Osteoarthritis of the hip joint is an elderly disease caused by degenerative processes of cartilage tissue. The development of osteoarthritis of the hip joint is accelerated by the mismatch of the articular surfaces, which leads to abnormal friction. In some patients, the disease develops as a result of 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 osteoarthritis of the hip joint is carried out with the latest drugs with high efficacy and minimal side effects. Doctors discuss cases of severe coxarthrosis and decide on treatment tactics for each patient. Rehabilitation therapists use regenerative therapies to slow the development of articular cartilage degeneration.
.jpg)
Symptoms of osteoarthritis of the hip joint
Patients suffering from deforming osteoarthritis complain of sudden stiffness attacks of the hip joint that appear after rest and disappear after some activity. Initially, minor pain lasts for 1 to 2 days and intensifies after prolonged weight lifting.
Frequent defensive lameness is caused by muscle spasms accompanied by pain and a gradually increasing feeling of joint stiffness. Osteoarthritis of the left hip joint manifests itself with the same symptoms as osteoarthritis of the right hip joint. Pain in osteoarthritis of the hip joint is localized along the antero-external or posterior surface of the joint, depending on the site of inflammation. It spreads to the anterior and inner surfaces of the thigh and popliteal fossa. The pain syndrome is exacerbated after prolonged load on the limbs and movements, especially in the direction of internal rotation, abduction and stretching. Patients often complain of increased pain in humid and cold weather and report relaxation in the heat and after taking acetylsalicylic acid drugs.
In the acute phase of osteoarthritis of the hip joint, patients report pain at the site of inflammation of the capsule, accompanied by muscle spasms involving the adductor muscles of the thigh. Orthopedists perform the Faber test: the patient places the heel of the affected joint behind the healthy foot and slides it from the tibial surface of the lower leg to the skin of the knee. It will be positive for any inflammatory process in the hip joint.
There are no changes in the radiography in the early stages of osteoarthritis of the hip joint. Later, radiologists discovered subchondral sclerosis, which from time to time causes narrowing of the joint space. An additional symptom is flattening of the head at the upper pole, which is accompanied by cystic changes in this area.
The degree of osteoarthritis of the hip joint
As it progresses, the deformed arthrosis of the hip joints goes through several stages that distinguish the three degrees of the disease.
Grade 1 deformity is the initial stage of the disease, there are still no obvious changes in the structure of the joint tissues. Pain syndrome is often absent, if it occurs, against the background of the inflammatory process. Patients may complain of stiffness and fatigue in the limbs. Often, the first degree of osteoarthritis of the hip joint is asymptomatic.
Morphological changes are evident with grade 2 deformity arthrosis. Articular surfaces are uneven, with significant bone growth. The bone tissue in the joint area is less strong. Due to the inflammatory process, the synovial membrane becomes very thick. The pain can be dull, aching in nature, and persistent, or it can be sharp and sudden.
In the case of grade 3 deforming osteoarthritis, the pain is so severe that it does not go away even after a long period of rest. The patient's joint mobility is reduced, the reading of the joint may be impaired. Ulcers and caries can form in the cartilage tissue surrounding the articular surfaces.
How to treat osteoarthritis of the hip joint
Conservative treatment of osteoarthritis of the hip joint is carried out with exacerbation of the disease. Includes muscle relaxation, traction, heat and massage. Salicylates are prescribed to reduce the inflammatory process. Glucocorticoid injections are performed for 1st and 2nd degree arthrosis of the hip joint. In the third stage of deformity of the hip joint, the only effective treatment is a planned replacement of the hip joint with an endoprosthesis.
Complex treatment of osteoarthritis of the hip joint is carried out with physiotherapy and kinesitherapy, dietary adjustment. Effective treatment of the early stages of the disease allows patients with 1st and 2nd degree arthrosis of the hip joint to avoid arthroplasty and limit the need for medication.
Surgical treatment of deforming coxarthrosis
With grade 3 coxarthrosis, when conservative treatment does not bring relief, only the prosthesis restores the joy of movement, relieving the patient of pain and discomfort. If there is fluid in the joint, it is removed after the puncture. Corticosteroid hormones are also injected into the hip joint.
With the help of arthroscopic debridement, the inner surface of the joint is cleaned of pieces of altered cartilage tissue and the cavity is washed with a therapeutic solution to alleviate the inflammatory process. Periarticular osteotomy is the fusion of the femur at a different angle after an artificial fracture. Surgery can reduce joint stress.
Rehabilitation methods for osteoarthritis deformity
The following types of physiotherapy are used to treat patients with osteoarthritis of the hip joint:
- shock wave therapy - exposure to sound waves that stimulate regeneration processes and provide blood flow to any part of the body that accelerates metabolism;
- myostimulation, which restores the function of weakened muscles due to the forced restriction of joint movements;
- phonophoresis is a method that combines the advantages of ultrasound 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 from the skin to the hip joint);
- ozone treatment - reduces anxiety and activates the growth of cartilage tissue due to the properties of the ozone-oxygen mixture.
Kinesitherapy is the basis for successful treatment of osteoarthritis 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 anxiety during normal daily stress. The exercise therapy teacher selects 1st, 2nd and 3rd degree exercises individually for hip arthrosis. Rehabilitation clinic specialists perform a variety of massages, including lymphatic drainage, using innovative hand therapy techniques aimed at passive work with muscles, ligaments and joints. Approaches used to help people with coxarthrosis reduce the need for deformable pills and needles that reduce the pharmacological load on the body.
Rehabilitation clinics are equipped with modern mechanical and computerized simulators from the world's leading manufacturers. They help to exercise together without significant physical effort, especially among older people. Stretching the joints with the help of a special traction device or a chiropractic hand increases the gap inside the joint, which "throws" the pathological process back a few steps, eliminates the symptoms and gives the body time to restore function. hip joint.
Dietary treatment is necessary for all patients with osteoarthritis of the hip joint, but it is most important for overweight people. Weight loss reduces stress on inflamed joints and improves metabolism. A balanced diet, along with other conservative methods, allows you to forget about pain and other manifestations of osteoarthritis 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 exacerbation of osteoarthritis;
- after the last operation;
- hernia, in the presence of 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 teacher takes into account the patient's age, the severity of the pathological process and the presence of concomitant diseases. Well-chosen gymnastics with deforming osteoarthritis 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 exercises in which you need to correct the position of the body for a few seconds. If such movements are sufficient, the muscles and ligaments of the legs receive the load necessary to restore the joint. The hip joint itself is minimal in such exercises and does not wear out.