Deforming osteoarthritis of the hip joint is a disease of the elderly, caused by degenerative processes of the cartilage tissue. The progression of osteoarthritis of the hip joint is accelerated by the mismatch of the joint surfaces, which leads to abnormal friction. In some patients the disease develops from ischemia of the femoral head following 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 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 each patient's treatment tactics. Rehabilitation therapists use innovative methods of restorative therapy to slow the progression of joint cartilage degeneration.
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Signs of osteoarthritis of the hip joint
Patients with deforming osteoarthritis complain of sudden attacks of stiffness in the hip joint, which appear after a state of rest and disappear after a certain activity. At first, minor pain attacks last from 1 to 2 days, intensifying after prolonged periods of loading.
Often, defensive lameness occurs due to muscle spasm, which is accompanied by pain and a gradually increasing sensation 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-external 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 load on the limb 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 in 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, which is accompanied by muscle spasm enveloping 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 healthy foot and slides it along 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 initial stage of osteoarthritis of the hip joint, there are no changes in the radiographs. Subsequently, radiologists occasionally reveal subchondral sclerosis, which gradually leads to a narrowing of the joint space. A further sign is the flattening of the head in its upper pole, which is accompanied by cystic changes in this area.
The degree of osteoarthritis of the hip joint
As it progresses, deforming osteoarthritis of the hip joints goes through several stages, respectively, which distinguish three degrees of the disease.
1st degree deforming osteoarthritis is the initial stage of the disease, when there are still no noticeable changes in the structure of the joint tissues. Pain syndrome is often absent, if it occurs, then against the background of the inflammatory process. Patients may complain of limb stiffness and fatigue. Often the first degree of osteoarthritis of the hip joint is asymptomatic.
With 2nd degree deforming osteoarthritis, morphological changes are evident. The joint surfaces are uneven, there are significant bone growths on them. The bone tissue in the joint area becomes less strong. Due to the inflammatory process, the synovial membrane noticeably thickens. The pain can be dull, aching in nature and last constantly, or it can come on sharply and suddenly.
In the case of grade 3 deforming osteoarthritis, 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 limb can be disturbed. In the cartilage tissue that covers the joint surfaces, ulcers and areas of decay can form.
How to treat osteoarthritis of the hip joint
Conservative treatment of arthrosis of the hip joint is carried out with exacerbation of the disease. Includes limb unloading, traction, heat and massage. To reduce the inflammatory process, salicylates are prescribed. Injections of glucocorticoids are performed for osteoarthritis of the hip joint of 1 and 2 degrees. 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 arthrosis of the hip joint is carried out by physiotherapy and kinesitherapy, diet correction. Effective therapy of the early stages of the disease allows patients with 1 and 2 degrees of osteoarthritis of the hip joint to avoid arthroplasty and limit the need for medication.
Surgical treatment of deforming coxarthrosis
With 3rd degree coxarthrosis, when conservative treatment does not bring relief, only prostheses help relieve the patient from pain and discomfort, restoring the joy of movement. If there is fluid in the joint, it is pumped out after the puncture. Corticosteroid hormones are injected simultaneously into the hip joint.
With the help of arthroscopic debridement, the internal 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 a different angle. Surgery can reduce the stress on the joint.
Rehabilitation methods for deforming osteoarthritis
For the treatment of patients with osteoarthritis of the hip joint, the following types of physiotherapy are used:
- shock wave therapy - exposure to sound waves that provide blood flow to the desired area of the body, which stimulates regeneration processes and accelerates metabolism;
- myostimulation, which restores the work of muscles that have weakened due to the forced limitation of movements in the joint;
- phonophoresis is a method that combines the advantages of ultrasonic and pharmacological effects on the body (under the influence of the device, a drug in the form of an ointment or cream penetrates more effectively through the skin to the hip joint);
- ozone therapy - reduces discomfort and activates the growth of cartilage tissue thanks to the properties of the ozone-oxygen mixture.
Kinesiotherapy is considered the basis for the successful treatment of arthrosis of any localization. Regular implementation of a special gymnastic exercise system strengthens the ligaments and muscles around the joint affected by the pathological process, which reduces discomfort during normal daily stress. The physical therapy instructor individually selects exercises for osteoarthritis of the hip joint of 1, 2 and 3 degrees. The rehabilitation clinic specialists perform various types of massage, including lymphatic drainage, use innovative manual therapy techniques aimed at passive work with muscles, ligaments and joints. The approaches used to help people with coxarthrosis reduce the need for pills and injections for deforming osteoarthritis, which reduces the drug 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 joint without significant physical exertion, which is especially in demand among older people. The extension of the joints with the aid of a special traction device or the hands of a chiropractor increases the space within the joint, which "pushes" the pathological process back a few steps, relieving 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 more important for people who are overweight. Losing weight reduces the stress on the inflamed joint and improves metabolism. In combination with other conservative methods, a balanced diet allows you to forget about pain and other manifestations of arthrosis-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 surgery;
- in the presence of a hernia, acute diseases of internal organs;
- during menstruation;
- with an increase in body temperature above 37, 50WITH.
The therapist selects all exercises individually. The physical therapy instructor takes into account the age of the patient, the severity of the pathological process and the presence of concomitant diseases. With deforming osteoarthritis, well-chosen gymnastics should give a payload 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 than dynamic exercises. Static exercises are those where you need to fix the body position 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 a minimal part in such exercises and does not wear out.