Coxarthrosis - degenerative disease that leads to collapse of the hip joint and has a chronic character to the flow. It is more common in older age groups. More sick women than men.
At the beginning of the disease - it gradually develops slowly. It may affect one joint, or both. Is the most common type of arthritis.
Why develops the disease?
Coxarthrosis in some patients accompanied by the natural aging process of the organism and is the dmd of the tissues of the hip joint. At its creation affect the following factors:
- reduced nutrition of the tissues;
- congenital anomalies of the hip joint, in particular hip dysplasia;
- the delegation of injuries to the pelvic area;
- post-infectious coxarthrosis;
- aseptic necrosis of head of the hip joint;
- disease Pertusa (osteochondropathy).
Unfortunately, to determine the cause of this disease is not always possible and the pathology of the hip joint is called idiopathic coxarthrosis - therefore, the causes of which are not installed. It is in the constant storage problems. Ongoing scientific work in this area and the doctors came to the conclusion that the higher the risk of koxartrózya observed in these patients, the patients:
- Hereditary tendency to pathology. Patients whose parents were suffering from diseases of cartilage and bone tissue, in most cases will also have the similar problems;
- Overweight. The great weight of the body is the load on the joints, which are already regularly exposed to manual work;
- Metabolic disorders, diabetes. This leads to poor supply of oxygen and nutrients to the tissues of the joint, due to which they lose their properties.
Know the basic risk factors of the disease, it is possible to plan preventive measures for its prevention.
How to recognize the pathology of the hip joint?
Symptoms koxartrózya depends on the anatomical features of the musculoskeletal system, causes of the disease and the stage of the process. Take a look at the main clinical manifestations:
- soreness of the joint;
- the irradiation of pain in the knee, hip, groin area;
- stiffness of movement;
- limited mobility;
- abnormal gait, lameness;
- decrease in muscle mass of the thigh;
- shortening of the injured limb.
The clinical picture corresponds to the internal changes in the tissues of the joint. The symptoms grow gradually and in the early stages of the patient is them devotes appropriate attention. This is dangerous because just at the beginning of the process of treatment brings a greater effect.
The clinical and radiological extent koxartrózya
Listed below are the symptoms of the disease characteristic of each stage.
- 1 degree. The patient experiences periodic pain and discomfort. Discomfort troubled after physical exertion, the longer the provisions in a static pose. The pain is localized in the area of the joint and takes place after a rest. In this stage of the process is not compromised gait and no shortening of the legs. The changes are evident on the radiograph - shrinking joint space appears osteophytes (bone growths).
- 2 the degree. Increasing the intensity of the pain may occur at rest and radiates in the neighboring parts of the body. Appears claudication after a person long walked, or surge. Is limited range of motion in the joint. In parallel with the evolving changes of the x-ray pattern: moves to the head of the femur, osteophytes grow on the inner and outer edge of the acetabulum of the trough.
- 3 phase. Soreness will acquire a permanent character, appears in the daytime and night time. Significantly aggravated by walking, appears constant claudication. Sharply declining motor function, atrophy of the muscles of the legs. change of muscle tissue leads to the fact that the foot is a little "stretches" and becomes shorter. This leads to deformity of the posture and curvature of the body. The x-ray image at a given stage of the process: the total narrowing of the gap between the surfaces of the joint, deformation of the femoral head, significant growth of osteophytes.
Diagnostic program in diseases of the
The main method of diagnosis - x-ray. With its help it is possible to determine the presence of disease and its stage. On the x-ray analysed the structure of the joint on the theme of joint space narrowing, osteophytes, destruction of the head of the hip bone.
If it is necessary in the study of the condition of the soft tissues - takes place the magnetic resonance tomography. It allows you to examine in detail the status of the cartilage of the land joint and also the muscles of the hip area.
Modern methods and directions of treatment koxartrózya of the hip joint
Treatment koxartrózya can be conservative and surgical. Treatment koxartrózya is aimed at achieving the following objectives:
- reduce the painful symptoms;
- restoration of locomotor activity;
- rehabilitation and restoration of earning capacity;
- the prevention of complications;
- enhance the quality of life of the patient.
The beginning of the treatment consists in the modification of risk factors. For this the doctor recommended the following actions:
- normalization of body weight;
- refusal of bad habits;
- complete nutrition;
- normalization of body activities;
- balanced drinking regime;
- for a healthy sleep.
Conservative treatment we distinguish: the treatment and non-drug. Treatment treatment includes non-steroidal anti-inflammatory drugs, analgesics, chondroprotectors. Reduce the inflammatory process in the tissues of the joint, eliminate swelling and pain, restore range of motion and improve the condition of the cartilage.
Non-drug treatment includes, among other things, massage the affected area. It stimulates the work of muscles, confronts their dystrophy and is shown to prevent the shortening of the limb. A complete and professional massage stimulates the blood circulation in the area of the joint, and this, in turn, leads to the normalization of metabolism in the tissues. Please note that massages are not always helpful in coxarthrosis - it spends only between aggravations and in some stages of the process. Prescribe it can the attending physician will recommend the techniques of massage, the value of treatments and the duration of the course.
A necessary condition of treatment - therapeutic exercise. It is the prevention of contractures and progression of the disease. Exercise you takes place every day, only then to have the effect. Gymnastics is designed individually and prescribed by a doctor. Exercise improves overall health, reduce the risk of emotional disorders, reinforce the strength of the body.
Physiotherapy is another method, which is applied in coxarthrosis. It may be mud, therapeutic baths and shower, magnetic therapy. Used electro - and phonophoresis of medicinal substances.
If the above methods of treatment have not produced the effect or adopted too late - it is necessary to surgical treatment.
Operative intervention in coxarthrosis
Surgical treatment is used when ineffectiveness of conservative methods. This is especially true when a late diagnosis. Modern operational techniques and high quality equipment, operating will allow you to restore the structure and function of the joint, to return the person to the amount of moves and a normal quality of life. The most effective method of surgical treatment is joint replacement surgery.
A testimony to surgical intervention, are:
- coxarthrosis 2-3 degrees;
- the lack of effect of therapy;
- total restriction in the movement of walking.
Contraindications, which do not allow you to perform operations:
- decompensated condition of the kidneys, the heart, the liver;
- mental illness;
- the acute phase of the inflammatory process in the body.
Just for this purpose, the is performed preoperative diagnosis. However, if there is a possibility to correct the condition - the patient is preparing for surgery and after the intervention.
The operation consists in removal of the affected tissue, and the installation of the prosthesis. There are different models of implants. They differ in the way of their fastening in the bone – cement and cementless, material from which is made a total replacement. About all the features of the endoprosthesis and the complexity of the rapid intervention, it is possible to get information on consultation with the attending physician.
The rehabilitation period after surgical treatment
From the first day after the surgery, undergoing rehabilitation under the supervision of a physician. First, it consists in the implementation of passive movements, then the load gradually increases. Walking in the first time is allowed only with crutches, is permitted to sit and squat.
Of course, in the first time after the operation, there are restrictions on the load. There's no need to worry - because without the surgery, these restrictions preserved until the end of life. Reduction in physical activity after surgical treatment, it is necessary to strengthen the position of the endoprosthesis, restore the integrity of bones, healing of wounds. During the 2 months should be excluded from sports activities, physical load on the joint, long walks and some kinds of exercises. After a complete reconstruction of a person returns to full-fledged life, can play sports and different activities.
Terms of service endoprosthesis: most companies indicates a survival rate of almost 90% in terms of observation up to 15 years.