Every child in the first months of life should be examined for the shape of the hip joint. Dysplasia occurs in every 20 newborns, meanwhile at this stage effective treatment of this defect can be made. Neglecting the proper development of the hip joint results in later problems with movement and further worsening of the disease. In many cases, childhood dysplasia turns into adult hip degeneration – a chronic disease that leads to serious impairment. What is the coksartrose, what symptoms and effects it causes?
Degeneration is a chronic and progressive process of degeneration of joint cartilage, i.e. a layer made of connective tissue, surrounding the roots of adjacent bones. The cartilage prevents the bones from rubbing against each other, thus preventing the abrasion of their surfaces and allows the painless movement of the joint. In the course of osteoarthritis of the hip joint, the cartilage covering the femoral head and the pelvic bone shell are damaged. The cartilage tissue becomes softened, which makes it susceptible to abrasion under the influence of movement. Next, the cartilage dries and breaks, and as a result ceases to fulfill its functions (free movement of the joint, damping of loads and vibrations, protection of the bone against abrasion). In addition, there are bone growths (osteophytes) that can generate hip pain. Over time, degeneration of the hip joints causes more and more problems with walking, until completely immobilized.
As we have already mentioned, koksartroza may be the result of congenital anatomical defects of the hip joint – according to statistics as many as 40% of people with degenerative disease were born with dysplasia, ie abnormal development of the acetabulum of the pelvic bone. Other malformations conducive to degeneration include valgus and varus of the hip, sterile osteonecrosis of the femur and hip sprain.
Osteoarthritis may progress to osteoarthritis, which progresses with age – although the disorder is also present in younger patients, postmenopausal women have particular predisposition to the development of degenerative changes.
Hip degeneration at a young age can be the result of obesity and a sedentary lifestyle, or the opposite – intensive exercise of sports that weigh on the joints excessively (bodybuilding, running).
Genetic strains, posture defects and poor protein diets are other factors that increase the risk of osteoarthritis. In addition, problems with hip joints are a complication of other rheumatic diseases, such as rheumatoid arthritis or juvenile idiopathic arthritis.
Also people who have experienced injuries, hip contusions or pelvic or femoral bone fractures are more likely to develop degeneration of the hip.
The onset of degenerative changes manifests itself mainly in the feeling of hip stiffness, which usually occurs in the morning or after a long time in a stillness. Stiffness passes after exercise, so patients often do not see any reason to consult an orthopedist.
When the degenerative disease goes into intermediate state, there are pain symptoms including hips, lower back and groin. The pain escalates especially during strong legs bending, eg when climbing stairs, standing up from a chair, running, squatting or dancing. Over time, the degeneration of the hip can also be felt when walking, even at night and on cold days.
As a result of cartilage damage, there is a limitation of mobility in the hip joint, therefore the patient starts to limp and set his legs in an unnatural position. At an advanced stage, the bones bordering one another seem to crackle, and in the place of degeneration there is edema and increase in body temperature.
In patients suffering from hip joint degeneration, treatment focuses mainly on broadly understood rehabilitation. The physiotherapist relaxes the muscles involved in the hip movement by means of massage and methods of muscle rolling. Restoration of hip joint mobility requires special exercises in suspension and stretching by stretching. In the treatment of degeneration is also aimed at widening the narrowed articular space with manual therapy. Working with a patient can also involve learning to move without lifting the hips and strengthening the muscles of the lower limb. In order to relieve pain, the doctor may recommend treatments using a magnetic field and ultrasound. In addition, the patient can get a referral for spa treatments using the healing properties of water and peat. Another important element of the therapy are injections with hyaluronic acid, which promotes the regeneration of cartilage.
Advanced degeneration of the hip joints, with severe pain and significant joint damage, requires surgery. Some patients will need arthroscopic surgery to clean the joints and remove osteophytes. A much more serious intervention in the body is hip arthroplasty, in which damaged parts of the hip are replaced by artificial elements.