Hip deformity osteoarthritis is a disease of the elderly caused by degenerative processes in cartilage tissue. The progression of hip arthrosis is accelerated by abnormalities in the joint surfaces, leading to abnormal friction. In some patients, the disease develops after fracture of the femoral neck or direct damage to the vertebrae due to ischemia of the femoral head; 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.
Deforming arthrosis of the hip joint is treated with the latest drugs that are extremely effective and have minimal side effects. Doctors discuss severe cases of coxarthrosis and decide on tactics to treat each patient. Rehabilitation therapists use innovative restorative therapies to slow the progression of articular cartilage degeneration.
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Signs of arthrosis of the hip joint
Patients with deforming arthrosis complain of sudden stiffness in the hip joint, which appear after rest and disappear after certain activities. Initially, seizures of mild pain last for 1-2 days and intensify after prolonged exercise.
Often, defensive lameness occurs due to muscle cramps, accompanied by pain and gradually increasing joint stiffness. Left hip arthrosis presents with the same symptoms as right hip arthrosis. Pain in the arthrosis of the hip joint is localized along the anterior, outer, or posterior surface of the joint, depending on the site of inflammation. It radiates to the anterior and inner surfaces of the thigh and to the popliteal fossa. Pain syndrome is exacerbated after prolonged loading of the limb and movements, especially in the direction of internal rotation, abduction, and stretching. Patients often complain of increased pain in wet and cold weather and note that it is relieved after taking warm and acetylsalicylic acid preparations.
During the acute period of arthrosis-arthritis of the hip, patients experience pain at the site of inflammation of the capsule, accompanied by a muscle spasm that absorbs the muscles of the thigh adductor. Orthopedists perform the Faber test: the patient places the corner of the affected limb on the back of a healthy leg and slides it upward on the skin of the tibia of the lower leg to the knee. It will be positive for any inflammatory process in the hip joint.
In the early stages of hip arthrosis, there is no change on radiographs. Later, radiologists occasionally reveal subchondral sclerosis, which gradually leads to narrowing of the joint space. Another sign is a flattened head in the upper pole of the head, which is associated with cystic changes in this area.
The degree of arthrosis of the hip joint
As it progresses, deforming arthrosis of the hip joints goes through several stages that distinguish three degrees of disease.
First-degree deforming arthrosis is the initial stage of the disease, when there are still no obvious changes in the structure of joint tissue. Pain syndrome is often absent, if it occurs, in the background of the inflammatory process. Patients may complain of limb stiffness and fatigue. Often, the first stage of osteoarthritis of the hip joint is asymptomatic.
With grade 2 deforming arthrosis, morphological changes are evident. The joint surfaces are uneven and have significant bony growths on them. The bone tissue in the joint area will be less strong. Due to the inflammatory process, the synovial membrane thickens greatly. The pain may be dull, sore and persistent, or it may appear sharp and sudden.
In grade 3 deforming arthrosis, the pain becomes so intense that it does not go away even after a long rest. Mobility in the diseased joint is reduced, and the axis of the limb can cause confusion. Ulcers and areas of decay may form in the cartilage tissue covering the joint surfaces.
How to treat hip arthrosis
Conservative treatment of hip arthrosis is performed as the disease worsens. This includes limb unloading, grip, warmth and massage. Salicylates are prescribed to reduce the inflammatory process. Glucocorticoid injections are given for 1 and 2 degree arthrosis of the hip joint. In the third stage of deforming arthrosis of the hip joint, the only effective treatment is the planned replacement of the hip joint with an endoprosthesis.
Complex treatment of hip arthrosis is performed with the help of physiotherapy and kinesitherapy, diet correction. Effective therapy in the early stages of the disease allows patients with grade 1 and 2 arthrosis of the hip joint to avoid arthroplasty and limit the need for medications.
Surgical treatment of deforming coxarthrosis
In grade 3 coxarthrosis, when conservative treatment does not bring relief, only the prosthesis helps relieve the patient of pain and discomfort, giving him or her the pleasure 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.
Arthroscopic debridement is used to clean the inner surface of the joint of fragments of altered cartilage tissue and to flush its cavity with a therapeutic solution to relieve the inflammatory process. Periarticular osteotomy is an artificial fracture of the femur followed by fusion at a different angle. Surgery can reduce the load on the joint.
Rehabilitation methods for deforming arthrosis
The following physiotherapy methods are used to treat patients with osteoarthritis of the hip:
- shock wave therapy - exposure to sound waves that provide blood flow to a desired area of the body, which stimulates regeneration processes and speeds up metabolism;
- myostimulation, which restores the work of muscles weakened by forced joint restriction;
- phonophoresis is a method that combines the benefits of ultrasound and medicated effects on the body (the device allows the drug in the form of an ointment or cream to penetrate more effectively through the skin to the hip joint);
- ozone therapy - reduces discomfort and activates cartilage tissue growth due to the properties of the ozone-oxygen mixture.
Physiotherapy is the basis for the successful treatment of arthrosis of any localization. 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 normal daily stress. The training therapy instructor individually selects the practices for 1, 2, and 3 degrees of arthrosis of the hip joint. Rehabilitation clinic specialists perform a variety of massages, including lymphatic drainage, using innovative manual therapy techniques aimed at the passive work of muscles, ligaments and joints. Methods used to help people with coxarthrosis reduce the need for pills and injections for deforming arthrosis, which reduces the pharmacological burden on the body.
Rehabilitation clinics are equipped with modern mechanical and computer simulators from the world’s leading manufacturers. They help with joint exercise without significant physical effort, which is especially demanding among the elderly. Extending the joints with the help of a special pull tool or chiropractor increases the space inside the joint, which "throws back" the pathological process by a few steps, relieves symptoms and gives the body time to repair the hip joint.
Diet therapy is necessary for all patients with hip osteoarthritis, but is most important for overweight people. Weight loss reduces stress on the inflamed joint and improves metabolism. Combined 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 hip arthrosis are not prescribed in the following cases:
- with exacerbation of arthrosis-arthritis;
- after a recent major surgery;
- in the presence of a hernia, in acute diseases of internal organs;
- during menstruation;
- with a rise in body temperature above 37. 50WITH.
The therapist selects each practice individually. The instructor of the training therapy takes into account the age of the patient, the severity of the pathological process and the presence of concomitant diseases. In deforming arthrosis, a well-chosen gymnastics should put a beneficial load on the muscles and ligaments of the hip joint, but not on the joint because it is already worn out.
The complex of gymnastic exercises for hip arthrosis consists of more static exercises than dynamic ones. Static exercises are those in which the position of the body must be recorded for a few seconds. If such movements are sufficient, the muscles and ligaments of the legs will receive the necessary load to restore the joint. The hip joint itself is minimally involved in such exercises and does not wear out.