Hip arthropathy is a disease caused by changes in the tissue structure of the hip joint.This disease has another name - hip arthritis or osteoarthritis.
Hip arthropathy is a complex degenerative disease caused by changes in articular cartilage tissue.Cartilage tissue cannot be restored after bone formation in the body is complete, so any damage to it will affect the condition of the tissue later in life.The condition of cartilage is also affected by synovial fluid, which lubricates the tissue.Due to insufficient lubrication and increased friction, the articular cartilage thins and eventually wears away completely.The loss of cartilage causes increased load on the bone surface and friction between the bones, causing changes in their shape and position, leading to pain.
Most commonly, hip joint disease occurs in older people because the function of the cartilage tissue has been lost by this time.
Types of Hip Arthropathy
Medically, there is a distinction between primary and secondary hip arthropathy.
In primary cases, the cause of the disease is unknown.
The occurrence of secondary hip arthropathy is affected by the following reasons:
- Suffering various injuries and fractures;
- Congenital hip defects (congenital hip dislocation);
- There is an inflammatory process in the buttock area;
- Rheumatoid arthritis (a connective tissue disease that destroys joint cartilage);
- Aseptic necrosis (death of the femoral head).
Stages of Hip Arthropathy
In medical practice, hip joint disease can be divided into 4 stages:
first stage
It is characterized by periodic pain in the joints.The pain occurs when you begin activity after resting, but disappears when you resume strenuous activity.In a calm state, pain does not occur.Joint mobility was unaffected.X-rays show slight bone growth and slight narrowing of the joint space.
second stage
Pain occurs with moderate physical activity and at rest.Lameness occurs when walking for long periods of time.Pain may occur in the knees or lower back.X-ray shows: the shape of the femoral head changes, the bone contour is uneven, the bone neck thickens, the bone tissue grows significantly, and the joint space shrinks 2 times.
The third stage
Persistent pain occurs regardless of physical activity, whether in an active or calm state.Pain can cause insomnia.Due to limited joint movement, the person is forced to walk with support.X-rays show that compared with normal, the width of the bone neck is significantly increased, the length is reduced, and the femoral head is deformed.The joint space is virtually non-existent.Physical conditions are severely restrictive.The patient may be considered disabled.
Stage 4
Patients experience excruciating pain at rest.Any movement causes extreme pain and the patient is unable to move with a support (crutches, cane).The only way to treat hip joint disease is surgery.
Causes of Hip Arthropathy
The appearance of hip joints is affected by several causes, but the most important is impaired blood circulation in the hip area.Due to poor blood circulation, the metabolism of the joints slows down, causing the leg muscles to gradually atrophy.
Other causes of hip joint disease include:
- sedentary lifestyle;
- Micro-trauma that does not cause pain to the patient;
- Endocrine disorders;
- changes in joint surfaces due to age;
- increased joint loading (most common in athletes);
- inflammatory and infectious processes in joints;
- Pathologies of the feet (flatfoot) and spine (scoliosis);
- Obesity (increased load on joints due to excess weight) and other causes.
Taking into account the health of the entire organism, the exact cause of the disease in a specific patient can be determined.
Symptoms of Hip Arthropathy
Osteoarthrosis affects both men and women after the age of 40.Women experience more painful symptoms.
Symptoms of hip joint disease include:
- Hip pain (which occurs periodically and is painful in nature);
- Uneven, uncertain gait (limping);
- Creaking sounds in joints;
- Limited movement of the injured leg (initially heavy movements, stiffness, fatigue, and general discomfort);
- The appearance of muscle atrophy in the thighs (changes in the volume and tone of the muscles, leading to pain in the knees).
Diagnosis of Hip Arthropathy
To confirm the diagnosis of hip arthropathy, diagnostic procedures are required:
- The patient is examined by a specialist;
- Perform general and biochemical blood tests (allowing us to identify inflammatory processes and differentiate between arthritis and joint disease);
- X-rays (used to detect damage and changes in bone tissue);
- Magnetic resonance imaging of joints (detects small changes in cartilage tissue).
Treatment of Hip Arthropathy
To treat this disease, experts use medical procedures and medications.
Treatment options for hip joint disease include:
- therapeutic exercises and massage;
- physiotherapy;
- ozone therapy;
- cryotherapy;
- drug treatment;
- Surgical treatment, etc.
In specialized clinics, a personalized hip treatment plan is selected based on each patient's age, comorbidities and stage of hip arthrosis.An individualized approach helps patients recover as quickly as possible.
Therapeutic gymnastics and massage
Gymnastics helps strengthen muscles and improves blood circulation.Morning exercise can not only wake up the body after sleeping, but also increase the synovial fluid in the lower parts of the joints.Synovial fluid lubricates cartilage tissue with essential nutrients, thereby increasing the cartilage's resistance to stress throughout the day.
However, with hip joint disease, physical exercise should be chosen wisely.Movements that are too sudden and violent can cause severe pain and damage the joints.It is recommended to go to a swimming pool as swimming helps strengthen muscles, relieves stress on joints and does not cause injuries.
Massage is a very effective and safe way to treat hip joints.It improves blood circulation, strengthens muscles, and relieves painful cramps, swelling, and muscle tension.When massaging the hip joints, lower back and back, the muscles relax and synovial fluid is therefore distributed throughout the cartilage.
physical therapy
Physical therapy combines a variety of methods:
- electrotherapy;
- UHF therapy;
- Ultrasound therapy;
- laser treatment;
- Paraffin therapy, etc.
The goal of all of these surgeries is to improve circulation and relieve spasm and inflammation due to restricted access to the hip joint.
drug treatment
There are many medications with different functions in treating hip joint disease:
- topical medications(Ointments, compresses, lotions).Under the influence of advertising, most patients believe that treatment with various ointments and creams is the most effective method.However, this is a misconception because the therapeutic effects of such drugs cannot reach the hip joint due to its deep location.They only temporarily improve circulation and relieve spasms.The causes of hip joint disease are not eliminated, and the disease continues to gradually develop into more complex stages.
- NSAIDs.They are used to eliminate inflammatory processes, relieve swelling and pain.Long-term use of NSAIDs can cause side effects that negatively affect internal organs (gastritis).These drugs do not restore the cartilage tissue needed for normal joint function.
- muscle relaxants(drugs that relax muscles).Improves blood circulation and relieves muscle tension around joints.The effects of the drug are temporary and joint function will not return.
- hormonal steroid drugs.Intra-articular steroid injections can help treat concomitant conditions, such as femoral tendon inflammation.They have side effects and short-term therapeutic effects.
- vasodilators.They are used to relax the smooth muscle of blood vessels, widen the lumen between blood vessels, relieve small vessel pain, and eliminate nighttime pain.Vasodilators also improve circulation in joints and help deliver nutrients needed by cartilage tissue.When used correctly, vasodilator drugs can provide significant therapeutic benefits.However, the effectiveness of treatment is affected by individual tolerance to the drug.
- chondroprotectant(drugs to restore cartilage).They are the most effective modern medicines, since they affect the restoration of cartilage tissue and nourish it with necessary substances.By regular use of chondroprotectants, the progression of hip joint disease can be halted.Positive results appear over time, and the process of cartilage repair continues after the medication ends.
Surgical treatment of hip joint disease
If the cartilage tissue is severely damaged, cannot be restored, and the joint cannot move, surgical intervention is required.In some cases, surgery is the only possible way to restore a person's ability to walk without pain.
Endoprosthesis is a procedure in which the affected joint is removed and replaced with an artificial analog (endoprosthesis).The endoprosthesis is shaped like a real joint, performs all the functions of a joint, and can withstand heavy loads during walking, running, etc.
Endoprosthesis service life
Like anything, endoprostheses have a lifespan.Endoprosthesis wear depends on load and mobility.The excess weight significantly increases the load, and the lifespan of the prosthesis will be around 10 years.Under moderate loads and mobility, endoprostheses last approximately 15 years.There are also some prostheses with a service life of 20-25 years, but their main disadvantage is their higher cost.
When the endoprosthesis wears out, a second surgery is required to replace it.However, over time, the hip bone thins and problems with the implant arise, complicating replacement.Therefore, in order to avoid repeated prosthetic repairs, conservative treatment methods are required for as long as possible.
It is worth mentioning the risks of hip replacement - the number of deaths after surgery is 1-2%.
Endoprosthesis postoperative rehabilitation
Joint replacement surgery is complex and takes time to restore lost mobility.The recovery period includes methods to strengthen the body: massage, gymnastics and breathing exercises.The volume and complexity of the load should be gradually increased so that the body adapts to all changes.
A healthy diet can also speed up the healing process.It is recommended to include foods rich in phosphorus and phospholipids in the diet, as their properties contribute to the recovery of cartilage tissue.
The recovery period lasts approximately 6 months.The patient is under observation in the hospital for 5 to 10 days.This is followed by a series of rehabilitation measures aimed at strengthening the gluteal muscles.First, the patient must walk with a cane, then with a cane, and finally without any support.
At the end of the recovery period, the patient regains his lost working ability and the joy of an easy gait!
Prevent hip joint disease
To prevent hip joint disease, it is necessary to:
- Maintain an active lifestyle (morning exercise, short walks);
- Not engaged in professional sports;
- Maintain a balanced diet as this will help avoid weight gain, which can put extra stress on joints;
- Get a course of chondroprotectants every 1-2 years after age 40 (if hip arthritis or joint damage runs in the family).