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 mismatching of the articular surfaces, which leads to abnormal friction. In some patients, the disease develops due to femoral head ischemia 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 use x-rays and computed tomography to diagnose osteoarthritis of the hip joint.
Treatment of deforming osteoarthritis of the hip joint is carried out with the latest drugs that are highly effective and have minimal side effects. Doctors discuss severe cases of coxarthrosis and decide the tactics of treating each patient. Rehabilitation therapists use innovative methods of restorative therapy to slow the progression of articular cartilage degeneration.
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Signs of osteoarthritis of the hip joint
Patients suffering from deforming osteoarthritis complain of sudden attacks of stiffness in the hip joint that occur after a state of rest and disappear after some activity. Initial mild attacks of pain last 1 to 2 days and increase after prolonged exertion.
Often, defensive lameness occurs due to muscle spasms accompanied by pain and a gradually increasing sense of joint stiffness. Osteoarthritis of the left hip joint manifests itself through the same symptoms as osteoarthritis of the right hip joint. Pain in osteoarthritis of the hip joint is localized along the antero-outer or posterior articular surface, depending on the site of inflammation. It radiates to the front and inside of the thigh and the hollow of the knee. The pain syndrome intensifies after prolonged exertion and movements, especially in the direction of internal rotation, abduction and extension. Patients often complain of increased pain in damp and cold weather and notice relief when heated and after taking acetylsalicylic acid preparations.
In the acute phase of osteoarthritis of the hip joint, patients notice pain over the inflammation site of the capsule, accompanied by muscle spasms engulfing the adductors of the thigh. Orthopedic surgeons perform the Faber test: the patient places the heel of the affected extremity on the back of the healthy foot and pushes it over the skin of the tibial surface of the lower leg up to the knee. It will be positive for any inflammatory process in the hip joint.
In the early stages of osteoarthritis of the hip joint, there are no changes on the x-rays. Later, radiologists occasionally show subchondral sclerosis, which gradually narrows the joint space. An additional sign is the flattening of the head at the upper pole, which is accompanied by cystic changes in this area.
Degree of osteoarthritis of the hip joint
In the further course, the deforming osteoarthritis of the hip joints goes through several stages, which differentiate between three degrees of disease.
Deforming osteoarthritis of the 1st degree is the initial stage of the disease when there are no obvious changes in the structure of the joint tissue. Pain syndrome is often absent, if it does occur, 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.
In deforming osteoarthritis of the 2nd degree, morphological changes are evident. The articular surfaces are uneven, there are distinct bony growths. The bone tissue in the joint area becomes less strong. As a result of the inflammatory process, the synovial membrane thickens greatly. The pain can be dull, inherently painful and persistent, or it can be sharp and abrupt.
With deforming arthrosis grade 3, the pain becomes so severe that it does not go away even after a long period of rest. The mobility in the diseased joint is limited, the limb axis can be disturbed. Ulcers and tooth decay can form in the cartilage tissue that covers the joint surfaces.
Treat osteoarthritis of the hip joint
Conservative treatment of osteoarthritis of the hip joint is carried out with the exacerbation of the disease. It includes limb relief, traction, warmth, and massage. To reduce the inflammatory process, salicylates are prescribed. Injections of glucocorticoids are carried out with osteoarthritis of the hip joint of 1 and 2 degrees. In the third stage of deforming hip arthrosis, 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 physiotherapy and exercise therapy, diet correction. Effective therapy of the initial stages of the disease allows sufferers with osteoarthritis of the hip joint 1 and 2 to avoid endoprosthetics and limit the need for medication.
Surgical treatment of deforming coxarthrosis
In the case of 3rd degree coxarthrosis, if conservative treatment does not bring relief, only prosthetics can help to relieve the patient of pain and discomfort and restore the joy of movement. If there is fluid in the joint, it is pumped out after the puncture. At the same time, corticosteroid hormones are 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 the cavity is rinsed with a therapeutic solution to alleviate the inflammatory process. The 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
To treat patients with osteoarthritis of the hip joint, the following types of physiotherapy are used:
- Shock wave therapy - exposure to sound waves that supply blood to the desired area of the body, stimulate the processes of regeneration and accelerate the metabolism;
- Myostimulation, which restores the work of muscles weakened due to the forced restriction of movement in the joint;
- Phonophoresis is a method that combines the benefits of ultrasound and drug action 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 into the hip joint);
- Ozone therapy - relieves discomfort and activates the growth of cartilage tissue due to the properties of the ozone-oxygen mixture.
Kinesitherapy is the basis for the successful treatment of osteoarthritis of any location. Regularly performing a special system of gymnastics exercises strengthens the ligaments and muscles around the joint affected by the pathological process, which reduces the discomfort associated with the usual daily load. The instructor individually selects exercises for hip osteoarthritis of 1, 2 and 3 degrees. The specialists of the rehab clinic perform various types of massage, including lymphatic drainage, use innovative manual therapy techniques aimed at passive work with muscles, ligaments and joints. Approaches that help people with coxarthrosis reduce the need for pills and injections for deforming osteoarthritis, which reduces the pharmacological burden on the body.
Rehabilitation clinics are equipped with modern mechanical and computer-aided simulators from the world's leading manufacturers. They help to train the joint without great physical exertion, which is particularly popular with older people. Stretching the joints with the help of a special traction device or the hands of a chiropractor increases the space in the joint, which sets the pathological process back a few steps, relieves symptoms and gives the body time to restore the hip joint to function.
Diet therapy is necessary in all patients with osteoarthritis of the hip joint, but it is most important in overweight people. Losing weight reduces the stress on the inflamed joint and improves metabolism. In combination with other conservative methods, a balanced diet will allow you to forget about pain and other manifestations of osteoarthritis arthritis of the hip joint.
Gymnastics for osteoarthritis of the hip joint
Gymnastic exercises with osteoarthritis of the hip joint are not prescribed in the following cases:
- with exacerbations of osteoarthritis arthritis;
- after a recent major surgery;
- in the presence of a hernia, acute diseases of the internal organs;
- during menstruation;
- with an increase in body temperature over more than 37, 50WITH.
The therapist selects all exercises individually. The trainer takes into account the age of the patient, the severity of the pathological process and the presence of concomitant diseases. In the case of deforming osteoarthritis, well-chosen gymnastics should sensibly strain the muscles and ligaments of the hip joint, but not the joint, as it is already worn out.
The complex of gymnastic exercises in osteoarthritis of the hip joint consists of more static than dynamic exercises. 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 stress to restore the joint. The hip joint itself only takes minimal part in such exercises and does not wear out.