Osteoarthritis is a degenerative degenerative lesion of articular cartilage with the involvement of periarticular tissues in the pathological process. Characteristic of the development of the disease for people 40-50 years. However, with age, the disease increasingly prevails over the body, and in elderly people the incidence reaches as much as 27%.This is due to the fact that osteoarthritis is an involutive process. And most often it affects the hip joints.
To date, there is no single point of view related to the true cause of the disease. The most important factor is the mechanical factor: macro- and microtraction, the violation of the statics of the joint.
The development of the disease is also affected by a violation of microcirculation and metabolism( venous stasis, a decrease in the content of chondraitin sulfate), a change in the structure of the synovial fluid. Secondary signs include: tissue involution, neurogenic and endocrine disorders, weakened heredity, the presence of a chronic foci of infection.
The mechanism underlying the onset of such a disease as coxarthrosis is a violation of the metabolism of proteoglycans with articular cartilage degeneration. The concentration of hyaluron in the synovial fluid changes, as a result of which the intra-articular fluid loses its function, and the articular cartilage loses its ability to withstand physical stress.
In places where soft tissues adhere to the joint, osteophytes are formed, because of which the limb is deformed. As a result of these processes, subchondral osteosclerosis and spongy bone cysts develop. It is on the links of etiopathogenesis that the treatment of arthrosis of the hip joint is directed.
Before you treat arthrosis of the hip joint, you must correctly diagnose. The list of diagnostic activities is as follows:
- Evaluation of data during the collection of complaints and history of the disease, the results of an objective examination: a slow, inconspicuous onset of the disease;debut with discomfort in the joint;"Starting" and night pain;reactive synovitis and tendo bursitis;a symptom of a crunch;deformation of the joint and curvature of the limb axis;flexion and contracture in the joint;muscle hypotrophy;joint blockade syndrome;
- Radiodiagnosis: with standard radiography of the hip joint: narrowing of the joint gap, osteophytes, subchondral sclerosis, osteoporosis of bone, impression of the end plate;
- ultrasound and magnetic resonance imaging allow us to clarify the nature of the lesion and the condition of periarticular structures;
- Laboratory data: in rare cases, the acceleration of ESR is more than 25 mm / h.
Conservative treatment of
Before answering the question, what to treat, it is necessary to determine the main pathogenetic factor. Treatment of osteoarthrosis of the hip joint is aimed at protecting, improving nutrition and preventing the destruction of articular cartilage.
Application of magnetotherapy in the treatment of arthrosis
Joint unloading is performed using traction therapy, which eliminates pathological muscle spasm. It is carried out by putting a tire on the hip behind the cuff, or by using a special orthopedic device.
Treatment of arthrosis of the hip joint folk remedies does not bring a proper positive effect. People's therapy is criticized by orthopedic traumatologists, as it forces the patient to seek medical help at a later stage of the pathological process, which significantly worsens the prognosis of hip arthrosis treatment.
Manual therapy helps increase the amount of movement in the joint, reduce muscle tension with the methods of post-isometric relaxation.
The use of drugs can effectively stop inflammation and pain. For this purpose,
- non-steroidal anti-inflammatory drugs( selective inhibitors of COX-2, for less effect on the stomach) are used;
- intra-articular injection of corticosteroids( relief of inflammation);
- chondroprotectors( for restoration of metabolic processes in cartilage);
- protectors of synovial fluid( to ensure normal viscosity of intraarticular fluid),
- medications that reduce intraosseous pressure.
The dosage and schedule of each drug should be strictly controlled by the attending physician, taking into account the contraindications and the overall somatic state of the patient.
Therapeutic physical training and physiotherapy
The main treatment is not only in the use of drugs, but also in the performance of adequate loads. A good effect is given by exercise therapy in the swimming pool, swimming and therapeutic gymnastics. Exercises are carried out in the position of unloading the hip joint. They are aimed at reducing pain, increasing the volume of movements, delaying degeneration. FTL also has a positive effect on the treatment process.
In the first and second stages of the disease, remission is achieved by conservative treatment. In case of ineffectiveness of these methods, surgical intervention is performed. The main types of operations: denervation of the joint, decompression myotomy, intraosseous decompression, osteotomy, arthrodesis, arthroplasty, arthroplasty.