Deforming osteoarthritis of the hip joint is a disease of the elderly, which is caused by degenerative processes in the cartilage tissue. The progression of osteoarthritis of the hip joint is accelerated by the displacement of the joint 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 from 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 CT scans.
Treatment of deforming osteoarthritis of the hip joint is carried out with the latest drugs, which are very effective and have minimal side effects. Doctors discuss severe cases of osteoarthritis and decide on the treatment tactics for each patient. Rehabilitation therapists use innovative methods of restorative therapy to slow the progression of joint cartilage degeneration.
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Signs of osteoarthritis of the hip joint
Patients with deforming osteoarthritis complain of sudden attacks of stiffness in the hip joint, which appear after a state of rest and disappear after some activity. At first, attacks of minor pain last 1 to 2 days, intensifying after prolonged periods of weight-bearing.
Often defensive lameness is due to muscle spasm, which is accompanied by pain and a progressively increasing feeling of joint stiffness. Osteoarthritis of the left hip has the same symptoms as osteoarthritis of the right hip. Pain in osteoarthritis of the hip joint is localized along the antero-external or posterior surface of the joint, depending on the site of the inflammation. It radiates to the anterior and internal surfaces of the thigh and to the popliteal fossa. The pain syndrome intensifies after prolonged load on the limb and movements, especially in the direction of internal rotation, abduction and extension. Patients often complain of increased pain in wet, cold weather and experience relief from heat and after taking acetylsalicylic acid preparations.
In the acute period of osteoarthritis-arthritis of the hip joint, patients note pain at the site of inflammation of the capsule, which is accompanied by muscle spasm that engulfs 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 along the skin of 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 stage of osteoarthritis of the hip joint, there is no change on the x-rays. Later, radiologists sometimes reveal subchondral sclerosis, which gradually leads to narrowing of the joint space. An additional sign is the flattening of the head in its upper pole, which is accompanied by cystic changes in this area.
The degree of osteoarthritis of the hip joint
As it progresses, deforming osteoarthritis of the hip joints goes through several stages, respectively, which distinguish three degrees of the disease.
1st degree deforming osteoarthritis is the initial stage of the disease, when there are still no obvious changes in the structure of joint tissues. Pain syndrome is often absent, if it occurs, then against the background of the inflammatory process. Patients may complain of stiffness and fatigue in the limb. Often the first degree of osteoarthritis of the hip joint is asymptomatic.
With 2nd degree deforming osteoarthritis, the morphological changes are evident. The articular surfaces are uneven, they present significant bony growths. The bone tissue in the joint area becomes less solid. Due to the inflammatory process, the synovial membrane thickens considerably. The pain can be dull, aching in nature and last constantly, or it can come on suddenly and abruptly.
In grade 3 deforming osteoarthritis, the pain becomes so severe that it does not go away even after prolonged rest. Mobility in the diseased joint is reduced, the axis of the limb may be disturbed. Ulcers and areas of decay can form in the cartilage tissue that covers joint surfaces.
How to treat osteoarthritis of the hip joint
Conservative treatment of osteoarthritis of the hip joint is carried out with an exacerbation of the disease. It includes limb unloading, traction, heat and massage. To reduce the inflammatory process, salicylates are prescribed. Glucocorticoid injections are given for osteoarthritis of the hip joint of 1 and 2 degrees. In the third stage of deforming osteoarthritis of the hip joint, the only effective treatment is the planned replacement of the hip joint with a stent.
Complex treatment of osteoarthritis of the hip joint is carried out using physiotherapy and physiotherapy, correction of the diet. Effective therapy in the early stages of the disease allows sick people with 1 and 2 degree osteoarthritis of the hip joint to avoid arthroplasty and reduce the need for medication.
Surgical treatment of coxarthrosis deformans
With 3rd degree coxarthrosis, when conservative treatment does not bring relief, only prostheses help to relieve the patient of pain and discomfort, restoring the joy of moving. If there is fluid in the joint, it is 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 fragments of altered cartilage tissue, and its cavity is rinsed with a therapeutic solution to relieve the inflammatory process. Periarticular osteotomy is an artificial fracture of the femur followed by its fusion from a different angle. Surgery can reduce stress on the joint.
Rehabilitation methods for deforming osteoarthritis
For the treatment of patients with osteoarthritis of the hip, the following types of physiotherapy are used:
- shock wave therapy - exposure to sound waves that provide blood flow to the desired area of the body, which stimulates regenerative processes and speeds up metabolism;
- myostimulation, which restores the work of muscles weakened due to the forced restriction of movement of the joint;
- phonophoresis is a method that combines the advantages of the effects of ultrasound and drugs on the body (under the influence of the device, a drug in the form of an ointment or cream more effectively penetrates through the skin to thehip joint);
- ozone therapy - reduces discomfort and activates the growth of cartilage tissue thanks to the properties of the ozone-oxygen mixture.
Physiotherapy is considered the basis of 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 discomfort during usual daily stress. The exercise therapy instructor individually selects exercises for osteoarthritis of the hip joint of 1, 2 and 3 degrees. The specialists of the rehabilitation clinic practice various types of massages, including lymphatic drainage, using innovative manual therapy techniques aimed at passive work of muscles, ligaments and joints. The approaches used to help people with hip osteoarthritis reduce the need for pills and injections for osteoarthritis deformans, 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 allow the joint to be exercised without significant physical effort, which is particularly requested in the elderly. Extending the joints with the help of a special traction device or the hands of a chiropractor increases the space inside the joint, which "pushes" the pathological process back a few steps, relieving symptoms and giving the body time to restore hip joint function.
Diet is necessary for all patients with osteoarthritis of the hip, but it is more important for those who are overweight. Losing weight reduces stress on the inflamed joint and improves metabolism. In combination with other conservative methods, a balanced diet allows you to forget about 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-arthritis;
- after recent major surgery;
- in the presence of a hernia, acute diseases of internal organs;
- during menstruation;
- with an increase in body temperature greater than 37. 50WITH.
The therapist selects all the exercises individually. The instructor of exercise therapy takes into account the age of the patient, the severity of the pathological process and the presence of concomitant diseases. With deforming osteoarthritis, properly chosen gymnastics should give a payload to the muscles and ligaments of the hip joint, but not to the joint, because it is already worn out.
The complex of gymnastic exercises for osteoarthritis of the hip joint includes more static than dynamic exercises. Static exercises are those where you have to fix the position of the body for a few seconds. If such movements are sufficient, the muscles and ligaments of the legs are given the necessary load to restore the joint. The hip joint itself takes minimal part in such exercises and does not wear out.