Degenerative osteoarthritis of the hip joint is a disease of the elderly, caused by degenerative processes of the cartilage tissue. The progression of arthrosis of the hip joint is accelerated by the mismatch of the articular surfaces, leading to abnormal friction. In some patients, the disease develops due to ischemia of the femoral head after a fracture 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.
Degenerative arthrosis of the hip joint is treated with the latest drugs, which are highly effective and have minimal side effects. Doctors discuss severe cases of coxarthrosis and decide on the treatment strategy for each patientRehabilitation therapists use new approaches to restorative therapy to slow the progression of articular cartilage degeneration.
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Symptoms of arthrosis of the hip joint
Patients suffering from deforming arthrosis complain of sudden attacks of stiffness in the hip joint, which appear after a state of rest and disappear after some activity. At first, minor pain lasting 1 to 2 days, gets faster after carrying the load for a long time.
Often, muscle spasms cause defensive lameness, which is accompanied by pain and a gradually increasing sensation of stiffness in the joint. Arthrosis of the left hip joint is manifested by symptoms similar to arthrosis of the right hip joint. . Pain in arthrosis of the hip joint is localized on the outer or posterior surface of the joint, depending on the site of inflammation. It extends to the front and inner surfaces of the thigh and the popliteal fossa. The pain syndrome is prolonged on the limbs and movementsIntensifies after loads, especially in the direction of internal rotation, abduction and extension. Patients often complain of increased pain in damp and cold weather and relief in heat and after taking acetylsalicylic acid preparations.
In the acute period of arthrosis-arthritis of the hip joint, patients note soreness at the site of inflammation of the capsule, which is accompanied by spasm of the muscles that surround 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 leg and slides it along the skin of the tibial surface of the lower leg to the knee. This will be positive for any inflammatory processes in the hip joint.
In the early stage of arthrosis of the hip joint, radiographs do not show any changes. Later, radiologists sometimes reveal subchondral sclerosis, which gradually leads to a decrease in joint space. An additional sign is its upperThere is a flattening of the head in the pole, which is accompanied by cystic changes in this area.
degree of arthrosis of the hip joint
As it progresses, deforming arthrosis of the hip joint passes through several stages, respectively, which distinguish three degrees of the disease.
Deformed arthrosis of the first degree is the initial stage of the disease, when there are still no obvious changes in the structure of the joint tissues. Pain syndrome is often absent, if it occurs, against the background of the inflammatory process. In patients in the limbsThere may be complaints of stiffness and fatigue. Often the first degree of osteoarthritis of the hip joint is asymptomatic.
With deforming arthrosis of the second degree, morphological changes are evident. The articular surfaces are uneven, there is significant bony growth on them. Bone tissue in the joint area becomes less strong. Due to the inflammatory process, the synovial membrane becomes very thick. The pain may be dull, aching in nature and may be persistent, or it may be sharp and sudden.
In the case of grade 3 deforming arthrosis, the pain becomes so intense that it does not go away even after prolonged rest. Mobility in the diseased joint decreases, the axis of the limb may be disturbed. Areas can form in the cartilaginous tissue that covers the articular surfaces.
How to treat arthrosis of the hip joint
Conservative treatment of arthrosis of the hip joint is carried out with exacerbation of the disease. It consists of limb amputation, traction, heat and massage. To reduce the inflammatory process, salicylates are prescribed. Injections of glucocorticoids 1 and 2 degreesIn the third stage of deforming arthrosis of the hip joint, the only effective treatment is planned replacement of the hip joint with endoprosthesis.
Complex treatment of arthrosis of the hip joint is carried out using physiotherapy and kinesitherapy, dietary correction. Effective therapy of the initial stages of the disease. Sick people with 1st and 2nd degree arthrosis of the hip joint need to avoid arthroplasty and limit the need for drugs. allows.
Surgical treatment of deforming coxarthrosis
With coxarthrosis of the third degree, when conservative treatment does not provide relief, only prosthetics help to relieve the patient from pain and discomfort, restoring him the pleasure of movement. If there is fluid in the joint, he may need to be punctured. The latter is taken out. Corticosteroid hormones are simultaneously injected into the hip joint.
With the help of arthroscopic debridement, the inner surface of the joint is cleaned of fragments of altered cartilaginous tissue and its cavity is washed with a therapeutic solution to relieve the inflammatory process. Periarticular osteotomy is an artificial fracture of the femur followed byIts fusion occurs at a different angle. Surgery can reduce the stress on the joint.
Methods of rehabilitation for deforming arthrosis
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 area of the body, which stimulates regeneration processes and speeds up metabolism;
- myostimulation, which restores the work of muscles that have weakened due to forced limitation of movements in the joint;
- Phonophoresis is a method that combines the benefits of ultrasonic and pharmaceutical effects on the body (under the influence of the device, a drug in the form of an ointment or cream penetrates through the skin to the hip joint more effectively);
- Ozone therapy - due to the properties of the ozone-oxygen mixture, reduces discomfort and activates the growth of cartilage tissue.
Kinesitherapy is considered the basis for the successful treatment of arthrosis of any location. Regular implementation of a special system of gymnastic exercises strengthens the ligaments and muscles surrounding the joint affected by the disease process, which reduces discomfort during normal daily stress. Reduces. Exercise therapy instructor individually selects exercises for arthrosis of the hip joint of the 1st, 2nd and 3rd degree. Rehabilitation clinic specialists perform various types of massage, including lymphatic drainage, of muscles, ligaments and joints. use of innovative manual therapy techniques aimed at passive work withit happens.
Rehabilitation clinics are equipped with modern mechanical and computerized simulators from the world's leading manufacturers. They help to perform joint exercises without significant physical effort, which is especially in demand among elderly people. With a special traction device or a chiropractor. Extending the joints with the help of hands increases the space inside the joint, which throws the disease process back a few steps, relieves symptoms and gives the body time to restore function. hip joint.
Diet therapy is essential for all patients with osteoarthritis of the hip joint, but is most important for those who are overweight. Losing weight reduces stress on the inflamed joint and improves metabolism. Combination of other conservative methodsIn the U. S. , a balanced diet allows you to forget about arthrosis-arthritic pain and other manifestations 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;
- recently after a major surgery;
- in the presence of a hernia, acute diseases of internal organs;
- during menstruation;
- 37. 5 in body temperature. with an increase of more than0with.
The doctor selects 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 arthrosis, well-chosen gymnastics of the muscles of the hip jointAnd a useful load should be given to the ligament, but not to the joint, because it is already worn out.
The complex of gymnastic exercises for arthrosis of the hip joint consists of more static exercises than dynamic ones. Static exercises are those where you need to fix the position of the body for a few seconds. If such movements are enoughIf the muscles and ligaments of the legs receive the necessary load to restore the joint. In such exercises the hip joint takes the least part and does not deteriorate.