Hip arthrosis, also called coxarthrosis, belongs to a group of diseases called chronic degenerative diseases, that is, diseases that progressively evolve, affecting certain areas or tissues of the body.
In the case of osteoarthritis of the hip, there is
progressive wear and tear of the cartilage of the hip joint.
This disease is also characterized by bone neoformation in
the region where there was joint wear. These neoformed structures are
popularly called parrot beaks.
Risk Factors for Hip Osteoarthritis
It is not known for sure why certain groups develop hip
arthrosis, but it is known that some situations tend to increase the
probability of developing this degenerative disease.
Among these factors are previous diseases of the hip, such
as epiphysiolysis, in addition to septic arthritis, congenital dislocation,
femoroacetabular impingement, rheumatism, fracture sequelae, as a result of
previous surgeries, etc.
This pathology usually affects older people. In the
case of previous diseases in the hip, it is called the pathology of secondary
hip arthrosis. It is estimated that in the population over 65 years of age
approximately 12% have symptomatic osteoarthrosis.
Symptoms
The main symptom of hip arthrosis is pain, located in the groin
area. But the patient may report other symptoms such as difficulty
performing simple movements such as bending down or bending, as well as joint
stiffness and crepitus.
Other symptoms are pain in the buttocks area and the pain
may be present even after a period of rest, especially at night.
Difficulty performing simple activities such as walking,
climbing stairs, sitting or crossing the legs is present in cases of
coxarthrosis.
As coxarthrosis is a progressive disease, the signs and
symptoms also have a progressive evolution, that is, they can start in a very
mild and little limiting way, but progress to intense and very limiting.
Thus, the first signs of coxarthrosis include joint
stiffness, which starts bothering more in the morning, but tends to disappear
during the day. In these cases, the limitation of movement is quite small.
With the passage of time and the evolution of the disease,
joint involvement also increases and, as a result, the stiffness becomes
greater and tends not to disappear during the course of the day. Even the
pain can even radiate to other places, such as the lumbar spine, for example.
Rest no longer helps to improve the condition and the
patient begins to feel pain in any location or position, feeling very
uncomfortable even when lying down or standing still.
The consequence of this is that the patient increasingly
decreases the level of movement and when he moves, he limps, trying to transfer
the load to the other side of the body that does not present the pathology.
Although this seems like a temporary solution, it actually
only worsens the situation, as it leads to muscle weakness in the leg and
buttocks, which are extremely important musculature for hip protection.
Thus, it is important that a professional is sought when the
first symptoms appear, so that the diagnosis is established and a good
treatment plan made, precisely to prevent the natural progression of the
disease from occurring.
Diagnosis of Osteoarthritis of the Hip
The diagnosis of this pathology is the responsibility of the
orthopaedic doctor in
Dwarka. Unfortunately, many patients are slow to seek medical
help, believing that the pain and the situation will spontaneously improve,
which is not the case with a degenerative disease.
Clinical evaluation is essential, with the professional
collecting information about the pain history and medical history of that
patient. In addition, some functional exams to check the patient's muscle
capacity in the region are performed.
It is important to check the muscle condition of the leg,
buttocks and thigh, to establish the degree of evolution of the disease.
Imaging tests may be ordered, such as X-rays and
MRIs. These exams are important to be able to assess the degree of
involvement of the joint surface.
The exam of choice for diagnosing hip arthrosis is the AP
radiograph of the pelvis, also called pelvic panoramic, and the lateral view of
the affected joint.
The other imaging tests are important when the orthopaedic doctor in Delhi
wants to eliminate other possible causes of the problem.
The reduction of the joint space, as well as the presence of
bony prominences in the region, are factors that are investigated with the
analysis of the image exams.
Treatment of Hip Osteoarthritis
For the treatment of coxarthrosis, it is important to point
out that not all cases require surgery, and conservative treatment is an
excellent alternative that should be considered because of its positive
results.
However, in some cases, depending on the level of joint
involvement, surgery becomes unavoidable.
Conservative treatment for hip osteoarthritis
The approach should always be individualized and geared to
the patient's lifestyle and expectations about treatment.
Depending on the degree of pain presented by the patient,
the orthopaedic in Dwarka
may prescribe appropriate analgesics and anti-inflammatory drugs to reduce the
acute pain. This is part of conservative treatment.
Physiotherapy in the Conservative Treatment of Hip
Arthrosis
Physiotherapy
in Dwarka is also indicated for pain reduction, since there are
physiotherapeutic techniques that are quite suitable for acute pain.
Among these physical therapy techniques, we can highlight
electrothermophototherapeutic resources, such as laser, TENS and ultrasound.
Other techniques include myofascial release and joint
mobilizations.
From the reduction of pain, it is possible to focus on a
second moment of conservative treatment with the support of physiotherapy in
Delhi, seeking muscle strengthening and range of motion.
Activities such as water walking and water activities
(hydrotherapy) can also be quite helpful.
At first, the exercises should start without movement, only
isometric contraction. Then, with light contraction, then with manual
resistance, elastic resistance and finally, resistance with weights.
Appropriate muscle strengthening for patients with
coxarthrosis prevents the progression of the disease, as it makes the
musculature absorb the necessary load from the patient's activities, preventing
this load from being transferred to the compromised joint region.
The result is an improvement in the patient's physical
condition, with reduced pain and improved functional and movement capacity.
Surgical Treatment for Osteoarthritis of the Hip
In some cases, due to the degree of involvement of the hip
joint, the surgical indication ends up being the best option for the patient
with coxarthrosis.
When there is a very large involvement of the joint region
or in cases where conservative treatment has failed, the surgical option can be
offered to the patient.
It is worth remembering that every surgical process has
risks and that the patient will still have to undergo a long physical therapy
rehabilitation after the surgery.
Therefore, orthopaedic in Delhi
explains to the patient that, although the results of the surgery can be
positive, physical therapy rehabilitation is essential.
The most indicated surgery for cases of hip arthrosis is
arthroplasty or hip replacement
in Delhi, but the indication of the surgical procedure will depend on
several factors, such as the patient's age, etiology, degree of activity and
range of motion.
In addition, it is important to check whether the disease is
present in only one hip joint or in both.
Surgical procedures can be divided into three types:
- Osteotomies and arthroscopies:
change the position of the hip bones;
- Fusion of the hip joint, called arthrodesis;
- Replacement of the hip joint with a prosthesis (arthroplasty).
Obviously, the most invasive surgical procedure of the three
described is the replacement of the hip joint with a prosthesis. There is
no rule, but in general, less invasive procedures are recommended in early cases.
Arthrodesis is now considered a disused
technique. Arthroplasty, on the other hand, is considered one of the
greatest successes in medicine in terms of surgery and there has been a lot of
progress not only in the surgical technique but also in the materials to be
placed as prostheses.
Even so, arthroplasty is indicated for the most severe cases
of joint destruction.
