Coxarthrosis (arthrosis deformans, osteoarthrosis) of the hip is a progressive degenerative process characterized by a gradual decrease of functionality of the affected area. The disease is diagnosed mainly in men after 40-45 years. Symptoms of coxarthrosis of the hip joint and the intensity of their manifestations depend on the stage of the pathological process, the degree of destruction of bone joints.
According to medical statistics, this is the most common form of arthritis. Women are more susceptible to the disease. This is due to the high loads in the process of labor activity and to some anatomical features.
Pathogenesis and common clinical manifestations
The hip joint is formed by two bones. The femoral head articulates with the iliac entering the stationary acetabulum. The head of the femur when the traffic goes in different directions as the hinge. Thanks to this committed rotation, flexion and extension, adduction and abduction of the lower limb.
The smooth slide of bones provides padding of the cartilage. It is durable, supple and smooth, uniformly covers the cavity of the acetabulum of the Ilium and the femoral head. Cartilage serves as a shock absorber, so sturdy bone structure do not cause each other damage, and move freely.
In the cavity of the articulation circulates synovial fluid. It serves as a lubricant and nourishes the hyaline cartilage. Itself bone joint encased in a solid joint capsule. Above it are the adjacent muscle (femoral and gluteal), reduction of which result in joint movement. Like hyaline cartilage, these muscles perform a cushioning function, protect the joint from damage.
The mechanism of development of osteoarthritis of this joint is that under the influence of negative factors, the quality of the synovial fluid worsens, the cartilage becomes dry, less elastic. Collagen fibers are gradually destroyed. The cartilage that provides cushioning of the bones at their point of articulation, ceases to function properly.
As a result, the femoral head and acetabulum are in contact, RUB against, which is the cause of the pain. Cartilage because of the high friction loses its elasticity, becomes thinner and protect their bones gradually begin to deform.
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In the development of coxarthrosis play the role of age-related changes, weight. Often develops this disease from those who are professionally engaged in sports. To provoke pathological process may of injuries and diseases of the joint.
The clinical picture is characterized by pathological degenerative changes in the cartilage in the affected joint. It becomes thinner and gradually loses its ability to reduce the load on the joint bones. Deficiency of cartilage tissue, the body compensates for the growth of the bones in the affected area. This leads to a change in the normal shape of the joint.
Rheumatologists are three degrees of coxarthrosis of the hip joint. The intensity of the symptoms of each of them depends on the depth occurring degenerative changes.
Pain in the affected joint, extending to thigh
The main feature of the disease is pain in the affected joint, extending to the thigh, groin, and sometimes the knee.
It also manifests the following symptoms:
- a feeling of stiffness in the joint;
- limited mobility;
- weakness of adjacent muscles;
- gait changes;
- changing the length of the leg of the affected side (in the vast majority of cases the limb is shortened, approximately 10% of patients the reverse process).
In the first stage of the pathological process, the person feels a slight pain caused by prolonged walking or other loads passing the rest. They are localized in the region of the affected joint can radiate to hip, groin or knee. At this stage of the development of degenerative changes of the people usually do not seek medical help.
Gradually the disease progresses, the discomfort becomes more pronounced, a person has problems with the diversion of the legs. There is stiffness, especially in the morning or after a long stay in a static position. It is, if you slightly move the limb. In most cases, change happens slowly, but sometimes under the influence of external factors is compounded by the pathological process dramatically. This may be due to trauma, falls, excessive load or failure of an awkward movement.
The treatment started in an early stage of arthrosis of the joints of the pelvic and femoral bones, may stop the destructive pathological process and the beginning of deformation, to maintain the efficiency of the joint.
The second stage of development of the pathology is characterized by increasing pain, manifested not only when the load on the joint, but also at rest. The person at this stage of coxarthrosis changing gait, mobility is becoming more limited. When driving sometimes hear the joint crack. At this stage starts the pathological changes in the surrounding muscles of the thigh: they weaken, atrophy.
Disturbances in the cartilage become more pronounced, the fabric it thinner, dries and loses its elasticity. Changing the shape of the femoral head: because of the lack of functionality of the cartilage it is flattened on the acetabulum of the Ilium. Includes a protective mechanism: starts the growth of bone tissue, appear growths, called osteophytes. In the second stage of the development of coxarthrosis of the hip joint these formations are clearly visible on the radiograph.
Change the number, composition and consistency of the synovial fluid, which ensures good sliding of the bones and reduces friction. The properties of this liquid and the cartilage nutrition worsens, that only accelerates the dystrophic process. For the thinning of the cartilage, the bones become closer to one another.
In the third stage of development of the pathological process pain be permanent and of high intensity. They are bothering a person not only in daytime but also at night. It is difficult to walk, has to use a cane. Mobility is greatly reduced, thigh and gluteal muscle atrophy.
With the breakdown of cartilage, the bones begin to RUB harder against each other, which leads to acceleration of the degenerative process. The more the disease evolves, the more likely to happen pathological transformation. There is a degeneration of the muscular tissue of the thigh. Muscles of the lower limb above the knee becomes dry, smaller in volume compared to the opposite leg.
Muscle weakness leads to the fact that the pelvis moves in a vertical plane, the leg of the affected side is shortened. There is a pronounced limp. As a result, the patient when walking is deflected in the direction of the patient’s joint to compensate for the shortening. The body more loads of the hip joint. So people running coxarthrosis definitely need to use a cane when walking.
Cartilage thinning so that the bones almost touch. In severe cases, the growth of bone spurs leads to fusion of the bones. The mobility disappears.
In the treatment of the third stage of coxarthrosis conservative therapies are ineffective, helps only surgery.
Degenerative process is irreversible, but the sooner treatment is started, the more successful it will be. If you see signs of osteoporosis, should consult a rheumatologist, examined. Timely action will slow down the disease process, to preserve joint flexibility.