With an increase in the average life expectancy in modern societies, degenerative diseases affecting the musculoskeletal system occur. Such a disease is coxarthrosis, which progressively worsens the quality of life and leads to difficulties in performing daily activities. Elderly people suffer from coxarthrosis. The disease has a slow but progressive nature, affecting the joint initially functionally, and at a later stage also structurally. In essence, coxarthrosis is arthrosis of the hip joint.
Nature and risk factors
At risk of developing arthrosis are mainly the so-called weight-bearing joints such as the knee and hip. From an anatomical-physiological point of view, they are subjected to great mechanical stress as a natural result of being burdened with body weight. As the years progress, degenerative changes reduce the joint space. This results in injury to the smooth cartilage surfaces of the joint partners and creates bone compression in the joint. Micropunctures appear in the cartilage surface. Not only its structure changes, but also the bone architectonics – bone cysts and osteophytes appear. The function of the joint is impaired. Burdening it vertically causes pain. Risk factors for the development of coxarthrosis are: overweight, metabolic diseases, osteoporosis, injuries, hip dysplasia.
Symptoms of coxarthrosis
Symptoms appear slowly and gradually over time, but at the same time they are permanent. The reason for this is the defeat of the dysfunction of the structures that make up the joint. There is morning stiffness and pain as the day progresses. At first, the pain disappears at rest, but soon after it becomes permanent in the patient’s daily life. Night pain is also observed, which disrupts sleep and the recovery of the body. The range of motion in the joint is limited. Weakness of the abductor, flexor and external rotator muscles is noted. The hip flexors and adductors are adaptively shortened. That is why patients complain of pain in the area of the inguinal ligament and the inner part of the thigh. If the symptomatology is ignored, joint contracture occurs, which shortens the length of the limb and the patient begins to limp. In practice, neurological symptoms originating from the lumbar spine are often superimposed. The hip joint and the lumbar spine are one functional unit, and disturbances in the structure and function of one unit directly affect the other. This explains why patients often wander between the offices of orthopedists and neurologists.
Diagnosis and conservative treatment
Examination and diagnosis is carried out by an orthopedic doctor, who determines the severity and degree of involvement of the joint. For this purpose, in addition to taking an anamnesis, the doctor can refer to imaging studies such as radiography and nuclear magnetic resonance. As a rule, after the diagnosis, regardless of the severity of the involvement, it is appropriate to exhaust all conservative treatment options before the patient is referred for endoprosthetics.
Conservative treatment consists of the combination of various physical factors and exercises. The goal of physiotherapy and kinesitherapy is to preserve the joint’s structure as much as possible and improve its functional deficit. The patient is approached aggressively with physical modalities having a regenerative effect on the structures. Therapeutic exercises are gradually included, which improves joint mobility and muscle tone. An individual complex of exercises is built, which the patient must implement in his daily life. The treatment plan requires revision and corrections in the patients’ daily habits in terms of physical activity and diet.
