Defective osteoarthritis of the hip joint is a disease of the elderly, caused by the degenerative process of cartilage tissue. The development of arthrosis of the hip joint is accelerated by the mismatch of the articular surface, which causes abnormal friction. In some patients, the disease develops due to femoral head ischemia after femoral neck fracture 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 deformed hip joint arthrosis is done with the latest medications, which are very effective and have minimal side effects. Doctors discuss severe cases of coxarthrosis and decide on tactics to treat each patient. Rehabilitation therapists use innovative methods of rehabilitation therapy to slow the progression of articular cartilage degeneration.
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Signs of arthrosis of the hip joint
Patients suffering from deformed arthrosis complain of a sudden attack of spasms in the hip joint, which appear after a state of rest and disappear after some activity. Initially, minor pain attacks last for 1 to 2 days, increasing after a prolonged period of weight -bearing.
Often, defensive lameness occurs due to muscle spasm, which is accompanied by pain and a gradual increased sensation of joint spasm. Arthrosis of the left hip joint is indicated by symptoms similar to arthrosis of the right hip joint. Pain in hip joint arthrosis is localized along the antero-outer or posterior surface of the joint, depending on the site of inflammation. It radiates to the anterior surface and in the thigh and to the popliteal fossa. The pain syndrome increases after prolonged load on the limbs and movement, especially in the direction of internal rotation, abduction, and elongation. Patients often complain of increased pain in humid and cold weather and experience relief in the warmth and after taking acetylsalicylic acid preparations.
In the acute period of arthrosis-arthritis of the hip joint, the patient notes pain at the site of capsule inflammation, which is accompanied by muscle spasm that strikes the thigh extension muscles. The orthopedist performs a Faber test: the patient places the heel of the affected limb on the back of the healthy foot and slides it over 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 stages of hip arthrosis, there are no changes on radiography. Later, radiologists sometimes reveal subchondral sclerosis, which gradually leads to narrowing of the joint space. An additional sign is flattening of the head on its upper pole, which is accompanied by cyst changes in this area.
Stages of arthrosis of the hip joint
During progression, arthrosis of the deformed hip joint goes through several stages, respectively, which distinguish the three degrees of the disease.
Damage grade 1 arthrosis is an early stage of the disease, when there is still no obvious change in the structure of the joint tissue. Pain syndrome is often absent, if it arises, then the background of the inflammatory process. Patients may complain of cramps and fatigue in the limbs. Often the first stage of osteoarthritis of the hip joint is asymptomatic.
With grade 2 modified arthrosis, morphological changes are evident. The articular surface is uneven, there is significant bone growth on it. The bone tissue in the joint area becomes less strong. Due to the inflammatory process, the synovial membrane thickens. The pain can be dull, painful in nature and persistent, or it can occur suddenly and abruptly.
If the arthrosis is a class 3 deformity, the pain becomes so strong that it does not disappear even after a long rest. Mobility in diseased joints is reduced, the axis of the limb may be disturbed. Ulcers and decayed areas can form in the cartilage tissue that covers the articular surface.
How to treat hip arthrosis
Conservative treatment of arthrosis of the hip joint is carried out with exacerbation of the disease. These include limb unloading, traction, warmth and massage. To reduce the inflammatory process, salicylates are prescribed. Glucocorticoid injections were performed for 1st and 2nd degree hip arthrosis. In the third stage of hip joint arthrosis deformity, the only effective treatment is planned hip joint replacement with endoprosthesis.
Complex treatment of arthrosis of the hip joint is carried out using physiotherapy and kinesitherapy, dietary correction. Effective therapy in the early stages of the disease allows people ill with 1st and 2nd degree arthrosis of the hip joint to avoid arthroplasty and limit the need for medication.
Surgical treatment of deformed coxarthrosis
With grade 3 coxarthrosis, when conservative treatment does not bring relief, only prosthetics help relieve the patient’s pain and discomfort, restoring the joy of his movements. If there is fluid in the joint, it will be pumped out after the puncture. Corticosteroid hormones are injected simultaneously into the hip joint.
With the help of arthroscopic debridement, the inner surface of the joint is cleaned of debris of altered cartilaginous tissue and the cavity is rinsed with a therapeutic solution to relieve the inflammatory process. Periarticular osteotomy is a false fracture of the femur followed by its fusion at different angles. Surgery can reduce the pressure on the joints.
Rehabilitation methods for arthrosis deformities
For the treatment of patients with osteoarthritis of the hip joint, the following types of physiotherapy are used:
- shock wave therapy - exposure to sound waves that provide blood flow to the desired areas of the body, which stimulate the regeneration process and speed up metabolism;
- myostimulation, which restores the work of muscles that have been weakened due to limited movement in the joints;
- phonophoresis is a method that combines the advantages of the effects of ultrasound and drugs on the body (under the influence of tools, drugs in the form of ointments or creams penetrate more effectively through the skin to the hip joint);
- ozone therapy - reduces discomfort and activates the growth of cartilage tissue due to the nature of the ozone -oxygen mixture.
Kinesitherapy is considered the basis for successful treatment of arthrosis of any localization. The implementation of a special gymnastic exercise system on a regular basis strengthens the ligaments and muscles around the joints affected by pathological processes, which reduces discomfort during normal daily stress. Exercise therapy instructors individually select exercises for 1st, 2nd and 3rd degree hip arthrosis. Rehabilitation clinicians perform a wide variety of massages, including lymphatic drainage, using innovative manual therapy techniques aimed at passive work with muscles, ligaments and joints. The approach used to help coxarthrosis patients reduces the need for pills and injections to reverse the arthrosis, which reduces the pharmacological burden on the body.
The rehabilitation clinic is equipped with modern mechanical and computerized simulators from the world’s leading manufacturers. They help smooth the joints without significant physical effort, which is very popular with the elderly. Joint elongation with the help of special traction devices or chiropractor’s hands increases the space inside the joint, which "throws" the pathological process back a few steps, relieving symptoms and giving the body time to restore hip joint function.
Dietary therapy is required for all patients with osteoarthritis of the hip joint, but is most important for people who are overweight. Losing weight reduces stress on inflamed joints and increases metabolism. In combination 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 arthrosis of the hip joint are not prescribed in the following cases:
- with exacerbation of arthrosis-arthritis;
- after a recent major surgery;
- in the presence of hernias, acute diseases of internal organs;
- during menstruation;
- with an increase in body temperature exceeding 37. 50WITH.
The therapist selects all exercises individually. Exercise therapy instructors take into account the age of the patient, the severity of the pathological process and the presence of concomitant diseases. With deformed arthrosis, well -chosen gymnastics should place a useful load on the muscles and ligaments of the hip joint, but not on the joints, as they are worn out.
The gymnastic training complex for hip joint arthrosis consists of exercises that are more static than dynamic ones. Static exercises are exercises where you have to improve your body position for a few seconds. If such movement is sufficient, the muscles and ligaments of the foot receive the load necessary to restore the joint. The hip joint itself participates minimally in such exercises and is not lethargic.