What is coxarthrosis?
The coxarthrosis or hip
osteoarthritis is the result of cartilage wear this
joint. Locally, there is disorganization of the collagen matrix and a
decrease in proteoglycans, which have a chondro-protective effect, calling
water by osmosis to its interior. As a consequence of the reduced osmotic
effect of proteoglycans, the water content of the cartilage is reduced, as well
as its thickness, and then osteoarthritis occurs.
Hip arthrosis is, together with knee arthrosis, one of the
most frequent arthrosis in the body. It affects 10-20% of the population
after the age of 60, with a higher incidence in men up to 45 years old and in
women after this age.
The terms coxarthrosis, hip osteoarthrosis, hip osteoarthrosis and
even hip arthrosis, are all synonymous and refer to the wear and tear of the
hip cartilage.
Arthrosis can also reach other joints with the
interphalanges of the hands, trapeziometacarpal (or rhizarthrosis, in the
thumb) and spine, conditioning, in addition to pain, also functional impotence
in the patients affected by it.
Bilateral, unilateral Coxarthrosis
The bilateral coxarthrosis, for achievement of both
hips is very common particularly in the case of bilateral primary
coxarthrosis. Unilateral affliction is often associated with
secondary coxarthrosis, especially that resulting from traumatic causes.
Usually, there is no predominance of left or right
coxarthrosis, and therefore, both sides can be equally affected.
Coxarthrosis - causes
Primary coxarthrosis is one that has no apparent
(ideopathic) cause, other than joint wear and degeneration. However,
coxarthrosis can have other causes and is then called secondary coxarthrosis.
The most frequent causes are the following:
- Traumatic
(fractures and dislocations);
- Femoral-acetabular
conflict and hip dysplasia;
- Avascular
necrosis of the femoral head;
- Sequelae
of congenital hip dislocation and childhood Perthes disease;
- Rheumatological
and infectious diseases.
Coxarthrosis - risk factors
One of the most important risk factors, which must be
controlled, is being overweight. The same is true of a sedentary
lifestyle. However, overuse, as in some high competition athletes, can
also lead to early joint wear, says orthopaedic in Delhi.
Circulatory, hormonal and metabolic disorders may also be
factors to be aware of.
Although coxarthrosis is not genetically transmissible,
there appears to be an increased incidence of arthrosis in certain families.
Coxarthrosis - symptoms
Coxarthrosis or hip arthrosis gives rise to the
following symptoms:
- Pain
in the hip, with mechanical character, that is, that worsens with the
movements, sometimes with irradiation to the groin, thigh or knee;
- Crackling,
joint stiffness and limited range of motion;
- Claudication
during the march, which sometimes requires the support of Canadians;
- Muscle
atrophy due to disuse;
- Progressive
reduction of gait perimeter without pain.
In bilateral coxarthrosis, symptoms cause more marked
functional impotence, and may even interfere with personal hygiene and
activities of daily living.
Diagnostic Coxarthrosis
Coxarthrosis is generally easy to diagnose, as the orthopaedic clinic in Delhi
is characteristic and a simple radiograph confirms it.
Usually, an X-ray of the pelvis under load and a profile of
the hips are performed. In these exams, the hip affected by coxarthrosis
has a reduction in the joint interline, the presence of subchondral sclerosis,
as well as osteophytes. In more advanced cases, the femoral head may lose
its normal sphericity.
When in doubt or when it is necessary to determine more
accurately the degree of joint damage and cartilage destruction, a TAC may.
The determination of the degree of arthrosis can be assessed
using two scales:
- WOMAC
- Kellgren-Laurence
Can Coxarthrosis be cured?
The coxarthrosis be cured, using hip
arthroplasty. More important than the treatment, it seems to be the
prevention of its evolution, through proper medication, weight control and
physical exercise.
Next, find out how to treat hip arthrosis.
Coxarthrosis - treatment
In coxarthrosis, treatment initially involves a
set of general measures, which are common to other forms of primary arthrosis
and which we will describe below.
In the most advanced forms already with important functional
attainment, the treatment for hip arthrosis involves undergoing hip
replacement surgery in Delhi, with total hip arthroplasty, through the
placement of a prosthesis in the hip.
Physical exercise and hip arthrosis
Intense physical exercise, with impact on the ground,
practiced in a continuous and prolonged way over time, as it happens, for
example, with the bottom runners, can condition an accelerated wear of the hip
cartilage and, thus, cause hip arthrosis. Therefore, moderation in its practice
is advised by orthopaedic
doctor in Delhi, especially in individuals with overweight.
Hip arthrosis - indicated exercises
Hip arthrosis can benefit from regular practice
of specific exercises in order to maintain mobility of the hip,
counteract muscle atrophy, and improve the overall function of the
joint. These exercises are usually practiced in water, in swimming or water
aerobics classes, since there the sustaining effect will facilitate a painless
mobilization with less effort than that performed under gravity.
The stretches, namely the muscles of the posterior aspect of
the thigh, such as the isqueotibial muscles, also help to avoid contractures
and vicious postures, both of the affected lower limb and of the spine.
Aerobic conditioning of the patient is also essential.
The improvement in the conditions of local circulation that
most of these exercises cause, seems to have a beneficial effect in delaying
the progression of the disease.
Other patients in the acute or advanced stage of the
disease, may benefit from rest, to discharge the joint and relieve pain, in
addition to lifestyle modification and weight reduction, explains orthopaedic in Dwarka.
Hip osteoarthritis - physiotherapy
One of the ways of controlling the symptoms of hip arthrosis
may be the use of adequate physiotherapy in Dwarka.
Physiotherapeutic treatment for osteoarthritis involves:
- Use
of a series of devices for anti-inflammatory purposes, for example:
ultrasound, short wave, tension, magnetotherapy;
- Thermotherapy
- heat or cold;
- Manual
techniques for stretching and joint mobilization;
- Muscle
strengthening through water aerobics exercises or with light loads.
Medicines for hip arthrosis
The prescription of analgesic and
anti-inflammatory drugs helps to control pain and local inflammation,
reducing the associated joint effusion and improving joint mobility.
Other remedies widely used for hip arthrosis may
be glucosamine sulfate and chondrointin supplements. These are essential
components of the joints and may be reduced when there is wear. Its intake
seems to be beneficial, as it manages to reduce the amount of anti-inflammatory
drugs needed to control pain.
Hyaluronic acid - hip arthrosis
The intra-articular injection of hyaluronic acid in
the hip with osteoarthritis is considered a treatment with results proven by
the literature. This product, which already exists in the joint, is
injected as a gel and acts as a lubricant and shock absorber.
It has proven effectiveness in reducing pain and improving
function, especially in arthritic joints, in stages of the disease not yet very
advanced. It can be applied several times throughout life with or without
ultrasound control.
Stem cell treatment
The treatment of arthrosis through the intra-articular
application of stem cells (“stem cells”) seems to be able to present
interesting results in animal experimentation. However, further studies
are needed in the future until they can be considered as a first-line
alternative in the treatment of coxarthrosis.
Surgical treatment
The arthrosis of the hip surgery, is classically in
three types of operations:
- arthrodesis
(an operation aimed at obtaining joint fusion to cancel the pain) was used
in young patients, but was practically abandoned because it completely
removed joint mobility;
- the
reorientation osteotomies, in which the orthopaedic surgeon in
Delhi tried to load the area of the femoral head less affected
by wear, failed due to incomplete and temporary relief of symptoms;
- the hip
replacement in Delhi came almost replace the previous 2 in
view of the excellent results and the long survival that is currently
possible to obtain.
