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Osteoarthritis of the hip joint

rehabilitation after hip osteoarthritis treatment

Osteoarthritis of the hip joint (ATS) is a slowly destructive disease. Under the influence of a number of reasons, in the course of the development of the disease, irreversible changes in the structure and properties of hyaline cartilage occur, which leads to increased pressure on the articular surfaces and their deformation or melting . Since mechanical overload is considered one of the main causes of the development of the disease, the hip joint is often affected by osteoarthritis.

Features of the anatomical structure of the hip joint

The hip joint (HT) is the junction of the pelvis and femur. This joint makes it possible to reduce and extend the lower limbs, raise the legs and bring them closer to the body, and carry out walking movements. From birth and throughout life, a person bears a large load on the hip joint.

On the side of the pelvic bone, the "acetabular" cavity participates in the joint, on the side of the femur - its epiphysis. The acetabulum has a collagen lip along the edges, which acts as a kind of gasket that firmly holds the epiphysis of the femur in its recess. The recess in the center of the acetabulum is covered with a collagen membrane and is the site of attachment of the ligament of the femur.

The composition of the TS capsule includes ligaments:

  • femoral-iliac - the strongest ligament that can withstand a load of more than 200 kg and prevents excessive arching of the hip back;
  • femoral-pubic - is responsible for the abduction and reduction of the thigh, which limits its circular movements;
  • femoral ischium - protects the vehicle from concussions, reduces the load when walking and running;
  • circular (loop) - prevents dislocations and holds the head of the femur in the cavity of the pelvic cavity and is the basis of the articular bag.

Numerous muscle and tendon groups allow the vehicle to move around three axes:

  1. Longitudinal (vertical).
  2. Transversal (horizontal, frontal).
  3. Sagittal (anterior-posterior).

Arthrosis of the joint can occur both in a healthy joint, and become a continuation of existing diseases of the musculoskeletal system.

What is this disease?

Hyaline cartilage performs cushioning functions and protection against damage to the joint surfaces. ATS is a disease in the process of development of which the structure of collagen cartilage fibers changes, which subsequently leads to their fragmentation and destruction. Fragments of cartilage fibers, if they get into the joint cavity, can provoke an inflammatory process. Bare surfaces undergo changes in bone tissue caused by friction and increased pressure. Cartilage tissue remaining along the edges of the epiphyses grows compensatory with subsequent ossification, causing ankylosis (immobility of the bony junction). In the later stages, in the absence of adequate therapy, the patient completely loses mobility and becomes disabled. Destructive processes are triggered by various reasons.

There are the following types of osteoarthritis of the hip joint:

  1. Primary. Its etiology is not fully understood. Idiopathic (primary) osteoarthritis develops in a previously healthy joint. Most often, it develops in older people.
  2. Secondary. It is provoked by previous diseases of the articular apparatus, congenital abnormalities of development, changes in the work of organs and systems of human vital activity.

The disease develops in one joint or affects both at the same time.

Causes of the disease

Among the causes that contribute to the onset of the disease and its progression, the following are identified:

  1. Hereditary genetic predisposition to the development of the disease.
  2. Bone joint injuries (dislocations, fractures, sprains and tendons).
  3. Unbearable systematic power and physical activity.
  4. Over weight.
  5. Functional disorders of the endocrine system (diabetes, psoriasis).
  6. Congenital pathologies of the structure and development of the musculoskeletal skeleton.
  7. Professional characteristics of the labor activity.
  8. Poor local circulation.
  9. Previous diseases caused by pathogenic flora.
  10. Legg-Calve-Perthes disease.
  11. Metabolic disorders (gout).
  12. Physical inactivity.
  13. Immune diseases.

These causes can not always cause ATS. Most often, the activation of pathological processes can be provoked by:

Obesity as a cause of hip arthritis.
  • increased stress and physical activity;
  • constant overwork;
  • hypothermia of the vehicle or of the body as a whole;
  • sudden lifting of heavy objects;
  • hormonal imbalance;
  • radiation exposure.

symptoms of the disease

The symptomatic manifestations of ATS are similar to the manifestations of arthrosis of other joints.

The main characteristic symptoms of this disease are considered to be:

  1. Stiffness in the morning or after a long period of immobility.
  2. Decreased range of motion, change in gait.
  3. Pain, first caused by mechanical or physical stress, later constant.
  4. The manifestation of creaks, creaks and clicks during sudden movements.
  5. Pronounced lameness in the affected limb.
  6. The appearance of contractures (restriction of passive movements).
  7. Narrowing or closure of the joint space (radiographic sign).

The severity of the signs of arthrosis of the hip joint depends on the degree of development of the disease and the reactive capabilities of the patient's body.

arthritic hip pain

Stages of coxarthrosis

Depending on the clinical manifestations, 4 stages of arthrosis of the hip joint can be distinguished:

  1. Osteoarthritis of the first degree of the hip joint does not have pronounced pain and other manifestations. The stage is difficult to diagnose, the disease can be detected by a biochemical study of hyaline cartilage tissue and the determination of an insufficient amount of glycosaminoglycans. The patient feels pain in the joint, and rarely pain at the beginning of physical activity.
  2. Second-degree osteoarthritis of the hip joint is characterized by changes in the density and elasticity of cartilage fibers. Cracks and breaks appear. Depreciation functions are reduced. The pain intensifies, radiates to the inguinal region, dilution and reduction movements of the affected limb are limited.
  3. At the third degree, the stratification of cartilage fibers occurs with greater intensity. The articular surfaces experience excessive pressure, foci of ischemia develop. Cartilage tissue grows along the edge of the epiphyses. The sensation of pain in the area of the damaged bone junction does not depend on the state of activity and rest. With any movement, the joint "creaks" and "creaks". The range of motion is reduced in all axes.
  4. The fourth degree is characterized by the exposure of the surfaces of the articular components with the formation of ulcers and depressions. The articular head of the femur is poorly fixed in the acetabulum, which leads to a violation of the comparison and separation of the articular surfaces. During this period, the patient experiences excruciating pain caused by narrowing, sometimes closing the joint lumen and compression of bundles of nerve fibers and blood vessels. Movement is limited, sometimes completely.

The classification of pathological changes caused by ATS is necessary to understand the mechanism and features of the development of the disease. Determining the severity of the disease helps to determine the correct tactics of treatment and disability (in case of serious illness).

Possible consequences

The progression of ATS leads not only to deformation of the femoral head and pelvic cavity, but also to the development of pathological processes in the functioning of the articular apparatus as a whole.

Pathologies derived from complications of hip osteoarthritis:

  • synovitis (inflammation of the synovial membrane of the joint);
  • aseptic necrosis of the femoral head;
  • joint destruction (osteonecrosis);
  • inflammation of the joint bag with a change in the amount of synovial fluid;
  • ankylosis (immobility of the bone joint) partial or complete;
  • contractures (limitation of mobility and impossibility of flexion-extension of the limb).

The development of ATS complications always leads to a deterioration of the general condition of the patient, the quality of his life, and loss of movement without assistance.

diagnostic methods

Diagnosis of arthrosis of the hip joint at the initial stage is difficult. Symptomatic manifestations are noted only when the epiphyses of the bones and nerve fibers are involved in the pathological process.

X-ray image of the hip joint with osteoarthritis.

During a medical examination in the progression stage, the following is noted:

  • visual change in joint contour;
  • palpation pain;
  • sometimes pastiness of the periarticular tissues;
  • shortening of the diseased limb.

The main role in the diagnosis of ATS is assigned to the X-ray examination. As auxiliary diagnostic methods used:

  1. Ultrasound, MRI.
  2. computed tomography
  3. Joint lubrication puncture (synovial fluid).
  4. Diagnosis by arthroscope (microprobe).
  5. Clinical and biochemical laboratory tests of urine, blood.

Timely diagnosis improves the prognosis of treatment and the future life of the patient.

How to apply for disability?

It is impossible to cure this disease completely. To confirm the right to social benefits and assign a disability group after passing the limited specialist exam, you should contact your doctor.

see a doctor for hip arthritis

The indication for disability allowance in case of arthrosis of the hip joint is:

  • oligoarthrosis (injury to no more than 2 joints) TS 2 degrees;
  • combined osteoarthritis of the 2nd degree of the TS and osteoarthritis of the 3rd degree of the knee joint;
  • a decrease in the length of the diseased limb by more than 6 cm;
  • Automatic reactive flow telephone exchange, documented.

When determining the disability group will help:

  • carefully collected anamnesis;
  • the conclusion of the medical advisory commission (MCC);
  • results of diagnostic studies;
  • going through the commission of medical and social experts (MSEC).

If the decision of the expert commission is negative, it can be appealed to higher authorities.

Prevention

Preventive measures are an easy way to avoid developing this disease. Prevention measures include:

  1. Adherence to an active lifestyle.
  2. Control of body weight indicators.
  3. Optimization of food and work and rest mode.
  4. Reduced mechanical and physical load.
  5. Treatment of diseases of viral and infectious etiology.
  6. Prevention and prevention of injuries at home and at work.
  7. Periodic preventive examination.

conclusion

The answer to the frequently asked question: "Is it possible to cure arthrosis of the hip joint? " Experts give a negative answer. Destroyed cartilage tissue cannot be completely restored, just as it is impossible to completely correct the deformation and destruction of the bones included in the joint. Do not ignore even minor manifestations of hip arthrosis, this reduces the chances of preventing further development of the disease.