Hip arthritis (arthritis, hip arthritis, osteoarthritis) is a slowly progressive degenerative dystrophic disease that eventually leads to the destruction of the affected joints, persistent pain and mobilityRestricted.
This disease affects people over the age of 40, and women suffer from the disease several times more frequently than men.
In the general structure of joints, the joint of the hip joint plays a major role. This is due to the prevalence of congenital diseases (dysplasia) in the hip joints and the large amount of physical exertion suffered by these joints.
Risk factors and causes of hip arthritis
In the pathological mechanism of the development of hip joint arthritis, the main effect is the changes in the physical and chemical properties of the synovial (intra-articular) fluid, which results in becoming more viscous. This impairs its lubricating properties. As it moves, the surface of the articular cartilage starts to rub against each other, become rough and covered by cracks. Small particles of hyaline cartilage rupture and enter the joint cavity, leading to the development of sterile (non-infectious) inflammation. As the disease progresses, bone tissue is sucked into the inflammatory process, leading to aseptic necrosis of the surface of the femoral head and acetabulum, forming osteophytes (bone growth), increasing inflammation and causing severe pain during exercise.
In the advanced stages of hip arthritis, inflammation spreads to the tissues around the joints (blood vessels, nerves, ligaments, muscles), leading to signs of arthritis. As a result, the hip joint is completely destroyed, function is lost, and movement stops. This condition is called tonic.
Causes of hip joint arthritis:
- Congenital dislocation of the hip;
- Hip dysplasia;
- Aseptic necrosis of the femoral head;
- Peters disease;
- Hip joint injury;
- Infectious arthritis of the hip joint;
- Gonorrhea (knee osteoarthritis);
- Professional sports;
- Flat feet; Spine curvature
- Sedentary lifestyle.
The pathology is not hereditary, but the child inherits the structural features of the musculoskeletal system from the parents, which may cause hip arthritis. This explains the fact that families exist, and their incidence is higher than that of the general population.
The form of the disease
According to the cause, arthritis of the hip is divided into primary and secondary. Secondary arthritis develops on the background of other diseases or injuries of the hip joint. The main form has nothing to do with previous pathology, and the cause of its development is usually uncertain. In this case, they are talking about idiopathic arthritis.
During hip arthritis, there are three stages (degrees):
- Initial-pathological changes will not be obviously expressed, as long as they are treated promptly and appropriately, they are reversible.
- Eventually-the motion in the joint is lost, resulting in rigidity. Treatment can only be done through surgery (to replace the joint with an artificial joint).
In 95% of cases, joint replacement surgery can completely restore limb mobility and restore the patient's ability to work.
Symptoms of hip arthritis
The main symptoms of hip joint arthritis:
- Pain in the groin, hip and knee area;
- The stiffness of the affected joints and the limitation of their mobility;
- la line;
- Lead limit;
- Atrophic changes in thigh muscles.
Certain symptoms of hip arthritis and their severity depend on the severity of the disease.
In grade I arthritis of the hip joint, patients complain of pain caused by the physical activity of the affected joint (long walking, running). In some cases, the pain is limited to the knee joint or thigh. After a short rest, the pain will go away on its own. The range of motion of the limbs is completely preserved, and the gait is not disturbed. The radiograph shows the following changes:
- Slight uneven reduction of the joint cavity;
- Osteophytes are located on the inner edge of the acetabulum.
No changes in the femoral neck and head were detected.
When the joint degree of the hip joint is II, pain will occur during rest (including at night). After exhaustion, the patient began to walk, forming a typical "duck" gait. There is so-called initial pain-after a long period of exercise, the first few steps will cause pain and discomfort, then gradually disappear and return to the original state after a long time load. The range of motion of the affected joint is restricted (abduction, internal rotation). X-rays showed uneven narrowing of the joint space, and its lumen was 50% of the normal value. Osteophytes are located along the inner and outer edges of the glenoid cavity, beyond the boundaries of the cartilage lips. The contour of the femoral head becomes uneven due to deformation.
In grade III arthritis of the hip, the pain is severe and persistent, and it stops at night. Walking was very difficult and the patient had to lean on crutches. The range of motion of the affected joint is greatly restricted, and then it stops completely. Due to the atrophy of the thigh muscles, the pelvis deviates from the frontal plane and the limbs are shortened. To compensate for this shortening, the patient is forced to deflect the torso toward the lesion while walking, which further increases the burden on the diseased joint. The radiograph showed multiple bone growth, the joint space was significantly reduced, and the femoral head was significantly increased.
The differential diagnosis of hip joint arthritis and other diseases of the musculoskeletal system is quite difficult. In the second-degree and third-degree joints of the hip, muscle atrophy occurs, which can cause severe knee joint pain, gonadalitis, or gonorrhea (knee joint disease). In order to differentially diagnose these diseases, the knee and hip joints are palpated, the amount of exercise is determined, and radiographic examinations are performed.
In spinal diseases, in some cases, the nerve roots of the spinal cord are compressed as the pain syndrome progresses. Pain can radiate to the hip joint area and mimic the clinical manifestations of its pathology. However, the nature of pain in root syndrome is different from that of hip joint arthritis:
- The pain is caused by heavy lifting or sudden embarrassing movements rather than under the influence of physical exertion;
- The pain is in the hip area, not the groin.
Osteoarthritis of the hip affects people over the age of 40, and women are several times more frequent than men.
Hip arthritis should be distinguished from trochanteric bursitis (trochanteric myositis). Trochanteric bursitis develops faster within a few weeks. Usually, there will be a lot of physical exercise or injury before this. Compared with hip arthritis, the pain caused by this disease is more pronounced. At the same time, no limb shortening and limited mobility were detected.
The clinical manifestations of atypical reactive arthritis and ankylosing spondylitis may be similar to those of hip arthritis. However, pain mainly occurred at night or at rest, and walking did not increase, but decreased. In the morning, the patient noticed joint stiffness, which disappeared after a few hours.
Treatment of hip joint arthritis
Orthopedics treat joint disease of the hip joint. For the I and II disease, conservative treatment is needed. Patients with severe pain syndrome can use non-steroidal anti-inflammatory drugs in the short term. They should not be taken for a long time, because they will not only negatively affect the gastrointestinal organs, but also inhibit the regeneration of hyaline cartilage.
Treatment options for hip joint arthritis include chondroprotectants and vasodilators, which create the best opportunities for the recovery of damaged cartilage tissue. For severe muscle spasms, it may be necessary to prescribe centrally acting muscle relaxants.
When the pain syndrome cannot be stopped with non-steroidal anti-inflammatory drugs, they resort to intra-articular injections of corticosteroids.
The topical treatment of hip arthritis with heating ointment can reduce muscle spasms and relieve some pain by distracting.
Physical therapy is also used in the complex treatment of hip arthritis:
- Magnetic therapy;
- Laser therapy;
- Ultrasound therapy;
- Medical gymnastics;
- Manual therapy.
The diet for hip arthritis is designed to correct body weight and normalize metabolic processes. Weight loss reduces the pressure on the hip joint, thereby slowing the development of the disease.
To reduce the pressure on the affected joints, the doctor may advise the patient to walk on crutches or crutches.
In grade III hip joint disease, conservative treatment is ineffective. In this case, only through surgical intervention can the patient's condition be improved and the patient can return to normal activities-replacing the damaged joint with an artificial joint (joint replacement).
Possible consequences and complications
The most serious complication of progressive arthritis of the hip is disability due to joint movement disorders. For bilateral hip joint disease, the patient loses the ability to move independently and requires constant external care. Lying in the same position for a long time creates a prerequisite for the occurrence of congestive (hypoplastic) pneumonia, which is difficult to treat and can lead to death.
The pathology is not hereditary, but the child inherits the structural features of the musculoskeletal system from the parents, which may lead to hip joint disease.
Hip arthritis is a progressive chronic disease. As long as the cause is eliminated, it can be completely cured at an early stage. In other cases, treatment can slow down its progress, but over time, implantation of hip prosthesis is necessary. In 95% of the cases, this type of surgery can completely restore limb mobility and restore the patient's working ability. Modern prostheses have a service life of 15-20 years, after which they must be replaced.
The purpose of preventing hip arthritis is to eliminate the possible causes of the development of this disease, including:
- Timely detection and treatment of hip joint diseases and injuries;
- Reject a sedentary lifestyle, regular but not excessive physical exercise;
- Weight control;
- Reasonable nutrition;
- Quit bad habits.