Vozniknoveniya the causes, extent, symptoms, and treatment of coxarthrosis
Osteoarthritis, the treatment of which required different methods, is a quite serious disease. Choice of means of treatment depends on the stage of development of the disease.
General information about the disease
Many patients with diagnosed coxarthrosis, wondering about what this disease. In accordance with ICD-10 (international classification of diseases), the disease is coded as the M-16.
Osteoarthritis is a disease that has a degenerative nature that affects mostly middle-aged and elderly. The disease affects the hip joint of the person. The development of the disease occurs gradually over several years and is accompanied by the appearance of pain in the hip joint, the emergence of limited mobility in this area.
In the later stages of the disease may appear atrophy of the muscular tissue of the thighs, in addition to observed the process of shortening of the limb. The development of coxarthrosis can be triggered by various reasons. Main ones are as follows:
- joint trauma
- the development of congenital abnormalities
- pathological curvature of the spine;
- joint diseases of inflammatory and noninflammatory nature.
In Addition to these reasons, contributing to the development of the disease, its occurrence may influence genetic predisposition. In some cases, the development of the disease occurs for no apparent reason.
The Disease can occur in both unilateral and bilateral form.
At an early stage of disease progression, are used conservative methods of influence. In the case of destruction of the joint, especially if such a development occurs in young or middle-aged, it is recommended to conduct surgery.
In Orthopaedics and traumatology disease is one of the most common types of osteoarthritis. The incidence of this type of disease is caused by rendering on high hip joint loads during activity and the high prevalence of pathological disorders congenital dysplasia of the joint.
the Anatomy of the hip joint and the mechanism of the disease
The Hip joint is formed by two bones – the iliac and femoral. The head of the femur articulates with the acetabulum of the available on the iliac bone; the articulation of the bones forming the connection joint. In the process of making the movements of the acetabulum is a fixed element of the hinge joint, and the head of the femur is able to move in different directions, thereby providing flexion, extension, abduction and rotation in the hip joint.
In the process of movements of the articular surfaces, which are part of the skeletal joints, provide unrestricted movement relative to each other. Such movement occurs due to the presence of smooth and elastic layer of hyaline cartilage that covers the mating surface and has a high level of strength. In addition to providing slide of hyaline cartilage performs the function of amortiziruemye and redistribution of loads on the joint during implementation of walking.
In the joint cavity contains a small amount of liquid, performing the function of lubrication. In addition, synovial fluid provides nutrition to cartilage. Sostavnoi joint is surrounded by a dense and strong connective tissue sheath. Over the capsule is placed a large femoral and gluteal muscle structures to ensure movement in the articular joint. Muscular structures also serve as shock absorbers, protecting the joint surfaces from injury during the Commission failed moves.
In the process of development of disease synovial fluid becomes more dense, it has higher viscosity. With further development of the disease is the drying up of hyaline cartilage, which leads to loss of smoothness and elasticity. Cartilage covered with cracks. As a result of the roughness of articular cartilage when performing movements constantly exposed to trauma, which causes hair thinning. These processes further exacerbate changes developing in the joint.
with the development of the disease the bone tissue, part of the bone begins to deform due process adaptability dice to the resulting high loads. In coxarthrosis deterioration of cartilage nutrition and metabolism.
Reasons for the development of coxarthrosis
In medicine distinguish two varietiesdeveloping coxarthrosis, primary and secondary. The primary type of the disease occurs in the body for unknown reasons, and the secondary is a consequence of other diseases.
Development of secondary coxarthrosis may be the result of diseases such as:
- hip dysplasia
- congenital hip dislocation
- Perthes disease
- aseptic necrosis of the femoral head;
- infectious lesions and inflammatory processes occurring in the articular joint;
- receiving traumatic injuries.
In Coxarthrosis primary varieties of concomitant lesions of the spine and knee joint. Causes of coxarthrosis 1 degree, which increases the likelihood of its development, as follows:
- constant high load on sostavnoi articulation
- poor circulation, hormonal balance in the body, metabolism processes;
- the development of pathologies of the spine and feet;
- old age
- sedentary lifestyle.
The Disease is not inherited, but certain features of metabolism, the structure of the musculoskeletal system and cartilage can be laid at the genetic level.
For this reason, in the presence of this disease in blood relatives, the likelihood of developing the disease increases significantly.
Symptoms and severity of
The Main symptoms of coxarthrosis following:
- pain in the region of the hinge joint;
- the emergence of constraint in movements and stiffness of joint;
- gait disturbance
- the development of muscle atrophy;
- limb shortening
- limitation of hip and appearance when performing movements the pain.
One of the first symptoms are pain.
1 degree Coxarthrosis patients manifest certain symptoms. The most common symptom is intermittent pain after exercise. The region of localization of pain is sostavnoi the hip joint and in rare cases, the hip or knee. After resting the pain disappear. The gait during this period, the person is not broken, movements are not limited and muscle atrophy is not observed.
The Hip of the second degree is characterized by more intense pain that can occur at rest. Coxarthrosis 2 degree distribution is characterized by pain in groin and thigh and some offset of the femoral head upward. The main signs of coxarthrosis second degree:
- lameness under load
- the volume of movements in joints;
- the limitations of hip internal rotation of the hip.
Coxarthrosis 3 degrees characterized by the appearance of constant pain both day and night. The process of walking is impeded, this leads to the fact that the patient begins to use a cane for support. This degree of development of the disease is characterized by a severe restriction of freedom of movement in the joints, atrophy of the muscular structures of the femur and tibia. Also there is a shortening of the limb, which leads to the inclination of the torso toward the damaged joint.
Treatment for early stages
If you are diagnosed of this disease the patient is primarily interested in the question of how to treat osteoarthritis.
The Doctor treats osteoarthritis at early stages through the use of conservative methods of influence on the patient's body. Treatment of coxarthrosis 1 and 2 degrees in the periods of exacerbation carried out using non-steroidal anti-inflammatory drugs. To treat the disease in the period of exacerbation is possible with the use of such drugs:
- brufen, etc.
Medications have analgesic effects, but their use should be remembered that these funds are not recommended for a long time. Drugs in this group can have a negative impact on internal organs, moreover, they can inhibit the ability to rebuild cartilage hinge joint.
To restore cartilage in the joints medications are used belonging to the group of chondroprotectors. Such preparations are:
- chondroitin sulfate
To improve circulation and elimination of spasm of small vessels of the circulatory system attending physician prescribes taking vasodilator drugs, such as Cinnarizine, nikoshpan, trental and teonikol. Depending on the state of the muscular tissue may be administered to the muscle, promoting muscle relaxation.
With long-term pain syndrome people suffering from illness, may be recommended the use of intra-articular injections of hormonal medications – hydrocortisone, and kenalog metipred.
During the treatment can be applied means of the local operation, which does not have a significant therapeuticthe effect, however, helps to relieve muscle cramps and reduce degrees of pain.
In the process of treatment also it is desirable to use a specially designed diet, which in the presence of excess weight reduce body weight and stress on the joints. Diet, affecting the course of illness, today has not been developed.
To Cure the disease completely impossible. The disease is incurable, methods of therapy can only slow its progress. When the third stage of the disease the patient receives the disability of the second group.
treatment of osteoarthritis in the later stages
At a late stage of the disease the only effective method of treatment is surgery, consisting in the replacement of the destroyed by disease of the articular joints by arthroplasty. Depending on the extent of the disease is used in unipolar or bipolar prosthesis. When unipolar prosthetic replacement of the femoral head, and with pole – like replacement of the femoral head and the acetabulum.
surgery when hip replacement is performed routinely. For the operation you want to perform a complete examination of the patient. The procedure is performed under General anesthesia. After appropriate antibiotic therapy. The stitches are removed after 10-12 days. In the postoperative period the patient is on outpatient treatment. Be sure after the operation that restores the person, actions on the patient's rehabilitation.