Osteoarthritis deformity of the hip joint is a disease of the elderly, which is caused by degenerative processes of cartilage tissue. The progression of osteoarthritis of the hip joint is accelerated by the mismatch 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 computed tomography.
Treatment of deforming arthrosis of the hip joint is done with the latest medicines, 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 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 stiffening attacks on the hip joint, which appear after a resting state and disappear after some activities. Initially, periods of minor pain last 1 to 2 days, intensifying after prolonged periods of weight bearing.
Often, protective lameness occurs due to muscle spasm, which is accompanied by pain and a gradually increasing sensation of joint stiffness. Osteoarthritis of the left thigh joint manifests with the same symptoms as osteoarthritis of the right hip joint. Pain in osteoarthritis of the thigh joint is localized along the antero-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. The pain syndrome intensifies after prolonged load on the limb and movement, especially in the direction of internal rotation, abduction, and stretching. Patients often complain of increased pain in wet and cold weather and notice relief in the heat and after taking acetylsalicylic acid preparations.
In the acute period of arthrosis-arthritis of the hip joint, patients notice pain at the site of inflammation of the capsule, which is accompanied by muscle spasm that swallows 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 into the skin of the tibial surface of the lower leg at 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 the radiograph. Later, radiologists occasionally detect subchondral sclerosis, which gradually leads to a narrowing of the joint space. An additional sign is the flattening of the head at its upper pole, which is accompanied by cystic changes in this area.
The degree of osteoarthritis of the hip joint
As it progresses, the deformity of the arthrosis of the thigh joints goes through several stages, respectively, which distinguish three degrees of the disease.
Deformity of grade 1 osteoarthritis is the initial stage of the disease, when there are still no noticeable changes in the structure of the joint tissue. Pain syndrome is often absent, if it arises, then against the background of 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 grade 2 deforming arthrosis, morphological changes are evident. The articular surfaces are uneven, there is considerable bone growth 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 persistent, or it may occur sharply and suddenly.
In the case of grade 3 deforming osteoarthritis, the pain becomes so intense that it does not go away even after prolonged rest. Mobility in the diseased joint is reduced, the limb shaft may be disturbed. Ulcers and breakdown areas can form in the cartilage tissues that cover the articular surfaces.
How to treat osteoarthritis of the hip joint
Conservative treatment of osteoarthritis of the hip joint is done with the aggravation of the disease. It includes limb relaxation, traction, warmth and massage. To reduce the inflammatory process, salicylates are prescribed. Glucocorticoid injections are performed for grade 1 and 2 hip arthrosis. In the third stage of hip arthrosis deformity, 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 kinesitherapy, dietary correction. Effective therapy of the early stages of the disease allows people with grade 1 and 2 arthrosis of the hip joint to avoid arthroplasty and limit the need for medication.
Surgical treatment of deforming coxarthrosis
With grade 3 coxarthrosis, when conservative treatment does not bring relief, only prostheses help relieve the patient’s pain and discomfort, restoring to him the joy of movement. If there is fluid in the joint, it is pumped after drilling. Corticosteroid hormones are injected simultaneously into the hip joint.
With the help of arthroscopic dissection, the inner surface of the joint is cleaned of fragments of altered cartilage tissue and its cavity is rinsed with a therapeutic solution to facilitate the inflammatory process. Periarticular osteotomy is an artificial fracture of the femur followed by its fusion at another angle. Surgery can reduce stress on the joints.
Rehabilitation methods for osteoarthritis deformity
The following types of physiotherapy are used to treat patients with osteoarthritis of the hip joint:
- shock wave therapy - exposure to sound waves that ensure blood flow to the desired area of the body, which stimulates regeneration processes and speeds up metabolism;
- myostimulation, which restores the work of weakened muscles due to forced restriction of movements in the joints;
- phonophoresis is a method that combines the advantages of ultrasonic effects and drugs in the body (under the influence of the device, a drug in the form of an oil or cream penetrates more effectively through the skin into the hip joint);
- ozone therapy - reduces anxiety and activates cartilage tissue growth due to the properties of the ozone-oxygen mixture.
Kinesitherapy is considered to be the basis for the successful treatment of osteoarthritis of any localization. Regular implementation of a special system of gymnastic exercises strengthens the ligaments and muscles around the joint affected by the pathological process, which reduces the discomfort during the usual daily stress. The exercise therapy instructor individually selects exercises for arthrosis of the hip joint 1, 2 and 3 degrees. Specialists of the rehabilitation clinic perform various types of massages, including lymphatic drainage, use 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 for osteoarthritis deformity, which reduces the pharmacological burden on the body.
Rehabilitation clinics are equipped with modern mechanical simulators and computerized by the world's leading manufacturers. They help to exercise the joint without considerable physical effort, which is especially in demand in the elderly. Elongation of the joints with the help of a special traction device or the hands of a chiropractor increases the space inside the joint, which "throws" the pathological process a few steps back, relieving symptoms and giving the body time to restore the function of the hip joint.
Dietary therapy is necessary for all patients with osteoarthritis of the hip joint, but it is most important for overweight people. Weight loss reduces stress in the inflamed joint and improves metabolism. In combination with other conservative methods, a balanced diet allows you to forget about the pain and other manifestations of osteoarthritis-arthritis 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 a hernia, acute diseases of the internal organs;
- during menstruation;
- with an increase in body temperature above 37. 50ME.
The therapist chooses all the exercises individually. The exercise therapy 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 give a beneficial load to the muscles and ligaments of the hip joint, but not the joint because it is already tired.
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 adjust your body position 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 thigh joint itself participates minimally in such exercises and does not get tired.