis of the hip joint to avoid arthroplasty and to limit the need for medication.
Surgical treatment of deforming coxarthrosis
In grade 3 coxarthrosis, when conservative treatment does not bring relief, only prosthetics help to alleviate the patient from pain and discomfort, restoring his joy of movement. If there is fluid in the joint, it is pumped out after the puncture. Corticosteroid hormones are injected into the hip joint at the same time.
With the help of arthroscopic debridement, the inner surface of the joint is cleaned of fragments of altered cartilage tissue and its cavity is rinsed with a therapeutic solution to alleviate the inflammatory process. Periarticular osteotomy is an artificial fracture of the femur followed by its fusion at different angles. Surgery can reduce stress on the joint.
Methods of rehabilitation of deforming arthrosis
The following types of physiotherapy are used to treat patients with osteoarthritis of the hip joint:
- shock wave therapy - exposure to sound waves that ensure blood flow to the desired area of the body, which stimulates regeneration processes and speeds up metabolism;
- myostimulation, which restores the work of muscles that have weakened due to forced restriction of movement in the joint;
- phonophoresis is a method that combines the benefits of ultrasound and the action of drugs on the body (under the influence of the device the drug in the form of ointment or cream more effectively penetrates the skin to the hip joint);
- ozone therapy - reduces discomfort and activates the growth of cartilage tissue due to the properties of a mixture of ozone and oxygen.
Kinesitherapy is considered to be the basis for successful treatment of arthrosis of any localization. Regular application of a special system of gymnastic exercises strengthens the ligaments and muscles around the joint affected by the pathological process, which reduces discomfort during normal daily stress. The exercise therapy instructor individually selects exercises for hip arthrosis for 1, 2 and 3 degrees. Rehabilitation clinic specialists perform various types of massage, including lymphatic drainage, using 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 to deform 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 joints without significant physical effort, which is especially sought after among the elderly. Extension of the joints with the help of a special traction device or chiropractor's hand increases the space inside the joint, which "rejects" the pathological process back a few steps, alleviating the 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 it is the most important for people who are overweight. Weight loss will be followed by fatigue and constant tiredness. Combined with other conservative methods, a balanced diet allows you to forget about the pain and other manifestations of osteoarthritis-arthritis of the hip joint.
Gymnastics for osteoarthritis of the hip joint
Gymnastic exercises for osteoarthritis of the hip joint are not prescribed in the following cases:
- with exacerbations of arthrosis-arthritis;
- after a recent major operation;
- in the presence of hernia, acute diseases of the internal organs;
- during menstruation;
- with an increase in body temperature above 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. In 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 osteoarthritis of the hip joint consists of more static exercises than dynamic ones. Static exercises are those where you have to fix your body position for a few seconds. If such movements are sufficient, the muscles and ligaments of the legs receive the necessary load for the renewal of the joint. The hip joint itself minimally participates in such exercises and is not worn out.