Deforming osteoarthritis of the hip joint is a disease of the elderly, caused by degenerative processes of cartilage tissue. The progression of osteoarthritis of the hip joint is accelerated by the misalignment of the articular surfaces, which leads to abnormal 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 joint using X-rays and CT scans.
The treatment of deforming osteoarthritis of the hip joint is carried out with the latest drugs, which are very effective and have minimal side effects. Doctors discuss severe cases of coxarthrosis and decide on the treatment tactics of each patient. Rehabilitation therapists use innovative restorative therapy methods 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, which appear after a state of rest and disappear after some activity. At first, episodes of mild pain last 1 to 2 days and intensify after prolonged periods of weight bearing.
Defensive lameness often occurs due to muscle spasm, which is accompanied by pain and a gradually increasing feeling 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 front and inner thigh surfaces and the popliteal fossa. The pain syndrome intensifies after prolonged loading on the limb and movements, especially in the direction of internal rotation, abduction and extension. Patients often complain of increased pain in cold, damp weather and experience relief from heat and after taking acetylsalicylic acid preparations.
In the acute period of osteoarthritis-arthritis of the hip joint, patients note 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 good foot and slides it across 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 on X-rays. 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 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 arthrosis of the hip joints goes through several stages, respectively, distinguishing three degrees of the disease.
Deforming osteoarthritis of the first degree is the initial stage of the disease, when there are still no obvious changes in the structure of the joint tissues. Pain syndrome is often absent, if it arises, 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 deforming osteoarthritis of the second degree, the morphological changes are obvious. The articular surfaces are uneven, there are significant bony growths on them. The bone tissue in the joint area becomes less strong. Due to the inflammatory process, the synovium becomes very thickened. The pain can be dull, painful in nature, and last constantly, or it can occur sharply and abruptly.
In the case of grade 3 deforming osteoarthritis, the pain becomes so severe that it does not go away even after a long rest. Mobility in the diseased joint is reduced, the axis of the limb may be altered. Ulcers and areas of breakdown can form in the cartilage tissue that covers the joint surfaces.
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. Glucocorticoid injections are done 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 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 in the early stages of the disease enables people with 1 and 2 degrees of osteoarthritis of the hip joint to avoid arthroplasty and limit the need for medications.
Surgical treatment of deforming coxarthrosis.
With third-degree coxarthrosis, when conservative treatment does not bring relief, only prosthetics help to relieve the patient of 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 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 to deform osteoarthritis.
For the treatment of patients with osteoarthritis of the hip joint, the following types of physical therapy are used:
- shock wave therapy - exposure to sound waves that provide blood flow to the desired area of the body, stimulating regeneration processes and accelerating metabolism;
- myostimulation, which restores the work of muscles that have been weakened due to forced limitation of movements in the joint;
- phonophoresis is a method that combines the advantages of ultrasonic effects and drugs 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 due to the properties of the ozone and oxygen mixture.
Kinesitherapy is considered to be the basis for the successful treatment of osteoarthritis of any location. The regular implementation of a special system of gymnastic exercises strengthens the ligaments and muscles around the joint affected by the pathological process, reducing discomfort during usual daily stress. The exercise therapy instructor individually selects exercises for osteoarthritis of the hip joint of 1, 2 and 3 degrees. The specialists of the rehabilitation clinic perform various types of massage, including lymphatic drainage, using innovative manual therapy techniques aimed at passive work with muscles, ligaments and joints. Approaches used to help people with coxarthrosis reduce the need for osteoarthritis deforming pills and injections, reducing the drug burden on the body.
The 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 effort, which is especially in demand among the elderly. Joint extension with the help of a special traction device or the hands of a chiropractor increases the space within the joint, which "backs off" the pathological process 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 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 arthrosis 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 the internal organs;
- during menstruation;
- with an increase in body temperature above more than 37. 50WITH.
The therapist selects all the exercises individually. The exercise therapy instructor takes into account the patient's age, the severity of the pathological process, and the presence of concomitant diseases. With deforming osteoarthritis, well-chosen gymnastics should provide a payload to the muscles and ligaments of the hip joint, but not to the joint, because it is already worn out.
The gymnastic exercise complex for 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 load to restore the joint. The hip joint itself has minimal involvement in such exercises and does not wear out.