How to distinguish from problems with the spine
- Coxarthrosis: pain in the groin, along the anterior and lateral surface of the thigh, often radiating to the knee; worsens when walking and getting up from a chair; limited internal rotation of the hip
- Radiculopathy: pain extends along the back of the leg below the knee, accompanied by numbness and weakness, aggravated by coughing and bending over.
- A simple guideline: if it is difficult to put on a sock and tie a shoelace on a sore leg, it is almost certainly a joint, not a back
Stages and symptoms
- Morning stiffness up to 30 minutes
- Difficulty putting on socks and shoes, cutting nails
- Crunching in the joint when moving
- Atrophy of the thigh and buttock muscles on the affected side
- 1 степень: боль после длительной ходьбы, проходит в покое; движения почти не ограничены.
- 2 степень: боль при ходьбе и вставании, отдаёт в пах и колено, появляется хромота, ограничивается вращение и отведение бедра.
- 3 степень: боль почти постоянная, выраженное ограничение движений, укорочение ноги, ходьба с тростью.
Reasons
- Hip dysplasia—undertreated in childhood, a common cause of coxarthrosis in young people
- Past injuries and fractures
- Aseptic necrosis of the femoral head
- Perthes disease and epiphysiolysis in childhood
- Inflammatory arthritis
- Excess weight, heavy physical labor
- Age-related changes
Treatment
- Unloading the joint: weight loss, cane in the opposite hand, limiting long walking and heavy lifting
- Physical therapy - exercises to strengthen the gluteal muscles, mainly lying down and in the pool
- Short course NSAIDs during exacerbation
- Intra-articular injections - performed only under ultrasound or X-ray control
- Physiotherapy and massage - auxiliary methods
- Endoprosthetics - for stage 3, persistent pain and limited function
Плавание и упражнения в воде — оптимальный вид нагрузки: мышцы работают, а сустав разгружен. Бег, прыжки и глубокие приседания при коксартрозе противопоказаны.
Endoprosthetics
Hip replacement is considered one of the most successful operations in orthopedics: it relieves pain and restores the ability to walk normally.
- Indications: stage 3, constant pain, significant limitation of movements, ineffectiveness of conservative treatment
- Modern dentures last 15–20 years or more
- Walking is usually allowed the next day after surgery.
- Rehabilitation begins immediately and continues for several months.
- In the first weeks, restrictions apply: do not bend your leg more than 90 degrees, do not cross your legs, do not sit on a low
- Prevention of thrombosis after surgery is mandatory