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 occur in the structure and properties of hyaline cartilage, which leads to increased pressure on the articular surfaces and their deformation or fusion. Since mechanical overload is considered one of the main causes of the development of the disease, the hip joint is often affected by arthrosis.
Characteristics of the anatomical structure of the hip joint
The hip joint (TC) is the junction of the pelvis and femur. This articulation makes it possible to reduce and spread the lower limbs, raise the legs and draw them to the body, as well as walking movements. From birth and throughout life, a person carries a high load on the hip joint.
On the side of the pelvic bone, the "acetabular" cavity takes part in the articulation, on the side of the femur, its epiphysis. The acetabulum has a collagen rim along the edges, which acts as a kind of gasket that holds the femoral epiphysis firmly in place. The space in the center of the acetabulum is covered with a collagen membrane and is the place of attachment of the femoral ligament.
The composition of the TS capsule includes ligaments:
- femoral-iliac - the strongest ligament that can withstand a load exceeding 200 kg and prevents excessive arching of the back;
- femoral-pubic - is responsible for abducting and reducing the thigh, thus limiting its circular movements;
- femoral ischial - protects the vehicle from shocks, reduces the load during walking and running;
- circular (loop) - prevents dislocations and holds the head of the femur in the cavity of the pelvic cavity and is the base of the articular bag.
Multiple groups of muscles and tendons allow the vehicle to move around three axes:
- Longitudinal (vertical).
- Transverse (horizontal, frontal).
- Sagittal (anterior-posterior).
Arthrosis of the joints 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 absorbent and protective functions against damage to joint surfaces. ATS is a disease in the process of development of which the structure of collagen cartilage fibers changes, which then leads to their fragmentation and destruction. Fragments of cartilage fibers, if they enter the articular cavity, can cause an inflammatory process. Bare surfaces undergo changes in bone tissue caused by friction and increased pressure. The remaining cartilage tissue along the edges of the epiphyses grows compensatory with subsequent ossification, causing ankylosis (immobility of the bony joint). In the later stages, in the absence of adequate therapy, the patient completely loses mobility and becomes disabled. Destructive processes are provoked by various reasons.
There are the following types of arthrosis of the hip joint:
- elementary. Its etiology is not fully understood. Idiopathic (primary) arthrosis develops in a previously healthy joint. More often, it develops in older people.
- Medium. It is provoked by previous diseases of the articular apparatus, congenital anomalies of development, changes in the work of organs and systems of human vital activity.
The disease develops in one joint or affects both at once.
Causes of the disease
Among the causes that contribute to the appearance of the disease and its progression, the following are identified:
- Inherited genetic predisposition to the development of the disease.
- Bone joint injuries (dislocations, fractures, sprains and tendons).
- Unbearable systemic strength and physical activity.
- Overweight.
- Functional disorders of the endocrine system (diabetes, psoriasis).
- Congenital pathologies of the structure and development of the musculoskeletal skeleton.
- Professional characteristics of work activity.
- Poor local circulation.
- Previous diseases caused by pathogenic flora.
- Legg-Calve-Perthes disease.
- Metabolic disorders (gout).
- Physical inactivity.
- Immune diseases.
These reasons are not always able to cause ATS. More often, the activation of pathological processes can be provoked by:
- increased stress and physical activity;
- continuous overwork;
- hypothermia of the vehicle or the body as a whole;
- sudden lifting of heavy objects;
- hormonal imbalance;
- exposure to radiation.
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:
- Stiffness in the morning or after a long period of immobility.
- Decreased range of motion, change in gait.
- Pain, first caused by mechanical or physical stress, then constant.
- Manifestation of creaking, creaking and clicking during sudden movements.
- Marked lameness in the affected limb.
- Appearance of contractures (restriction of passive movements).
- Narrowing or closing of the key space (X-ray sign).
The severity of the signs of arthrosis of the hip joint depends on the degree of development of the disease and the reactive abilities of the patient's body.
Stages of coxarthrosis
Depending on the clinical manifestations, 4 stages of arthrosis of the hip joint can be distinguished:
- First degree arthrosis of the hip joint does not have significant pain and other manifestations. The stage is difficult to diagnose, the disease can be detected using a biochemical study of hyaline cartilage tissue and the determination of an insufficient amount of glycosaminoglycans. The patient feels joint pain and rarely pain at the beginning of physical activity.
- Second-degree arthrosis of the hip joint is characterized by changes in the density and elasticity of cartilage fibers. Cracks and breaks appear. Damping functions are reduced. The pain intensifies, radiates to the inguinal region, the movements of thinning and reduction of the affected limb are limited.
- In the third degree, the layering of cartilage fibers occurs with greater intensity. 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 junction of damaged bones does not depend on the state of activity and rest. With each movement, the joint "jumps" and "jumps". The range of motion is reduced in all axes.
- 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 the narrowing, sometimes closing of the articular 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 treatment tactics and disability (in case of severe disease).
Possible consequences
The progression of ATS leads not only to the deformation of the femoral head and the pelvic cavity, but also to the development of pathological processes in the functioning of the articular apparatus as a whole.
Pathologies resulting from complications of hip arthrosis:
- synovitis (inflammation of the joint synovial membrane);
- aseptic necrosis of the femoral head;
- destruction of joints (osteonecrosis);
- inflammation of the joint bag with a change in the amount of synovial fluid;
- ankylosis (immobility of bone articulation) partial or complete;
- contractures (restriction of mobility and inability to bend-extend the limb).
The development of complications of ATS always leads to a deterioration of the patient's general condition, his quality of life and the loss of unaided movement.
Diagnostic methods
Diagnosis of arthrosis of the hip joint in the initial stage is difficult. Symptomatic manifestations become visible only when the epiphyses of bones and nerve fibers are involved in the pathological process.
During a medical examination in the progress stage, the following are observed:
- visual change in the articular contour;
- palpation pain;
- sometimes the pastiness of the periarticular tissues;
- shortening of the diseased limb.
The main role in the diagnosis of ATS is assigned to X-ray examination. As auxiliary diagnostic methods used:
- Ultrasound, magnetic resonance.
- CT scan.
- Articular lubrication puncture (synovial fluid).
- Diagnosis using an arthroscope (microprobe).
- Laboratory clinical and biochemical tests of urine, blood.
Timely diagnosis improves the prognosis of the treatment and the further life of the patient.
How to apply for disability?
It is impossible to completely cure this disease. To confirm the right to social benefits and assign a disability group after passing the examination by close specialists, you should contact your doctor.
The indicator for assigning disability in case of arthrosis of the hip joint is:
- oligoarthrosis (lesion of no more than 2 joints) TS 2 degree;
- combined arthrosis of the second degree of TS and arthrosis of the third degree of the knee joint;
- a decrease in the length of the diseased limb by more than 6 cm;
- automatic reactive flow switchboard, documented.
Determining the disability group will help:
- carefully collected anamnesis;
- the conclusion of the medical advisory commission (MCC);
- results of diagnostic studies;
- passage of the commission of medical and social experts (KSZH).
If the decision of the commission of experts is negative, it can be appealed to higher bodies.
prevention
Preventive measures are a simple way to avoid the development of this disease. Preventive measures include:
- Maintaining an active lifestyle.
- Control of body weight indicators.
- Optimization of nutrition and way of working and resting.
- Reduced mechanical and physical load.
- Treatment of diseases of viral and infectious etiology.
- Prevention and prevention of injuries at home and at work.
- Regular 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 involved in the joint. Do not ignore even small manifestations of hip arthrosis, this reduces the chances of preventing the further development of the disease.