Coxarthrosis of the hip joint

In youth, we actively use the hips – dancing, football, running. But in old age, there is often a different picture – if the hips hurt with every step, this may be a sign of wear on the hip joint.

The hip joints are the two largest joints in our body. They connect the hips to the pelvis. Over time, the cartilage between the top of the thigh and the hip (acetabular) socket can wear down, resulting in painful friction against the groin. However, this condition can be effectively treated.

What is coxarthrosis of the hip joint

Arthrosis is a chronic, long-term inflammation of the joint. Coxarthrosis is a lesion of the hip joint, which doctors may call osteoarthritis or osteoarthritis. In fact, this is one and the same process, a progressive lesion of the joint.

Inflammation in it occurs due to the fact that the tissues age with age, wear out, the cartilage covering the edges of the bone in the joint area loses water, cracks, and begins to crumble. The joint moves worse, discomfort is felt, the cartilage loses its smoothness, and is injured. If this process is not slowed down, left untreated, the joint can collapse completely, which will lead to serious problems, up to disability and immobility.

Causes of coxarthrosis of the hip joint in adults

The main reason for the deterioration of the cartilage tissue is age and excessive loads, excessive impact on the joint. This wear and tear causes inflammation of the joints, leading to pain and discomfort that worsens as the disease progresses: the bone under the damaged cartilage grows, forming bone spurs (osteophytes or sharp projections) around the joint.

Factors that can contribute to joint damage include:

• trauma;
• age;
• overweight.

In addition, osteoarthritis can sometimes be caused by other factors:

• the joints could initially form incorrectly;
• there may be genetic (hereditary) cartilage defects.
• a person may experience additional stress on the joints due to activities that involve the hip and place undue stress on it.

Primary coxarthrosis accounts for two-thirds of cases and occurs in people over 60 years of age. Secondary coxarthrosis is the result of an injury (fracture, dislocation) or a significant load on the joint (associated with sports or certain professions). Osteoarthritis of the hip can also be caused by deformity of the hip, which explains why this condition can affect young people.

In the development of coxarthrosis, successive stages are distinguished that replace each other. They range from the first to the third, depending on the severity of the changes. And the first stage is the easiest of them.

At the very beginning, the pathology proceeds almost without symptoms or there are weak and inconsistent, not pronounced pains. They usually appear after a heavy load, a long stay on your feet, or towards the end of the working day. Initially, people attribute these manifestations to overwork or overexertion. Therefore, the first stage of coxarthrosis is detected quite rarely.

More noticeable will be the manifestations of coxarthrosis in the second stage of the disease, as changes in the joints progress. At this stage, the joint space narrows by almost half, and the femoral head begins to significantly shift and deform.

As you move into the third stage, the pain becomes excruciating and unbearable, it can appear even at night, with immobility. The pain radiates to the thigh area, to the lower leg, gluteal muscles and groin, there is almost no joint space left, osteophytes are formed on the surface of the bones that form the joint – sharp spikes, in the presence of which movement becomes almost impossible. Therefore, patients walk with a cane or on crutches.

Symptoms of coxarthrosis of the hip joint in adults

If you notice any of the following symptoms, you should contact your doctor immediately:

• joint stiffness that occurs when you get out of bed;
• joint stiffness after sitting for a long time;
• any pain, swelling, or tenderness in the hip joint;
• a crunch or sensation of bone rubbing against bone;
• inability to move the hip during routine activities, such as putting on socks.

Treatment of coxarthrosis of the hip joint in adults

Coxarthrosis of the hip joint is a serious disease that quickly leads to disability, as it affects the bearing joint.

Pain is usually one of the first signs in the diagnosis of coxarthrosis of the hip joint or. It can be felt in the groin and sometimes in the buttocks or the back of the thigh. Pain in the knee may also indicate this diagnosis. With the development of the disease, joint pain begins to increase, lameness appears.

Diagnostics

There is no single test for diagnosing coxarthrosis, but it is often diagnosed by abnormal changes on x-rays that show characteristic features such as joint narrowing and sharpening of its edges. Doctors can see if the shape of the bone in the joint has changed or if the joint space has narrowed. The more cartilage missing from the hip joint, the narrower the joint space.

The physical exam will include checking how the hip is working and may reveal loss of motion. During a physical examination, specialists examine the condition and displacement of the capsule in the joint. They also look for the exact cause of any pain during movement.

Additional tests may be required for a more accurate diagnosis. If inflammatory joint disease is suspected, doctors also do blood tests or draw fluid from the hip joint.

Modern treatments

The main goal of treating coxarthrosis is to improve joint mobility. Treatment plans may include:

• rest and dosed loads;
• using a cane to take weight off the affected hip;
• non-pharmacological methods of pain relief for pain control;
• weight loss;
• medicines, including paracetamol, non-steroidal anti-inflammatory drugs such as ibuprofen (Nurofen), or prescription pain relievers (Ketorol, Nise, Diclofenac).

In addition, you will need to lead a healthy lifestyle (control your own weight, give yourself light physical activity) – this is necessary to reduce pain and prevent exacerbation of the disease. Therefore, sports such as swimming are highly recommended.

When these treatments no longer work, corticosteroid injections, hyaluronic acid supplementation, or platelet-rich plasma (PRP) therapy may be considered.

Finally, a doctor may suggest a total hip replacement. But, although hip prostheses currently have a relatively long service life (more than 90% of prostheses remain in place for 20 years), this operation is usually postponed to a later date. However, it cannot be delayed either, since coxarthrosis in its advanced form can lead to bone destruction, which will greatly complicate the operation.

During a hip replacement, the damaged ball is replaced with a metal one. The surface of the hip joint is covered with a metal shell and a plastic insert.

Another option for reconstructive surgery is grinding of the hip joint. In this case, the affected surfaces are surgically removed and replaced with metal. However, the entire femur is preserved. Grinding makes it possible in the future to have an operation to replace the hip joint.

Prevention of coxarthrosis of the hip joint in adults at home

One way to prevent osteoarthritis of the hip is to maintain a healthy weight. In addition, you should exercise – exercise strengthens the muscles around the joints, which will help prevent cartilage wear.

The attending physician may offer additional recommendations to minimize the risk of developing coxarthrosis.

Popular questions and answers

Answered popular questions about coxarthrosis of the hip joint traumatologist-orthopedist Ruslan Akzhigitov.