Hip joint arthrosis

rehabilitation after hip osteoarthritis treatment

Osteoarthritis of the hip joint (ATS) is a slowly destructive disease. Under the influence of various reasons, in the course of the development of the disease, irreversible changes occur in the structure and properties of the hyaline cartilage, which leads to increased pressure on the joint surfaces and their deformation or fusion. Bearing in mind that mechanical overload is considered one of the main causes for the development of the disease, the hip joint is frequently affected by arthrosis.

Features of the anatomical structure of the hip joint

The hip joint (TC) is the junction of the pelvis and femur. This joint makes it possible to reduce and spread the lower limbs, raise the legs and pull them towards the body, in addition to carrying out walking movements. From birth and throughout life, a person carries a large load on the hip joint.

From the side of the pelvic bone, the "acetabular" cavity participates in the articulation, from the side of the femur, its epiphysis. The acetabulum has a collagen lip along the edges, which acts as a kind of gasket that holds the femoral epiphysis firmly in its recess. The recess in the center of the acetabulum is covered by a collagen membrane and is the site of attachment for the ligamentum femur.

The composition of the TS capsule includes ligaments:

  • femoral-iliac - the strongest ligament that can withstand a load of more than 200 kg and prevents excessive arching of the hips backwards;
  • femoro-pubic - is responsible for the abduction and reduction of the thigh, thus limiting its circular movements;
  • femoral sciatic - protects the vehicle from concussions, reduces the load when walking and running;
  • circular (loop) - prevents dislocations and keeps the head of the femur in the cavity of the pelvic cavity and is the basis of the joint bag.

Numerous muscle groups and tendons allow the vehicle to move around three axes:

  1. Longitudinal (vertical).
  2. Transversal (horizontal, frontal).
  3. Sagittal (anterior-posterior).

Joint arthrosis can occur both in a healthy joint, and become a continuation of existing diseases of the musculoskeletal system.

What is this disease?

Hyaline cartilage performs shock-absorbing functions and protection against damage to joint surfaces. ATS is a disease in the process of development in which the structure of collagen cartilage fibers changes, which subsequently leads to their fragmentation and destruction. Fragments of cartilage fibers, if they get into the joint cavity, can cause an inflammatory process. Bare surfaces undergo changes in bone tissue caused by friction and increased pressure. The remaining cartilaginous tissue along the edges of the epiphyses grows compensatory with further ossification, causing ankylosis (immobility of the bony junction). In later stages, in the absence of proper therapy, the patient completely loses mobility and becomes disabled. Destructive processes are triggered by various reasons.

There are the following types of arthrosis of the hip joint:

  1. Primary. Its etiology is not fully understood. Idiopathic (primary) osteoarthritis develops in a previously healthy joint. Most often, it develops in older people.
  2. Secondary. It is provoked by previous diseases of the joint apparatus, congenital developmental anomalies, changes in the functioning of organs and systems of human vital activity.

The disease develops in one joint or affects both at the same time.

Causes of the disease

Among the causes that contribute to the onset of the disease and its progression, the following are identified:

  1. Hereditary genetic predisposition to the development of the disease.
  2. Bone joint injuries (dislocations, fractures, sprains and tendons).
  3. Unbearable systematic power and physical activity.
  4. Overweight.
  5. Functional disorders of the endocrine system (diabetes, psoriasis).
  6. Congenital pathologies of the structure and development of the musculoskeletal skeleton.
  7. Professional characteristics of work activity.
  8. Poor local circulation.
  9. Previous diseases caused by pathogenic flora.
  10. Legg-Calvé-Perthes disease.
  11. Metabolic disorders (gout).
  12. Physical inactivity.
  13. Immune diseases.

These reasons are not always able to cause ATS. Most often, the activation of pathological processes can be provoked by:

obesity as a cause of hip arthritis
  • increased stress and physical activity;
  • constant overwork;
  • hypothermia of the vehicle or the body as a whole;
  • sudden lifting of heavy objects;
  • Hormonal imbalance;
  • radiation exposure.

disease symptoms

Symptomatic manifestations of ATS are similar to manifestations of arthrosis of other joints.

The main characteristic symptoms of this disease are considered:

  1. Stiffness in the morning or after a long period of immobility.
  2. Decreased range of motion, change in gait.
  3. Pain, first caused by mechanical or physical stress, later constant.
  4. The manifestation of creaking, grinding and clicking during sudden movements.
  5. Pronounced lameness in the affected limb.
  6. The occurrence of contractures (restriction of passive movements).
  7. Narrowing or closing of the joint space (X-ray sign).

The severity of signs of arthrosis of the hip joint depends on the degree of development of the disease and the reactive abilities of the patient's body.

arthritic hip pain

stages of coxarthrosis

Depending on the clinical manifestations, 4 stages of arthrosis of the hip joint can be distinguished:

  1. Arthrosis of the 1st degree of the hip joint does not have pronounced pain and other manifestations. The stage is difficult to diagnose, the disease can be detected by the biochemical study of the hyaline cartilage tissue and by the determination of an insufficient amount of glycosaminoglycans. The patient feels pain in the joint and rarely pain at the beginning of physical activity.
  2. Arthrosis of the second degree of the hip joint is characterized by changes in the density and elasticity of cartilage fibers. Cracks and breaks appear. Depreciation functions are reduced. The pain intensifies, radiates to the inguinal region, dilution and reduction movements of the affected limb are limited.
  3. In the third degree, the stratification of cartilage fibers occurs with greater intensity. Joint surfaces experience excessive pressure, foci of ischemia develop. Cartilaginous tissue grows along the edge of the epiphyses. The feeling of pain in the area of \u200b\u200bthe damaged bone junction does not depend on the state of activity and rest. With any movement, the joint "creaks" and "crushes". Range of motion is reduced in all axes.
  4. The fourth degree is characterized by exposure of the surfaces of joint components with formation of ulcers and depressions. The articular head of the femur is poorly fixed in the acetabulum, which leads to a violation of the comparison and separation of the articular surfaces. During this period, the patient feels excruciating pain caused by narrowing, sometimes closing of the joint lumen and compression of bundles of nerve fibers and blood vessels. Movement is limited, sometimes completely.

Classification of the pathological changes caused by ATS is necessary to understand the mechanism and features of disease development. Determining the severity of the disease helps to determine the correct tactics of treatment and disability (in case of severe illness).

possible consequences

The progression of ATS leads not only to deformation of the femoral head and pelvic cavity, but also to the development of pathological processes in the functioning of the joint apparatus as a whole.

Pathologies resulting from complications of hip arthrosis:

  • synovitis (inflammation of the synovial membrane of the joint);
  • aseptic necrosis of the femoral head;
  • joint destruction (osteonecrosis);
  • inflammation of the joint bursa with changes in the amount of synovial fluid;
  • partial or complete ankylosis (immobility of the joint of bones);
  • contractures (limitation of mobility and impossibility of flexion-extension of the limb).

The development of ATS complications always leads to deterioration of the patient's general condition, quality of life and loss of unassisted movement.

Diagnostic methods

Diagnosis of arthrosis of the hip joint at the initial stage is difficult. Symptomatic manifestations become noticeable only when the epiphyses of bones and nerve fibers are involved in the pathological process.

x-ray image of hip joint with arthrosis

During a medical examination in the progression phase, the following is observed:

  • visual alteration of joint contour;
  • pain on palpation;
  • sometimes pastiness of periarticular tissues;
  • shortening of the diseased limb.

The main role in the diagnosis of ATS is assigned to the examination of x-rays. As auxiliary diagnostic methods used:

  1. Ultrasound, MRI.
  2. computed tomography.
  3. Joint lubrication puncture (synovial fluid).
  4. Diagnosis using an arthroscope (microprobe).
  5. Clinical and biochemical laboratory tests of urine, blood.

Timely diagnosis improves the prognosis of treatment and the future life of the patient.

How to apply for disability?

It is impossible to cure this disease completely. To confirm entitlement to social benefits and assign a disability group after passing the examination by narrow specialists, you should contact your doctor.

consultation with a doctor for hip arthritis

The indication for attribution of disability in case of arthrosis of the hip joint is:

  • oligoarthrosis (injury to no more than 2 joints) TS 2 degrees;
  • 2nd degree combined arthrosis of the TS and 3rd degree arthrosis of the knee joint;
  • a decrease in the length of the diseased limb by more than 6 cm;
  • automatic reactive flow telephone exchange, documented.

When determining the disability group will help:

  • carefully collected anamnesis;
  • completion of the medical advisory committee (MCC);
  • results of diagnostic studies;
  • approval by the Medical and Social Expert Committee (MSEC).

If the expert commission's decision is negative, appeals may be made to higher courts.


Preventive measures are an easy way to prevent the development of this disease. Prevention measures include:

  1. Adherence to an active lifestyle.
  2. Control of body weight indicators.
  3. Optimization of nutrition and mode of work and rest.
  4. Reduced mechanical and physical load.
  5. Treatment of diseases of viral and infectious etiology.
  6. Prevention and prevention of injuries at home and at work.
  7. Periodic preventive examination.


The answer to the frequently asked question: "Is it possible to cure arthrosis of the hip joint? " Experts give a negative answer. The destroyed cartilaginous tissue cannot be fully restored, just as it is impossible to completely correct the deformation and destruction of the bones included in the joint. Do not ignore even the smallest manifestations of arthrosis of the hip, this reduces the chances of preventing the development of the disease.