Deformative osteoarthritis of the hip joint is a disease of the elderly that is caused by degenerative processes in cartilage tissue. The progression of osteoarthritis of the hip joint is accelerated by discrepancy between the joint surfaces, leading to abnormal friction. In some patients, the disease develops due to ischemia in the femoral head after fracture of the femoral neck or direct damage to 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 performed with the latest drugs, which are extremely effective and have minimal side effects. Physicians discuss severe cases of coxarthrosis and decide the tactics for treating each patient. Rehabilitation therapists use innovative methods of restorative therapy to slow the development 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. First, bouts of minor pain last for 1 to 2 days, intensifying after prolonged periods of weight bearing.
Defensive lameness often occurs due to muscle spasms, which are 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-outer 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 strain on limbs and movements, especially in the direction of internal rotation, abduction and elongation. Patients often complain of increased pain in humid and cold weather and notice relief in heat and after taking acetylsalicylic acid preparations.
During the acute period of osteoarthritis of the hip joint, patients notice tenderness over the site of inflammation in the capsule, which is accompanied by muscle spasms that engulf 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 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.
In the early stage of osteoarthritis of the hip joint, there are no changes on X-rays. Later, radiologists occasionally detect subchondral sclerosis, which gradually leads to a narrowing of the joint space. A further sign is the flattening of the head in the 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 that separate three degrees of the disease.
Deformation of osteoarthritis of 1st 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 occurs, then due to the inflammatory process. Patients may complain of stiffness and fatigue in the limbs. Often, the first degree of osteoarthritis of the hip joint is asymptomatic.
With 2nd degree deforming osteoarthritis, 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 strong. Due to the inflammatory process, the synovial membrane thickens a lot. The pain may be dull, painful in nature and last constantly, or it may appear sharp and sudden.
In the case of grade 3 deforming osteoarthritis, the pain becomes so intense that it does not go away, even after prolonged rest. The mobility of the diseased joint is reduced, the axis of the limbs may be disturbed. Wounds and decay areas can form in the cartilage tissue that covers the joint surfaces.
How to treat osteoarthritis of the hip joint
Conservative treatment of osteoarthritis of the hip joint is performed with exacerbation of the disease. It includes limb reading, traction, heat and massage. To reduce the inflammatory process, salicylates are prescribed. Injections of glucocorticoids are performed for osteoarthritis of the hip joint at 1 and 2 degrees. In the third stage of deformity of osteoarthritis 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 performed using physiotherapy and kinesiotherapy, dietary correction. Effective therapy of the early stages of the disease allows sick people 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 third-degree coxarthrosis, when conservative treatment does not provide relief, only dentures help relieve the patient of pain and discomfort, restoring him 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.
By arthroscopic debridement, the inner surface of the joint is cleansed of fragments of altered cartilage tissue, and its cavities are 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 the strain on the joint.
Rehabilitation methods for deforming osteoarthritis
The following forms of physiotherapy are used to treat patients with osteoarthritis of the hip joint:
- shock wave therapy - exposure to sound waves that provide blood flow to the desired area of the body, stimulating regeneration processes and speeding up metabolism;
- myostimulation, which restores work in muscles that are weakened due to the forced restriction of movements in the joint;
- phonophoresis is a method that combines the benefits of ultrasound and drug 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 due to the properties of the ozone-oxygen mixture.
Kinesitherapy is considered to be the foundation for a successful treatment of osteoarthritis in any localization. The regular implementation of a special system of gymnastic exercises strengthens ligaments and muscles around the joint that are affected by the pathological process, reducing discomfort during the usual daily stress. The exercise therapist instructor individually selects exercises for osteoarthritis of the hip joint at 1, 2 and 3 degrees. Rehabilitation clinic specialists 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 pills and injections to deform osteoarthritis, reducing 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 exertion, which is especially in demand among the elderly. Elongation of the joints using a special traction or the hands of a chiropractor increases the space inside the joint, which "throws" the pathological process back a few steps, relieves symptoms and gives the body time to restore the function of the hip joint.
Diet is necessary for all patients with osteoarthritis of the hip joint, but is most important for the obese. Weight loss will be followed by fatigue and constant tiredness. In combination with other conservative methods, a balanced diet allows you to forget about pain and other manifestations of osteoarthritis 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 osteoarthritis;
- after a recent major operation;
- in the presence of hernia, acute diseases of internal organs;
- during menstruation;
- with an increase in body temperature above more than 37, 50WITH.
The therapist selects all exercises individually. The training therapist 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 provide a useful strain to the muscles and ligaments of the hip joint, but not to the joint because it is already worn.
The complex of gymnastic exercises for osteoarthritis of the hip joint consists of more static exercises than dynamic ones. Static exercises are those where you need to determine the position of the body for a few seconds. If such movements are sufficient, the muscles and ligaments of the leg receive the necessary load to restore the joint. The hip joint itself participates minimally in such exercises and does not wear out.