Deforming osteoarthritis of the hip joint is a disease of the elderly, which is caused by degenerative processes of cartilage tissue. The progression of osteoarthritis of the hip is accelerated by the mismatch of the joint surfaces, which leads to unusual 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 with the help of X-rays and computed tomography.
The treatment of deforming arthrosis of the hip joint is performed with the latest drugs that are highly effective and have minimal side effects. Doctors discuss severe cases of coxarthrosis and decide on treatment tactics for each patient. Rehabilitation therapists use innovative methods of rehabilitation therapy to slow the progression of articular cartilage degeneration.
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Signs of osteoarthritis of the hip
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. Initially, attacks of mild pain last from 1 to 2 days, intensifying after prolonged periods of weight bearing.
Often, protective lameness occurs due to muscle spasm, which is accompanied by pain and a gradually increasing feeling of joint stiffness. Osteoarthritis of the left hip is manifested by the same symptoms as osteoarthritis of the right hip. Pain in osteoarthritis of the hip is localized along the antero-outer or posterior surface of the joint, depending on the site of inflammation. It radiates to the anterior and inner surface of the thigh and to the popliteal fossa. The pain syndrome intensifies after prolonged loading of the limb and movements, especially in the direction of internal rotation, abduction and stretching. Patients often complain of increased pain in wet and cold weather and experience relief from heat and after taking acetylsalicylic acid preparations.
In the acute period of osteoarthritis of the hip, patients notice pain above the site of inflammation of the capsule, which is accompanied by muscle spasm, which covers 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 firm foot and slides it up the skin on the tibial surface of the lower leg to the knee. It will be positive for any inflammatory process in the hip joint.
There are no X-rays in the early stages of osteoarthritis of the hip. Later, radiologists occasionally revealed subchondral sclerosis, which gradually led to narrowing of the joint space. An additional sign is the flattening of the head at its upper pole, which is accompanied by cystic changes in this area.
The degree of osteoarthritis of the hip joint
As it progresses, the deforming arthrosis of the hip joints goes through several stages, respectively, which distinguish three degrees of the disease.
Grade 1 deforming osteoarthritis is the initial stage of the disease, when there are still no obvious changes in the structure of the joint tissues. The pain syndrome is often absent, if it occurs, then against the background of the inflammatory process. Patients may complain of stiffness and fatigue in the limbs. Often, first-degree osteoarthritis of the hip is asymptomatic.
In grade 2 deforming osteoarthritis, the morphological changes are obvious. The joint surfaces are uneven, there are significant bone growths on them. The bone tissue in the joint area becomes less healthy. Due to the inflammatory process, the synovial membrane thickens significantly. The pain may be dull, painful in nature, and persistent, or it may appear sharp and abrupt.
In the case of grade 3 deforming osteoarthritis, the pain becomes so severe that it does not disappear even after prolonged rest. Mobility in the diseased joint is reduced, the axis of the limb may be impaired. Ulcers and areas of putrefaction can form in the cartilage tissue that covers the joint surfaces.
How to treat osteoarthritis of the hip
Conservative treatment of osteoarthritis of the hip is carried out with exacerbation of the disease. It includes limb unloading, traction, warmth and massage. Salicylates are prescribed to reduce the inflammatory process. Glucocorticoid injections are performed for osteoarthritis 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 osteoarthritis of the hip joint is carried out with the help of physiotherapy and kinesitherapy, dietary adjustment. Effective therapy in the early stages of the disease allows patients with grade 1 and 2 osteoarthritis of the hip to avoid arthroplasty and 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 relieve the patient's pain and discomfort by restoring the joy of movement. If there is fluid in the joint, it is pumped after the puncture. Corticosteroid hormones are injected simultaneously into the hip joint.
With the help of arthroscopic removal, the inner surface of the joint is cleaned of fragments of altered cartilage 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 different angles. Surgery can reduce stress on the joint.
Rehabilitation methods for deforming arthrosis
The following types of physiotherapy are used to treat patients with osteoarthritis of the hip:
- 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 that have weakened due to the forced restriction of movements in the joint;
- phonophoresis is a method that combines the advantages of ultrasound and drug action on the body (under the influence of the device drug in the form of 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 the basis for the successful treatment of osteoarthritis from any location. Regular application of a special system of gymnastic exercises strengthens the ligaments and muscles around the joint affected by the pathological process, which reduces the discomfort during the usual daily stress. The exercise instructor individually chooses exercises for osteoarthritis of the hip joint of 1, 2 and 3 degrees. The specialists in the rehabilitation clinic perform various types of massages, including lymphatic drainage, use innovative techniques for manual therapy, aimed at passive work with muscles, ligaments and joints. The approaches used to help people with coxarthrosis reduce the need for pills and injections to deform the osteoarthritis, which reduces the pharmacological burden on the body.
Rehabilitation clinics are equipped with modern mechanical and computer simulators from the world's leading manufacturers. They help to exercise the joint without significant physical effort, which is especially sought after among the elderly. Elongation of the joints with the help of a special pulling device or the hands of a chiropractor increases the space inside the joint, which "throws" the pathological process a few steps back, relieving symptoms and giving the body time to restore hip function.
Diet therapy is necessary for all patients with osteoarthritis of the hip, but is most important for overweight people. Weight loss reduces stress on the inflamed joint and improves metabolism. In combination with other conservative methods, a balanced diet allows you to forget about the pain and other manifestations of osteoarthritis of the hip.
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 osteoarthritis;
- 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, 50S.
The therapist chooses all exercises individually. The exercise instructor takes into account the age of the patient, the severity of the pathological process and the presence of concomitant diseases. In deforming osteoarthritis, 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 in which 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.