Arthropathy of the hip, or coxoarthropathy, is a degenerative, dystrophic disease that causes the loss of elasticity and destruction of cartilage tissue and premature wear of the joints of the same name. Arthropathy is considered an age-related problem, which is confirmed by world statistics: after 40 years, a person faces a diagnosis every second, and approaching the age of 70, pathology will be found in 80% of cases. The frequency of hip structural changes in women is 2. 5 times that of men.
cause of disease
The hip joint is formed by the acetabulum, including the femoral head. A greater trochanter is attached to the head of the joint, surrounded by a synovial pocket containing a thick myxoid mass. The synovium nourishes the hip cartilage and ensures easy sliding between them without noise and pain. Age-related reductions in synovial fluid production and changes in its viscosity are major causes of hip arthropathy.
Hip arthropathy of the movable joint of the hip occurs when:
- Perth disease.
- Hip dysplasia.
- Reactive or infectious coxitis.
- Metabolic disorders. Diabetes and gout can lead to joint disease.
- Articular chondromatosis. The disease is characterized by the formation of free intraarticular bodies that destroy hyaline cartilage.
- mechanical injury. This includes hip fractures or dislocations (including congenital), joint capsule tears, frequent minimally invasive joints.
At risk are people who are overweight and have bad habits. In professional runners or weightlifters, connective tissue wears down quickly, and athletes are not immune to the effects of displacement of articular cartilage and rupture of hip muscles. By itself, arthropathy of the hip is not inherited, however, the structural characteristics of bone tissue or slow metabolism are genetically determined.
course of disease
First, arthropathy affects the large joints of the pelvis and knee (knee arthropathy), which are subject to enormous loads during exercise. Acute arthropathy develops during exacerbations, with pain on palpation of joint and hip tissue. As a result of incomplete or incorrect fusion of the femur after an injury, a new joint or pseudarthrosis can form, which is filled not with callus, but with connective tissue.
There are degrees 1, 2 and 3 arthropathy of the hip joint, and each stage of the disease has its own characteristics:
- Degree 1 arthropathy develops slowly, does not affect the mobility of joint structures, and has normal muscle tone. In the early stages of hip disease, the disease can only be detected on X-rays.
- Second-degree hip arthropathy is accompanied by severe pain in the hip, sometimes with a creaking sound at the joint. In arthropathy, it is difficult to rotate the hip joint and move it to one side, the joint space is narrowed, and the tension of the hip muscles is reduced. Contractures begin to form.
- For degree 3 hip arthropathy, the pain syndrome is evident. The legs are shortened due to muscle atrophy in the hip area and expansion of the femoral neck. When walking, the patient uses a support. Joint space can be completely lost due to arthropathy, in this case they speak of ankylosis.
In clinical practice, physicians frequently encounter involute hip arthropathy (typically in the elderly) and postinfectious hip arthropathy. Patients taking corticosteroids and antidepressants are at risk for endocrine-disordering arthropathy, a type of arthropathy that also affects the joints of menopausal women. In Arthritis-Arthritis, inflammatory rather than degenerative processes predominate in the hip joint.
If the cause of the disease has not been identified, we are talking about primary or idiopathic hip disease. Typically, the disease affects the joints of people who cross the 50-year milestone. Secondary arthropathy develops at a young age and is usually diagnosed as either the left hip or the right hip (unilateral hip arthropathy).
symptom
Symptoms of hip arthropathy do not bother the patient at first, except for occasional prolonged loads or awkward movements on the affected area as a reminder of the problem.
Hip hip joint disease manifests as:
- Pain in the hip area. The intensity and nature of joint pain depends on the stage of the arthropathy and weather conditions.
- Elevated body temperature. Arthritis of one or both hip joints - Arthritis observes joint chills and swelling.
- Weakness and subsequent atrophy of the muscles in the hip region.
- There is a noticeable tightening in the joints. May be a sign of hip disease, but not mandatory.
- lame. An indeterminate "duck" gait develops due to destruction of the femur in arthropathy.
People with hip joint disease often experience pain radiating to the patella, so inexperienced physicians, after listening to patients' chief complaints, may make the wrong diagnosis, delaying the recovery process for months.
diagnosis
Arthritis is diagnosed by a rheumatologist, traumatologist, or orthopedic surgeon. After questioning the patient, the doctor performs an external examination of the buttocks area, checks the mobility of the legs, and evaluates the gait of patients with hip arthropathy.
The most effective ways to diagnose arthropathy include:
- General and biochemical analysis of blood.
- Flat piece for the buttocks area.
- Ultrasound and NMR.
If femoral joint infectious arthropathy is suspected, the amount of synovial fluid is determined and its cellular content examined. To rule out the presence of autoaggressive antibodies in the body, the patient was sent for radiofrequency analysis in serum.
How is hip osteoarthritis treated?
Treatment of hip arthropathy is selected considering the stage of hip arthropathy, the age of the patient, and concomitant diagnoses. Arthropathy of the 1st and 2nd degrees can be cured using a comprehensive approach: taking pharmaceutical preparations in combination with physiotherapy methods, massage and special diets.
After the acute hip disease phase of hip therapy, aerobic exercise is allowed, but running and jumping are not allowed.
After the acute phase of hip joint disease, choose gymnastics with limited range of motion and aerobic exercise training without running and jumping to treat the hip joint. In the final stage, the treatment of hip arthropathy takes place in a nursing home setting.
medical treatement
Conservative treatment of the disease aims to relieve hip pain and preserve joint function. The primary goal is complete recovery or stable remission of hip arthropathy.
Treatment of arthropathy is incomplete without an appointment:
- Non-steroidal anti-inflammatory drugs. Nonsteroidal drugs relieve pain and inflammation in active joints, but tablets are not associated with restoration of hyaline cartilage structure in hip arthropathy.
- Vasodilator. The preparation provides nutrients to the joints affected by arthropathy, eliminating congestion in the buttocks area.
- chondroprotective agent. They saturate joint tissue with water, improving its lubricating properties. Stop destroying the joint structure in the hip area. Glucosamine and chondroitin sulfate are part of many chondroprotective agents.
- Gels and ointments against arthropathy. They have a warming, stimulating or distracting effect. It means that the joint disease of the hip joint has been successfully cured.
- Inject steroid drugs into the joint cavity, it is recommended to inject in the acute phase of hip joint disease to eliminate pain.
Compression with medical bile may increase the effectiveness of the listed treatments for arthropathy. Therapeutic dressings should not be used in areas of the hip joint where there is damage to the lymphatic system and fever (infectious coxopathy).
physiotherapy
Although the hip joint is deep, physical therapy methods can provide relief from hip joint disease. Popular physical therapy procedures include electrophoresis, laser therapy, and application of heated paraffin. Acupuncture improves the innervation of cartilage tissue and the function of internal organs. Sonography with hydrocortisone in arthropathy combines the advantages of ultrasound with medicinal effects on the hip region.
Diet and Nutrition
Special diets for hip disease include low-fat products and high levels of vitamins B, C, and E, as well as calcium, potassium, and magnesium. It's best to start your day with a glass of freshly squeezed juice. Prioritize boiled and steamed dishes.
The daily menu for arthropathy should include:
- dairy products.
- Fresh vegetables and fruits.
- Low-fat varieties of fish and meat.
- Whole wheat bread.
- Kasha is boiled in water.
Eliminate salty and spicy foods, nightshades, muffins, bacon, carbonated beverages from your diet. When treating hip disease, do not buy ready-made or semi-finished products from the supermarket.
endoprosthesis
In the final stages of hip disease it is necessary to replace the affected joint with an artificial joint. Before surgery, patients must pass a general blood and urine test, an ultrasound of the hip, and an electrocardiogram.
The main stages of the program:
- Surgeons cut the femoral head and inserted a pin to connect it to the titanium implant in the femoral head.
- A portion of the pelvic surface was removed, with a polymer bed attached in its place, which was attached to the titanium head.
Dentures are best fixed with bone cement. If arthropathy affects the joint at a young age, a cementless connection method is sometimes used.
massage
Massage relieves muscle spasms and strengthens ligaments in the case of hip joint disease. During the procedure, patients with arthropathy should adopt a comfortable position and relax. First, we massage the back (10 minutes), then massage the sacral buttocks area. By flexing the fingers in a circular motion, we knead the problematic thigh in the direction of lymph flow - from bottom to top. To slow the progression of joint disease, the procedure is performed 3 times a day.
Exercise and Exercise Therapy
The load level of the arthropathy hip is chosen by the exercise therapist. Physiotherapy exercises are recommended in rooms specially equipped for this purpose. Swimming or skiing in the pool can speed up the recovery of the hip joint.
Methods of combating arthropathy proposed by practicing rheumatologist P. V. Evdokimenko are gaining popularity. Gymnastics Evdokimenko consists of static exercises to strengthen the buttocks muscles, stretch marks with minimal stress on the affected area. For example, if you lie on your left side, bend your left leg to your knee and extend your right leg, then hold it in the elevated position for about 30 seconds, and the muscles will begin to contract. For hip disease, each leg performs the task in 5 ways.
folk remedies
At the heart of folk methods of treating hip joint disease is the basic concept of medicinal properties. Before the development of the pharmaceutical industry, eucalyptus oil, cloves, and fresh aloe vera juice were rubbed into diseased joints to treat arthropathy. Celandine ointment relaxes the hip muscles and tendons.
Effective Alternative Medicine Recipes:
- Grind 200 grams of white prairie roots and add lard (300-400 grams). Heat it on low heat, and after 5-7 minutes, the medicine for treating hip joint disease is ready. Rub the cooling substance into the affected joint overnight for 2 weeks.
- Whisk egg whites with 1 tablespoon. l. Flour. The therapeutic mixture should be used for arthropathy in the hip area before going to bed. Don't forget to wrap the sore joint in parchment paper and a wool scarf.
Mumiyo has a strong restorative effect and improves mobility of the hip joint. For arthritis and joint disease, dissolve 5 grams of mummy in 10-20 ml of water and pour over 45 grams of heated petroleum jelly. Gently rub the product into the thigh skin.
prevention
Prevention of hip arthropathy includes abandoning bad habits, a sedentary lifestyle, extra load on the hip area, exceeding the physiological limit of joint strength. Follow the routine and principles of PP for hip disease, paying attention to your posture. To prevent irreversible changes in the body of people with arthropathy, check the joints once a year starting at the age of 30.
Among the lesions of the musculoskeletal system, arthropathy of the hip joint predominates. The disease reduces patients' quality of life and is a leading cause of disability at a young age. Even if you can't protect yourself from hip disease, don't despair - do it!