Arthrow of the hip joint (cothartrous)- This is a chronic degenerative joint disease that causes the deformation of bone tissue.All components of the compound, all components of the compound, adjacent to articular cartilage, cartilage, synovial crust, gardens, capsules and adjacent muscles, bone structures.In the event of a disease, article cartilage is destroyed, the muffin and osteophyllic microgundness (bone growths) appear, and the muscle-lighabent device of the hip is formed.
Every fifth person in the world complains of joint problems.It can be limited to both pain and joints and the combination of these symptoms.Every second outpatient vision falls to patients with bone muscle disorder, people with 66% of those under 65 years.According to the latest epidemiological research, the spread of the artery of knee and hip compounds among the adult population is 13%.
Risk factors for the development of COXARTROP:
- Genetic tendency.A common cause of coksarthrosia of hip compounds is the congenital or obtained mutation of type II type II Prollen.
- Old age.The probable cause of the spread of arthrosis at the age of old age is the discrepancy between the influence of damage to the joint cartilage and opportunities to restore.
- The floor.Women suffer from osteoarthritis more often than men.This is due to the impact of the influence of women's sex hormones of the estrogen in bone mineral metabolism.However, the effect of the floor is unequivocally - According to some authors, unlike damage to other joints, there is no difference in sexual basis for coksartrosis: In men, the arthrosis of the hip joint is as in women.
- Already body weight.The relationship is already proven between the formation of body mass and arthrosis.Increases the harmful load on the sticky tissue cartilage now.In addition, the adipose texture produces pro-meter enzymes that damage the cartilage tissue.
- The frequent development of bones and joints.In accordance with the research, 80% of a rough rear and sublimose are associated with defects that do not previously diagnose in the development of hippiplines and subluxation.
- Heavy physical labor.Excessive cargo combinations in a hip combination, which are certain physical work, can lead to formation of arthrosis.The risk is the people of agricultural workers, drilling workers and similar work specialties.
- Injuries.The risk of developing the Kotolar Gray is growing after receiving injury to the hip combination.Moreover, both were injured and both can participate in the process.
- Sports to play professional.Professional sports can also verify the formation of Coxarthroos and injuries due to excessive loads of joints.Potential dangerous sports include weightlifting, athletics jumping, parachute sports.
- Bones and joint diseases- Rheumatoid arthritis, psorized arthritis, joint infections, avascular necrosis, gouty arthritis, etc.
- Endocrine pathologies- hypothyroidism, hypopariaidoidism, acromegali (front pituitary fluid defective function), diabetes, obesity.
If similar symptoms are detected, consult a doctor.It is not self-to-do - dangerous to your health!
Artomic symptoms of hip joints
The main symptoms of Coxarthroos are: the joint pain, mobility restrictions and the crisis, their deformation, the functional shortening of the lower extremity and periodic swelling.
Pain of different intensity.Joint pain, originally insignificant and arises for a short time.For example, souts, trends and weight in the lifting, or other physical effort appears or strengthens.As the disease develops, the pain intensifies, and even a long rest does not bring comfort.In addition, pain occurs in a situation with long-term inactivity and combination.
Patients complain about "starting" pain in a car and other stretching inactivity and other stretching inactivity, so much in hip joints."Starting" pain is not more than 30 minutes for COXARTRIZ?Pain is intensified in hypothermia or stressful condition.Budun can be localized in the front or side surface of the hip or groin.Lomber can be transferred to the thighs away from the center of the body or directory by spreading pain on the nerves.Sometimes the pain lumbosakral belongs to the spine and tailbone.
Restriction of joint mobility.The actions in a hip combination with coksartrosis are limited due to pain.At the same time, the rotation (both domestic and outside) is more often broken (to move to the middle of the body), but it may be limited (moving from the middle axis of the body), as well as flexion and extension.Inability to do passive actions in the combination due to an opening pain syndrome, the compensator causes a pelvic bias.The patient's gait change, the hip is withdrawn, the body moves forward when the body gives weight to the damaged side.In patients with coksarthrosis, "my duck place" is formed with bilateral damage.
Occur periodically with CoxarthroosSwelling in a combinationmay be invisible for muscle and oil sheet.Also, the disease is characteristicIn the joints during the movement, their gradually deform the deformation and the functional shortening of the bottom part.
Often, it affects a common disease, then the process belongs to others.However, sometimes arthrosis affects several joints at a time and the poliosostoartoartitrait occurs.PolosteoDartyz is characteristic of elderly people or hereditary and is also characteristic of the diseases - the bones, joints and endocrine disorders are characteristic of disorders.
Artogenesis of hip joints
In the pathogenesis of the architectural arthropist, an important role, mechanical damage and micrometers, physical, hormonal and metabolic factors in common physically.Often, it is not possible to learn which factor affects the development of the disease, but often the disease develops after tissue damage.
Tissue damage stimulates the section of cartilage tissue cells (chondrocites), and the production of prochromamatic cytok is only in a small amount of cartilage.Cytokines, for example, launch an inflammatory process, for example, enzymes under the influence of inflammatory Cytokine IL-1 are different from the enzymes that destroy the unification cartilage.In addition, under the influence of cytokines, the production of the TSOG-2 enzyme and increasing other substances that affect the cartilage.
Sinovites also play a major role in the development of gross - inflammatory diseases of the joints or ligaments of the synovial crust, and inflammatory diseases of the synovial crust with the collection of fluid in the space.
The reduction in the elasticity and strength of articular cartilage related to metabolic disorders lead to a reduction in mechanical stress resistance.With covsarthrosis, all components of joints are involved in the pathological process, including subchondral bone.Large combinations of large combinations of lower extremities are large combinations for large combinations of the body, are experiencing significant mechanical stress because the microvolams occur in the subchondral plate and cartilage.As a result of the microveloms, subchondral bone, the subchondral bone, which causes regional growth of bone tissue, is squeezed.And, in turn, stimulates the further violation of articular cartilage.
In some cases, the arthrosis of the hip joint is inherited.Hereditary arthrosis is likely to be a polygen legacy - for many genes, each has a weakness.The cause of some diseases is not mutating in genes that are coding of articular cartilage macromoline causing predators.Genes in charge of the Chondrocites distribution may also suffer.In addition, metabolic disorders remain inherited as a pyrophosphate arthropath - an articular cartilage and synovial liquid of calcium pyrofosphate crystals are a disease collected.
Classification and stages of development of artrosis of hip joints
Depending on the reasons for the disease, COXARTHROZ is divided into two main forms: initial (idiopathic) and secondary (from other diseases).
Preliminary Coksartrosis:
- Localized (only affects hip combinations):
- one-sided;
- bilateral.
- Generalized (polyosteodarthrosis) with a lesion of at least three joint groups (eg small combinations of hip, knees and brushes or legs).
Middle Arthrosis:
- Post -traumatic:
- sharply - as a result of acute injury;
- Chronic - as a result of some sports or professional activities.
- Metabolic diseases (oconosis, hemoxrome, Wilson disease, Gaucher disease).
- Congenital pathologies and developmental defects (congenital dysplasm of hip combination, disease, the slide of the femur epiphythe, subchimon, scoliosis))).
- Endocrine pathologies (acromegali, hypothyroidism, diabetes Mellitus, hyperparatireism, obesity).
- Calcium salts (Pyrofosphate arthropath, calculator tendonit).
- Diseases of bones and compounds (rheumatoid arthritis, psorized arthritis, pedigetical disease, cliff necrosis, infections).
According to clinical manifestations, the following forms of rudeness are different:
- Little symptom.
- Manifests self-evident with bright clinical symptoms:
- The development of symptoms is developing rapidly in the first four years from the beginning of the disease;
- Slowly progress - clinically significant symptoms appear after the five years of the disease.
In accordance with the X -Ray, two types of arthrosis of hip compounds can be set:
- Hypertrophic - With the signs of increased restorative response (lesions are replaced by a new texture, for example, osteophytes appear);
- Atrophic (decreased volume of tissue).
The stages of the disease can be determined radiologically and clinically.Kellgren and Lawrence (1957) classification are most commonly used to determine the radiological phase of the hip joint artrosis.
Artrosis stages in radiological classification
| Stagnate | Signs |
|---|---|
| 0 | X -Ray pictures do not have any signs of arthrosis |
| 1 | The joint space is not changed, unified regional osteophytes are displayed |
| 2nd | Joint space is not changed, important regional osteophytes are displayed |
| 3rd | The height of the joint cavity is moderately reduced, significant regional osteofits are displayed |
| To 4 | The height of the joint cavity is significantly reduced, significant regional osteophycomes and subchondral osteosclerosis are visible (bone tissue in the lower surface of cartilage with the structure of cartilage) |
To determine the clinical phase of the disease, classification (1961) is used and uses both clinical signs and visualization criteria.
Clinical stages of arthros
| Stagnate | Signs |
|---|---|
| 0 | The articular gap was unequivocally and unequally narrowed, the edges of articular cracks are slightly signed (initial osteophytons), some movements are marked slightly limited |
| 1 | Articular gaps significantly narrowed (50-60%), important osteophycomes, cystic awareness in subchondral osteocosclerosis and bone epiphos;The clinic is a rough crisis during the limitation of mobility, actions, insignificance or medium muscle atrophy |
| 2nd | deformation, the stiffness of the joint;The articular gap is shrinks by more than 60-70% of the norm, or not completely, wide osteophylls, subchondral cysts, articular "mice" are bone, cartilage or mixed pathological formations |
Aggravation of artrosis of hip joints
Without Coxarthroz, all complications are clearly associated with pathological changes in joints.
Coksartrosis will be complicated with local inflammatory processes:
- Bursite - Inflammation of Synovial bags in the joints;
- Tendovainit - inflammation of the vagina of muscle tendun;
- The nerve's tunnel syndrome-pinches with the formation or joint deformation of large osteophets.
With the transition to clinical stages and its III and III, it limits the mobility of pain, and over time, it is accompanied by a joint ankylosis (fibrous, bone or cartilage).
Can cause a significant joint deformationFractures of bones or aseptic necrosis.For coksarthrosis, the femur necrosis of the femoral head is the most terrible complication.
May occur with pronounced coxerySubluxation and dislocation of the compoundAlso, the Femur's head penetrates the pelvic cavity.Dislocations and subcupciation of the hip combination are strengthened (first sharp, then boring and pain), and other physically, the deformation of the lame and sometimes to shorten the deformation of the lame and sometimes affected extreme.
Despite the lack of systematic manifestations of the arthropist's system, more attention is paid in modern clinical practice.These are such pathological conditions that exist or arising in the background of the existing disease.In connection with inflammatory reactions in arthrosis, the emergence of atherosclerotic boards in the interior walls of ships increases the riskCardiovascular diseases.Causes a decrease in physical activity due to restriction of pain and joint mobilityWorsening of obesity, depression and quality of life.Usersteroidal anti -inflamational drugs with long-term use,Upper gastrointestinal parts are affected,AlsoCardiovascular pathologies and kidney diseases are increasing.
Diagnosis of arthrosis of hip joints
The diagnosis of "Coksartrous" was developed on the basis of clinical manifestations and radiological examination.There are no characteristic lab signs for the diagnosis of arthrosis.
Among clinical manifestationsThe main pain and its character for the diagnosis of hip joint arthrosis.Pain for arthrosis of the hip combination occurs and gradually gradually growing in a few years (sometimes a rapidly progressive shape) (sometimes several months).Pain occurs or develops or develop in a state of physical strength or permanent.If the patient just started to feel pain, inflammation (Sinovit) joined.The statement is marked by up to 30 minutes and inactivity in the morning.
The limitation of joint mobility is gradually growing, it applies to both active and passive actions.With the development of the disease, joints are deformed, the length of the functional length may occur.
In a physics examinationThere is a large speech of joint mobility, their deformation, abbreviations of extremities, the palpation of the merge and the femur, muscle atrophy.
Laboratory methodsNot required to diagnose hip joints arthrosis.However, the arthritis (rheumatoid and chronic) can be used for differential diagnosis of arthritis (rheumatoid and chronic), there is no inflammatory change since the arthrosis and the rheumatoid factor is not increased.In addition, the use of laboratory tests, the opposite hints were found for drug treatment methods.
Instrumental methodsFor the diagnosis of hip joints arthrosis:
- Radiography- This is the main method of diagnosis of arthrosis of hip compounds.The radiographer determines the characteristic of the characteristic of coksartrosis: mixed cavity, osteofit, erosion and ulasama, the advantage of subchondral cysts and osteosclerosis.X -Ray examination is a classical method for the diagnosis of coksarthrosis and radiological signs are classified.But now, other methods of visualization of the partners are increasingly used as ultrasound and magnetic resonance image.
- Ultrasonic examination (ultrasound) -Ultrasonic advantage when the body does not have radial load.
- Magnetic Resonance Tomography (MRI)- Compared to other methods, it allows you to make a clearer visibility of joint damage.
- Arthroscopy-Allows you to damage the articular cartilage.Surface and average crack and surface erosion can also be displayed.
Identification of coxery is not usually indicated specifically, but when evaluating a particular clinical situation, it is necessary to remember the secondary origin of the arthropons of hip joints, for example, the possible secondary origin of arthropons between endocrine disorders.
Treatment of arthrosis of hip joints
The treatment of hip joints arthrosis can be both conservative and operational or operational.Conservative treatment is used in 1-2 phase of the disease, surgical-3 stages.Surgical treatment can be recommended in 2 stages without resistant pain and response to conservative therapy.
Objectives of conservative therapy:
- Increase life quality - reduce pain and increase joint mobility;
- Stop the development of the disease or slow down.
The following treatment methods include:
- Empty of the hip joint (reducing body weight, creating additional support and transfer to a portion of body weight);
- Physiotherapy physical education;
- Physiotherapy treatment methods.
Coxarthrosun treatment begins with non-methodic methods, physiotherapy exercises are rigorated.With severe pain, you should use patient support.Support should be used to support the presence of contraindications of the same illness and endoprostetics.
Drug treatment of CukhartrosisThe symptoms of the disease include drugs.These are medicines from the group of Azerbaijani and non-terminoidal antiestination drugs (NSAID).NSAIDS is divided into non-quality and selection.
Analgesics for the arthrosis of the hip joint are used in a short time to eliminate the pain and inflammation of NSAids, pain and inflammation.Currently, there is no non-infunflamary agent on the other, so a particular drug choice depends on the side effects and a certain clinical situation.
NSAID's need to remember that there are a number of side effects.When buying them, the mucous membrane of the stomach and the duodenum is affected, resulting in traditions and bleeding.The NSAID has a poisonous impact on a number of liver and kidneys.In addition, NSAIDs break the platelet collection and eventually violated by the patient thrombosis and has bleeding trends.NSAIDs that use long-term NSAIDs are investing in the processes and can create aprasty anemia and agranulocytosis.The adoption of the voter NSAIDs leads to many more complications.
Ointment and jells that cause less side effects than local products.Medications containing heating and reduction in arthrosis are used.These can contain, menthol, nicotinic acid esters, salicylate, bee venom.Also, NSAIDs have a good effect.
If it is not an effect on analgesic and NSAIDs or not to choose the optimal dose of medicine, the painkillers of the central action can be set for a short time.
In the event of an inflammation, the non-thermosteroid administration of corticosteroids is used.Corticosteroids are not used more than 2-3 times a year because it can cause more frequently used cartilage degeneration.
Slowly include medication, weakens the symptoms of the disease, chondroprotants, avocados or soy, hyaluronic acid inappropriate combinations.These drugs are included in the recommendations of the European Anti-Imagatical League for the treatment of arthrosis of hip joints.Preparations reduce pain and develop joint mobility.
Endoprostetics of hip jointsWhen pain syndrome cannot be removed and joint mobility is significantly limited, the third stage is used in the critical events of III.The hip joint prosthesis, reduces pain syndrome, improving the functional situation of the combination and improves the quality of the patient's life.The effect lasts for 10-15 years, after which the second operation may be required.During the operation, the hip joint is replaced by the ceramics, metal (most commonly used titanium prostheses) or artificial imitation of the polymer.
The forecast.Prevention
The arthros of the patient's life of the hip joints is affordable, but the disease often leads to disability.According to the World Health Organization, 80% of the elderly patients with COXARTRAZ violate the mobility and cannot make 25% of daily issues.In this regard, it is important to prevent the main prevention of arthrosis of hip joints.
Prevention measures:
- Reduce body weight.You need to adjust the nutrition to reduce and download the Kale.In addition, the decrease in the volume of adipose tissue reduces the amount of inflammatory mediators released.
- Avoid overloading heavy physical labor and sport.Physical transportation is often the cause of arthrosis of hip joints, but rather physical activity improves the situation of articular cartilage, protects normal mobility and reduces the burden in other joints.
- Correct the main disease.If the patient is found in the secondary diseases that can cause secondary cokesarthrosis (endocrine, rheumatic and others), the main disease is needed.The fact that the Hormonal Foundation's normalization and the sustainable remission of Rheous diseases is the main prevention of the arthropist and the ability to slow down the development.
- Take a healthy lifestyle.Avoid the formation of coksartrosis with a balanced diet, as well as a balanced diet, as well as secondary physical activity, risk factors that restricted polygeless fatty acids and simple hydrocarages.
Currently, the prevention of the disease of the hip combination is mandatory in neonatology and pediatrics.Over time, the adjustable congenital diction of the hip combination significantly reduces the risk of coking during adulthood.