Types and symptoms of coxarthrosis of the hip joint

Coxarthrosis of the hip joint is a disease of degenerative-dystrophic genesis, manifested by pronounced deformation of articular surfaces and bone tissue, and also accompanied by a violation of functional and structural features bones.

Depending on the cause, which causes the onset of the disease, specialists identify the primary or idiopathic form of coxarthrosis (independent a disease accounting for about a quarter of all cases) and secondary (developing against a background of traumatic or congenital diseases of the hip joint).

Types of deforming arthrosis of the hip joint

The disease is classified according to the cause, which served as an impetus to its development.

According to this classification, the following types of disease are distinguished:

1. Idiopathic form- the exact cause that caused the development of the disease can not be identified.
2. Dysplastic form- the main factor in the development of the disease in this case is the congenital maldevelopment of the hip joint structures.
3. Involute or age-related form of the diseaseIt develops as a result of the physiological degeneration of the cartilaginous tissues of the joint, which is characteristic of older people.
4. The pre-traumatic form- the cause of deforming arthrosis is inadequate or untimely treatment of fractures of the femur or pelvic bones.
5. Postinfection or reactive formdevelops against the background of diseases of an infectious or allergic nature (allergic, rheumatoid, purulent or specific arthritis).
6. Dyshormonal form- its occurrence is due to the long-term use of corticosteroids.
7. Metabolic intoxication formdevelops against the background of metabolic disorders in diabetes mellitus, gout or obesity.
8. Osteoarthritis, which develops against the backdrop of Perthes' disease.

Causes of the disease

There are many reasons for the development of deforming arthrosis. These include:

• mechanical factors - excessive overload. The risk group includes professional athletes, people who are overweight or obese, those whose professional activities are associated with increased workload;
• violation of normal blood circulation in the joint - as a result of a reduced influx of arterial blood and outflow of venous in the tissues of the joint accumulate under-oxidized metabolic products, which activate enzymes that destroy the cartilaginous the cloth;
• Infectious processes, inflammatory diseases, purulent arthritis;
• various trauma - fractures of the pelvic bones, femur, dislocations and bruises can lead to the development of coxarthrosis in people of quite a young age;
• changes in biochemical processes in the cartilaginous tissue of the joint, metabolic processes and hormonal background in the human body;
• congenital pathologies - dysplasia, Perthes disease, congenital hip dislocation;
• genetic predisposition of the organism to the development of the disease;
• Passive lifestyle leads to the formation of excess weight and stagnation of blood circulation.

Mechanism of development of coxarthrosis

The mechanism of development of the disease consists of two components: changes in the properties of the joint fluid and impaired circulation in the joint.

Because of various factors, the fluid normally washing the articular surfaces changes its composition, becomes thick and viscous, the surface dries, and in the cartilaginous tissue degenerative-dystrophic changes. This leads to roughness, thinning, and eventually damage to the cartilaginous surfaces that ensure the normal functioning of the joint. The naked heads of the bones entering the joint begin to deform, pain and restriction of motor activity appears.

Along with this process, there is a slowing of blood circulation in the hip joint, which results in a slowing of metabolism and the accumulation of enzymes that destroy the cartilaginous tissue. As the disease develops, degenerative-dystrophic changes increase, which causes the emergence of severe clinical signs.

Symptoms of coxarthrosis depending on the degree of development of the disease

First degree

For the first degree of development of the disease, it is clearly localized in the region of the hip joint pain that appears after prolonged physical exertion (walking, running, exercising in the gym or simulators). After rest, the pain disappears. The motor activity of the joint, the gait and the length of the diseased limb are not violated.

Second degree

The second degree of coxarthrosis is manifested by intensifying pain, the appearance of their irradiation in the thigh or groin region, the appearance at the moment of rest. In addition to pain, lumbling with prolonged walking, violation of movements in the joint (violation of the lead and rotation of the thigh inward), weakening of the muscles due to which the length of the diseased limb begins to decrease.

Third degree

In this period, the pain is constant, they do not pass even at night, the patient can not walk without a cane, the motor activity of the joint is considerably limited up to ankylosis (complete immobility), the length of the diseased limb is significantly changed (more often shortened), and the muscles of the thigh, lower legs and buttocks atrophied.

With the development of deforming arthrosis of the third degree hip joint (especially if ankylosis is diagnosed) they talk about disability for the patient.The second degree of the disease is treatable with significant recovery of motor activity as a result. However, in some cases, disability is given with the second degree, it depends on the clinical course of the disease and the cause that caused it.

Methods of treatment for coxarthrosis

The methods of treatment of coxarthrosis depend on the degree of joint damage and range from conservative (in the initial stages disease) to operative (prosthetics of the hip joint with its complete destruction in the third stage coxarthrosis).

Conservative treatment of the disease

For the treatment of coxarthrosis the following groups of drugs are used:

1. Anti-inflammatory non-steroidal(movalis, diclofenac, tilfen, ibuprofen) - well stop the inflammatory process and relieve pain, but with prolonged use can suppress the ability of cartilage tissue to regenerate.
2. Drugs with vasodilator effect(nikoshpan, trental, cinnarizine) - significantly improve the blood supply of the joint, before use it is necessary to check the drug for individual intolerance.
3. Muscle relaxants(sirdolud, midokalm) - relax the muscle fibers, relieving spasms, can cause dizziness and inhibition.
4. Chondroprotectors(chondroitin, glucosamine) - stimulate the restoration of the structure of cartilaginous tissue.
5. Hormonal intraarticular injections(hydrocortisone, kenalog) - it is good to relieve inflammation, but they have many contraindications and give unstable result.

Physiotherapy methods

UHF (ultrahigh-frequency therapy), electrotherapy, magnetotherapy, inductothermy, ultrasound, laser therapy and light therapy are invasive.

Physiotherapy techniques provide a local effect on the joint area, improving blood circulation in it.

Massage and Extension

After the course of conservative treatment and elimination of the inflammatory process, massage can be prescribed - 10 procedures every other day. It is important that the manipulation is carried out by an experienced manual therapist, specializing in therapeutic massage.

For stretching, two methods can be used:

• Manual - the doctor manually performs the procedure of traction of the joint;
• with the aid of a traction apparatus - drawing is done on a vertical axis on a specially designed apparatus.

The third stage of coxarthrosis is treated mainly with the help of operative joint replacement, this method is called endoprosthetics.

Diet for patients with coxarthrosis

Doctors prescribe a diet as an obligatory part of the treatment, because proper nutrition will help to compensate for the missing components in the cartilaginous tissue.

The supply of the hip joint provides a fluid that forms directly inside it. When its quality or quantity changes for the worse, the amortization capabilities of the joint sharply decrease. If you saturate the body with useful microelements, the process of recovery will begin. This process ensures proper nutrition, in which the necessary vitamins and trace elements enter the body.

For restoration at the cellular level, the body needs a group of vitamins: A, E, C and B vitamins.It is necessary to consume vegetable food, as much as possible vegetables and fruits, which contain vitamins and minerals. In addition, very useful cereals are coarse. When preparing dishes, it is recommended to use by-products. They are brewed for starters, and then they are used. It is necessary to eat more fish and seafood, because they contain a lot of fluoride and phosphorus.

Daily you need to eat porridge: rice, oatmeal, buckwheat, pearl. Rice is better to prefer brown. That during cooking from croups did not leave all microcells, it is better to bring them only to the state of semi-preparedness. In order not to eat raw porridge, the pan can be tightly closed with a lid and wrapped with a towel, then the croup will reach the desired state under the influence of steam. Ready-made cereals can be added honey, dried apricots, raisins.

Pregnancy in coxarthrosis

Bearing a child with coxarthrosis requires careful management of pregnancy by two specialists at once by a gynecologist and rheumatologist. The second and third trimester future mother should hold, observing bed rest and not allowing even a minimal load on the hip joint. Childbirth with coxarthrosis is most often performed by caesarean section to avoid excessive exercise. Which can cause destruction of the hip joint of the mother.

Deforming arthrosis of the hip joint is a complex and rather dangerous disease requiring well-chosen complex treatment, therefore at the first symptoms it is necessary to consult a doctor.