Hip joint deforming osteoarthritis is a disease of the elderly, which is caused by degenerative processes in the cartilage tissue. The progression of hip joint arthrosis is accelerated by incompatibility of the joint surfaces, which leads to abnormal friction. In some patients, the disease develops due to femoral head ischemia following femoral neck fractures or direct damage to the articular cartilage; in 50% of cases, the cause of the disease is unknown. Doctors diagnose hip joint osteoarthritis using x-rays and CT scans.
The treatment of deforming arthrosis of the hip joint is made with the most modern drugs, highly effective and with minimal side effects. Doctors discuss severe cases of coxarthrosis and decide on treatment tactics for each patient. Rehabilitation therapists use innovative restorative therapy methods to slow the progression of articular cartilage degeneration.
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Signs of arthrosis of the hip joint
Patients suffering from arthrosis deformans complain of sudden attacks of stiffness in the hip joint, which appear after a state of rest and disappear after some activity. At first, bouts of mild pain last 1 to 2 days, intensifying after prolonged periods of weight-bearing.
Defensive lameness often occurs due to muscle spasm, which is accompanied by pain and an increasing sensation of joint stiffness. Arthrosis of the left hip joint presents with the same symptoms as arthrosis of the right hip joint. Arthrosis pain of the hip joint is located along the antero-external or posterior surface of the joint, depending on the site of inflammation. It radiates to the front and inner surfaces 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 damp, cold climates and notice relief in the heat and after taking aspirin 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 involving 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 across the skin from the tibial surface of the leg to the knee. It will be positive for any inflammatory process in the hip joint.
In the early stage of arthrosis of the hip joint, there are no changes on radiographs. Later, radiologists occasionally reveal subchondral sclerosis, which gradually leads to a 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 arthrosis 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.
First-degree deforming arthrosis is the initial stage of the disease, when there are still no evident changes in the structure of joint tissues. Pain syndrome is usually absent, if it arises, then in the context of the inflammatory process. Patients may complain of stiffness and fatigue in the limbs. First-degree hip joint osteoarthritis is often asymptomatic.
In second-degree deforming arthrosis, morphological changes are evident. Joint surfaces are uneven, with significant bony protuberances. Bone tissue in the joint area becomes less strong. Due to the inflammatory process, the synovial membrane becomes very thick. The pain can be dull, painful in nature, and last constantly, or it can occur acutely and abruptly.
In the case of deforming arthrosis grade 3, the pain becomes so intense that it does not disappear even after prolonged rest. Mobility in the diseased joint is reduced, the limb axis may be disturbed. Ulcers and areas of decomposition can form in the cartilaginous tissue that covers the joint surfaces.
How to Treat Arthrosis of the Hip Joint
Conservative treatment of arthrosis of the hip joint is carried out with exacerbation of the disease. Includes limb discharge, traction, heat and massage. To reduce the inflammatory process, salicylates are prescribed. Glucocorticoid injections are performed for 1-degree and 2-degree hip joint arthrosis. In the third stage of deforming arthrosis of the hip joint, the only effective treatment is planned replacement of the hip joint with an endoprosthesis.
The complex treatment of arthrosis of the hip joint is carried out with physiotherapy and kinesiotherapy, correction of the diet. Effective therapy of the early stages of the disease allows patients with 1-degree and 2-degree arthrosis of the hip joint to avoid arthroplasty and limit the need for medications.
Surgical treatment of deforming coxarthrosis
In 3rd degree coxarthrosis, when conservative treatment does not bring relief, only the prosthesis helps to relieve the patient's 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 simultaneously injected into the hip joint.
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 a different angle. Surgery can reduce stress on the joint.
Rehabilitation methods for deforming arthrosis
For the treatment of patients with osteoarthritis of the hip joint, the following types of physical therapy are used:
- shockwave 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 work to weakened muscles due to the forced limitation of joint movement;
- phonophoresis is a method that combines the advantages of ultrasonic effects and medications on the body (under the influence of the device, a medication in the form of an ointment or cream penetrates more effectively through the skin to the hip joint);
- ozone therapy - reduces discomfort and activates cartilage tissue growth due to the mixed properties of oxygen and ozone.
Kinesiotherapy is considered the basis for the successful treatment of arthrosis in 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 discomfort during habitual daily stress. The exercise therapy instructor individually selects 1, 2, and 3 degree hip joint arthrosis exercises. Specialists in rehabilitation clinics perform various types of massage, including lymphatic drainage, use innovative manual therapy techniques aimed at passively working muscles, ligaments and joints. Approaches used to help people with coxarthrosis reduce the need for pills and injections for arthrosis deformans, which reduces the drug burden on the body.
Rehabilitation clinics are equipped with modern computerized mechanical simulators from the world's leading manufacturers. They help exercise the joint without significant physical effort, which is especially sought after among the elderly. Extending the joints with the help of a special traction device or with the hands of a chiropractor increases the space within the joint, which "throws" the pathological process backwards in 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 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 pain and other manifestations of arthrosis-arthritis of the hip joint.
Gymnastics for arthrosis of the hip joint
Gymnastic exercises for arthrosis of the hip joint are not prescribed in the following cases:
- with arthrosis-arthritis exacerbations;
- 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 physiotherapy 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 arthrosis of the hip joint consists of static rather than dynamic exercises. Static exercises are exercises where you need to fix your body position for a few seconds. If such movements are sufficient, the muscles and ligaments in the legs are given the necessary load to restore the joint. The hip joint itself plays a minimal role in these exercises and does not wear out.