The traumatologist told who needs to monitor the health of the joints

In autumn, many people remember about sore joints. Most often, the cause of aching pain is a sharp drop in atmospheric pressure. Because of it, there is a jump in blood pressure, which is transmitted to the articular bag. If at the same time there are already age-related degenerative changes in the joint, the cartilage transmits movements to the nerve endings – the person experiences pain. Today we will analyze one of the types of this disease – coxarthrosis or arthrosis of the hip joint – and methods of its treatment.

With its history from practice, which vividly reflects the topic of today’s discussion,

Artur Glumakov, deputy chief physician, traumatologist-orthopedist at the Open Clinic on Prospekt Mira shared with MK.

— I had a 60+ patient. In the past, she devoted a large amount of time to sports, namely rhythmic gymnastics. Since 2012, she has been worried about constant pain in her right hip joint. From the anamnesis, I found out that at the age of 10, while doing gymnastics, she unsuccessfully fell on a beam and hit hard in the perineum, and also at the age of 28 she fell, having injured her arm and thigh.

A year before she contacted me, she had been treated by another doctor abroad. He made SVF-therapy (this is a method of treating diseases of the joints by injecting biologically active cells obtained from the patient’s own adipose tissue. – Approx. ed.). But the procedure did not bring a positive effect.

I made a diagnosis by MRI: primary bilateral arthrosis-arthritis of the hip joints (stage II on the left, stage III on the right), trochanteritis. In simple terms, the problem was that she had destruction of the joint itself and there was inflammation around the joint at the greater trochanter, where the main stabilizing muscles of the hip joint are attached. On examination, I noticed that active and passive movements on the right side of the hip joint were limited and painful. In addition, there was asymmetry in the angles of the scapulae, iliac bones, that is, there was a skew of the pelvis. And also against the background of this skew functional shortening of the right leg up to 1 cm.

The patient was very loyal, she immediately settled down to me when we met. I explained to her that she had big problems with her joints. The appearance of the joint had indications for its replacement, but she categorically did not want to perform this operation. After the examinations, we consulted with a physiotherapist, who recommended that we apply a course of high-intensity laser therapy together with magnetotherapy and medical support. In parallel, we planned two injections of plasma into the right joint and then, after 10 days, three injections of hyaluronic acid preparations. That is, we prepared the joint with plasma in order to start the normal functioning of synovial cells, bring down inflammation, and restore damaged tissues. And then we introduced drugs that will perform a lubricating function.

As soon as we finished the injections, we began to gradually develop the thigh with physiotherapy exercises. It was predicted that a pain reaction could occur. It is normal for the joint restrictions to be very rough initially. She did 10 sessions of exercise therapy and the pain appeared. I explained that we needed to address the second problem of our diagnosis, which was inflammation around the joint. We have planned periarticular injections with hyaluronic acid preparations.

Now the patient is abroad again, and her joints have not bothered her for two years. This is a very good result, but it is possible only with a complex impact and full confidence in the doctor.

Why did I choose this story? Because coxarthrosis is primarily affected by women and athletes, and here we have “two in one”. In general, for understanding: coxarthrosis is a degenerative disease, as a result of which we get a disease of the bone component, but also of all the soft tissues that surround the joint (joint capsule, ligaments, tendons and muscles). Any joint is in fact a hinge, in which there are at least two bones. One of its components is the acetabulum, which is formed by the bones of the pelvis, the second component is the head of the femur.

The prerequisites for coxarthrosis are hard physical or, conversely, sedentary work. In the first case – due to high axial loads on the lower limbs, in the second – due to the absence of these loads. These factors influence the appearance of irreversible changes in the joint.

As for the risk group, according to my personal statistics, this disease most often occurs in postmenopausal women, when they experience hormonal changes, against their background they can get osteoporosis. This is a disease due to which the mineral density of bones decreases and two parts of the body are most often affected – the hip joints and the lumbar spine. Also, the risk group includes patients who receive a daily overload: for example, athletes.

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Dear readers, as always, we are waiting for your questions to the orthopedic doctor at [email protected] and will continue to acquaint you with stories of successful treatment and rehabilitation.