Coxarthrosis of the hip joint 2nd degree: causes, symptoms, treatment, complications
The content of the article:
- The reasons for the development of pathology
- Symptoms of coxarthrosis of the hip joint 2nd degree
- Diagnostics
-
Treatment of coxarthrosis of the hip joint 2nd degree
-
Drug treatment
- Non-steroidal anti-inflammatory drugs
- Chondroprotectors
- External means
- Corticosteroids
- Physiotherapy
- Surgery
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- Prognosis and complications
- Prevention
- Video
Grade 2 coxarthrosis of the hip joint is a degenerative-dystrophic chronic disease in which the cartilage in the articular cavity is deformed. The cause of the disease is a malnutrition of the intra-articular structures.
With coxarthrosis, there is a gradual destruction of the hip joint
In most cases, the disease occurs in people over 40 years of age. Osteoarthritis of the hip joint (HJ) can be unilateral or bilateral. Depending on the localization, a distinction is made between right-sided or left-sided arthrosis.
The articular surfaces of the bones of the hip joint evenly distribute the load. Under the influence of unfavorable factors, deformation or restructuring of the hyaline cartilage can occur, which leads to a violation of the distribution of the load during movement. Part of the joint begins to change both functionally and anatomically.
Microcracks appear in the cartilage, and the surfaces of the bones become rough. Initially, the cartilaginous tissue in the area of damage grows, over time it ossifies with the formation of osteophytes - bone outgrowths in the joint cavity. They change the shape of the joint and deform it. In the process of the disease, fibrous tissue forms in the joint capsule, the joint ligaments lose their strength.
The reasons for the development of pathology
There are primary and secondary forms of the disease. In the first case, the cause of the disease cannot be identified.
Various reasons can lead to the development of coxarthrosis.
Secondary osteoarthritis of hip joint can result from the following diseases / conditions:
- hip joint injuries: dislocations, fractures of the hip or pelvis;
- autoimmune diseases: rheumatoid or psoriatic arthritis;
- congenital dislocation of the hip;
- dysplasia of the hip joint;
- infectious diseases: osteomyelitis;
- Perthes disease: aseptic necrosis of the femoral head.
There are certain factors that can trigger the development of the disease. These include overweight, since in this case the load on the hip joint increases significantly.
Symptoms of coxarthrosis of the hip joint 2nd degree
There are three degrees of the disease. At the initial stage, the patient develops pain in the hip region after a long run or walk, which disappears if the person rests even for a short time.
Coxarthrosis of the 2nd degree is characterized by the following symptoms:
- painful sensations. They arise as a result of a decrease in the amount of intra-articular fluid and friction of the articular surfaces of the bones. The pain can be aching, stabbing, or shooting. It intensifies after exertion and at the end of the working day. After rest, the pain decreases or disappears, but then returns again. Pain sensations can be given to the groin or legs;
- crunching and clicking in the joint. This symptom occurs as a result of friction of the articular surfaces against each other. Also, friction against the articular surfaces of osteophytes can be the cause. At the 2nd degree of the disease, a rather rough crunch is observed, which is accompanied by pain;
- limitation of mobility in the joints. Thinning of the hyaline cartilage causes the joint space to narrow. Gradually, the cartilage tissue grows, and the synovial fluid changes its properties. Rotational movements (both active and passive) are initially disturbed;
- muscle spasm. Deformation of the joint (which can be seen in the photo) and weakening of the ligaments can lead to displacement of the femoral head, resulting in severe muscle spasm. Usually the lumbar and gluteal muscles are spasmodic, less often - the abductor muscle of the thigh. The process is accompanied by strong painful sensations;
- lameness. The reason for this is the pain that occurs in the hip joint with any movement. Also, overgrowth of osteophytes can lead to lameness, resulting in flexion contracture, which makes it impossible to fully straighten the leg. It is difficult for a person to maintain balance while walking, so he begins to limp.
Diagnostics
The disease is diagnosed based on clinical signs and X-ray data. In most cases, the image makes it possible to determine not only the degree of coxarthrosis, but also the reasons for the degenerative changes (Perthes disease, dysplasia, trauma).
An x-ray is prescribed to make a diagnosis
X-ray data allow one to see a pronounced narrowing of the joint space, osteophytes in the femur and acetabulum, as well as subluxation of the femoral head.
Additionally can be assigned:
| Diagnostic method | Description |
| CT scan | To assess changes in bone structures |
| Magnetic resonance imaging | To identify pathology of soft tissues |
Treatment of coxarthrosis of the hip joint 2nd degree
Drug treatment
At the first stage, drug treatment is carried out.
Non-steroidal anti-inflammatory drugs
The patient is prescribed non-steroidal anti-inflammatory drugs (NSAIDs) based on diclofenac, nimesulide, ibuprofen.
Medicines in this group can relieve pain and morning stiffness. They also reduce inflammation and increase the range of motion in the affected joints.
Chondroprotectors
The drugs of this group inhibit the development of degenerative processes, stimulate the regeneration of cartilaginous tissue and maintain the viscosity of the synovial fluid. The result is a partial restoration of the cartilage tissue. Such drugs are based on chondroitin and glucosamine (Teraflex, Dona, Artra).
As part of the complex treatment, chondroprotectors are prescribed
In order to get the desired effect, the drugs must be taken over a long period.
External means
In order to reduce pain, ointments, gels or creams based on ketorolac, diclofenac or nimesulide are used.
To reduce pain, external non-steroidal anti-inflammatory drugs are used
Often in complex therapy, drugs are used based on bee or snake venom, red pepper or larkspur. The procedures are carried out 2-4 times a day, applying funds to the damaged area.
Corticosteroids
In some cases, corticosteroids are prescribed to treat acute inflammation. Hormonal drugs based on mometasone quickly eliminate the inflammatory process, while the pain becomes less pronounced.
Physiotherapy
From the moment of diagnosis, the patient should regularly engage in therapeutic exercises. This will make it possible to avoid the growth of osteophytes and the formation of contractures in the joints.
To prevent the proliferation of osteophytes, you need to engage in therapeutic gymnastics
Exercises can be performed only during remission with 1 and 2 degrees of the disease. With coxarthrosis of the 3rd degree hip joint, therapeutic exercises are not prescribed, since the changes are irreversible and can be eliminated only by surgery.
Surgery
Most often, with coxarthrosis of the 2nd degree, hip arthroplasty is performed. During surgery, the articular surfaces of the femoral head and acetabulum are removed, and a mechanical joint is implanted into the femur.
If the treatment is ineffective, hip arthroplasty is performed
The prosthesis is made of a special porous material, it is fixed to the bone with a special glue. Subsequently, the bone tissue grows into the pores of the structure, merging into one whole and providing stability.
Prognosis and complications
It will not be possible to completely get rid of the disease with the help of drug therapy. If the hip joint begins to collapse, the disease will progress.
With the second degree of coxarthrosis, a person may experience quite severe pain, but his working capacity is preserved. In the third degree of the disease, the articular cartilage is completely destroyed, so the patient loses the ability to move independently without improvised devices. In this case, he can be assigned a disability group.
If the disease is not treated on time, the following complications may develop:
- deformation of the acetabulum;
- aseptic necrosis of the femoral head;
- inflammation of the periarticular bag (bursitis);
- arthritis of the knee joints;
- complete fusion of articular surfaces;
- deformation of the articular bones.
Prevention
In order to prevent the development of the disease, it is necessary to lead a healthy lifestyle. Moderate physical activity makes it possible to improve microcirculation in the hip joint area. You also need to follow a diet, since excess body weight contributes to the destruction of the joint.
If signs of the disease are detected, it is necessary to seek advice from a traumatologist or rheumatologist.
Video
We offer for viewing a video on the topic of the article.
Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
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