Coxarthrosis - Hip Arthrosis

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:

1. WOMAC
2. 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:

1. Use of a series of devices for anti-inflammatory purposes, for example: ultrasound, short wave, tension, magnetotherapy;
2. Thermotherapy - heat or cold;
3. Manual techniques for stretching and joint mobilization;
4. 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:

1. 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;
2. 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;
3. 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.