Treatment of coxarthrosis of the hip joint in Moscow

Coxarthrosis is a degenerative-dystrophic disease that affects the hip joint in middle-aged and elderly people. Where to treat coxarthrosis of the hip joint in Moscow?

Effective therapy and rehabilitation of patients suffering from coxarthrosis is carried out at the Yusupov Hospital. In the first and second stages, the disease is treated with non-steroidal anti-inflammatory drugs, muscle relaxants, and chondroprotectors. Doctors at the Yusupov Hospital use only drugs registered in the Russian Federation. They are highly effective and have a minimal range of side effects.

In advanced cases, orthopedic traumatologists at partner clinics perform hip replacement. After surgery, patients need rehabilitation. A team of specialists from various fields of rehabilitation clinic uses innovative methods of rehabilitation therapy, physiotherapeutic procedures, and non-traditional methods of treatment. Therapeutic physical education for coxarthrosis of the hip joint is performed under the guidance of a senior instructor-methodologist of exercise therapy.

Severity

There are three degrees of severity of hip arthrosis:

First degree of coxarthrosis. This degree of severity is characterized by moderate pain and lack of stiffness when performing movements. When performing an X-ray examination, a narrowing of the joint space can be noticed, and isolated bone growths and osteophytes are also possible. It is possible to detect coxarthrosis of the first degree only by undergoing an X-ray examination.

Second degree coxarthrosis. In the second degree of severity, aching pain is observed. It is worth noting that in this case a person experiences pain even when the leg is at rest. When trying to turn the foot of a straightened leg to the left and right, the pain intensifies. A person with grade 2 coxarthrosis limps, and sometimes you can hear a crunching sound in the joint. X-rays show deformation of the femoral head, as well as numerous osteophytes and a significant narrowing of the joint space (by about 1/3).

Third degree coxarthrosis. This is the most severe stage of the disease, in which a person is constantly bothered by severe pain. With degree 3 coxarthrosis, muscle atrophy develops (buttocks and thighs) - the patient experiences a “skew” of the entire body towards the affected side. An X-ray examination reveals a deep deformation of the joint and a narrowing of the joint space up to complete union of the bone surfaces.

Progress of the operation

The intervention is classified as complex. The qualifications of the surgeon play a special role. On average, prosthetics take about two to three hours. General or spinal anesthesia. In the second case, the patient is conscious, there is no sensitivity only below the injection site. The operation takes place in several stages:

Cutting tissue, removing unnecessary elements, preparing the surface.
Installation of implants, fixation.
Examination of the new joint by an orthopedist, assessment of correct installation.
Installation of a liquid removal system (drainage).
Applying sutures and a soft bandage.

The estimated time of hospital stay after surgery is ten days. During this period, antibiotics and painkillers may be prescribed. For recovery to go well, body position and leg fixation must be correct. If everything went well, the patient can begin to move independently after three days. The use of a support is mandatory.

Causes

Among the most common provoking factors, the following are especially worth highlighting:

Mechanical injuries of the femoral region, pelvic bones, articular joints;
Diseases of a systemic nature, including ankylosing spondylitis, psoriasis and others;
Inflammatory processes occurring in the tendons;
Arthrosis, arthritis, osteomyelitis and other similar diseases;
Blood diseases, including those of an oncological nature;
Tuberculosis of the joints, spine or bones;
Increased loads on the lower limbs.

This problem is especially observed in older people, athletes and those who experience problems with excess weight.

Symptoms of coxarthrosis

The primary sign of coxarthrosis is pain after any physical activity. Unpleasant sensations can occur in the groin area, hip or knee.

Often, at the very beginning of the disease, pain is concentrated in the knee joint. A person comes to the doctor with just such a complaint. If the specialist is not experienced enough, he may send the patient for an x-ray of the knee and, if any minor changes are detected, make an erroneous diagnosis - first-degree gonarthrosis. Thus, the person will not be prescribed correct and timely treatment, and coxarthrosis will develop. It is important to seek advice from specialized clinics with experienced doctors.

Untimely treatment of coxarthrosis of the hip joint will lead to the development of the following symptoms:

muscle weakness;
change in gait;
clicks and crunching sounds while moving;
limping.
severe pain in the joints;
muscle spasms;
tingling in the limbs when standing up or moving;
swelling (in some cases);
rapid fatigue of the legs when walking;
pain when distributing the load from one leg to the other;
stiff legs after sleep

Over time, coxarthrosis leads to muscular atrophy of the thigh and visual shortening of the affected limb. In the later stages, osteoarthritis of the hip joint develops into ankylosis - complete fusion of the femur with the pelvis, causing the leg to be fixed in one position and serve only as a support.

Diagnostics

Before the operation, the specialist clarifies:

General health and the presence of chronic and acute diseases.
Blood clotting rate (coagulogram and OAC are prescribed).
Allergy to anesthesia and medications.
The severity of damage to the hip joint (diagnosis using X-ray and CT).

Based on the images, a suitable implant design is determined so that it takes root 100% and does not limit the functionality of the joint.

Treatment

The fight against coxarthrosis requires the use of different methods: from medications and physical therapy to courses of joint traction and surgery, which is usually prescribed in unsuccessful attempts to reverse the development of the disease. Conservative treatment. Non-surgical treatment is time-consuming and expensive, but it can improve a patient's quality of life—eliminating the need for surgery. The first thing an orthopedist prescribes to a patient with coxarthrosis is medications that relieve pain and inflammation (non-steroidal and steroidal anti-inflammatory drugs, muscle relaxants). To activate blood supply to the area of arthrosis and restore cartilage tissue, vasodilators and chondroprotectors are prescribed. In addition, the patient can be offered a modern method of stimulating regenerative processes - plasma lifting, that is, injections of the patient’s blood components into the site of the disease. These measures are most effective for osteoarthritis of the hip joint of 1st and 2nd severity.

Preparing for surgery

The most important step is the examination of the patient. To do this, you need to pass clinical tests, undergo an ECG, consultations with specialized specialists, and ultrasound. The patient is hospitalized at least one day before surgery. As preparation you need:

Get examined to identify diseases and exclude contraindications.
Normalize weight if it exceeds acceptable limits.
Get dental treatment if necessary.
Tell your doctor about bad habits – smoking in particular.

Recommendations one month before surgery:

Familiarize yourself with the features of the future operation.
Prepare housing for the rehabilitation period: stock up on groceries, do general cleaning, remove all objects that could cause a tripping hazard.

Three weeks before surgery:

Enlist the help of loved ones in household chores for the first time or hire someone for these purposes.

Two weeks before surgery:

Make adjustments to medication intake.
Purchase equipment that will be needed after the intervention and learn how to use it.

During the week:

Make a list of medications and necessary items that you need to take with you.
Prepare money and everything you need.
Leave valuables at home.

Immediately before surgery:

Refuse to drink and eat for several hours.
Take all medications that will be prescribed.

Conservative treatment of coxarthrosis

Non-surgical methods

In addition to drug therapy, ointments, and injections, treatment of coxarthrosis requires the use of physiotherapy and kinesiotherapy, as well as diet correction. A care strategy developed by an experienced orthopedist allows people with grades 1 and 2 arthrosis of the hip joint to avoid endoprosthetics and limit the need for medications.

Physiotherapy (ultrasound, heat, cold stop inflammatory processes, relieve pain, relax muscles, enhance the effect of medications, normalize blood circulation, which helps restore cartilage)
Kinesitherapy
Diet therapy
Therapeutic exercise (improves joint mobility, strengthens muscles, relieves tension)
Massage (warming effect allows muscles to relax and relieve spasms)
Drug therapy (allows to relieve pain and eliminate muscle spasms)

Surgical treatment of coxarthrosis

Surgical treatment is prescribed when conservative methods are ineffective or the disease develops. Surgical intervention is also used for grade 3 coxarthrosis of the hip joint, and the worn-out joint is replaced with an artificial one (hip arthroplasty). Methods such as osteotomies and arthrodesis are now used extremely rarely, because outdated.

Surgery includes procedures performed by a surgeon in an operating room. All of them, except for puncture of the hip joint, require hospitalization and a many-month recovery period. In case of coxarthrosis of the 3rd degree, when conservative treatment does not bring relief, only prosthetics helps relieve the patient from discomfort and pain, restoring the joy of movement.

Puncture (minimally invasive intervention) involves pumping out excess fluid from the joint cavity, which relieves pain and improves leg mobility. May be performed repeatedly, especially when steroid drugs are prescribed.
Arthroscopic debridement involves cleaning the inner surface of the joint from fragments of altered cartilage tissue, washing its cavity with a medicinal solution to relieve inflammation. This operation is performed through several punctures, without opening the joint cavity.
Periarticular osteotomy is an artificial fracture of the femur followed by its fusion at a different angle, which reduces the load on the joint. Such an intervention cannot be called a panacea - after 2-5 years the pain returns, but in some conditions, when endoprosthetics is impossible, periarticular osteotomy of the hip joint is the best solution to the problem of coxarthrosis.
Endoprosthesis replacement means a complete replacement of a joint with a prosthesis that can last up to 20 years. Despite the complexity of the intervention, it is well tolerated by patients of different ages who are ready for active rehabilitation after surgery. Surgeons note that an important condition for success is preliminary treatment of obesity and the use of kinesitherapy methods to restore the strength of the muscles surrounding the joint.

Rehabilitation after surgical treatment of coxarthrosis

The patient’s time for complete recovery after surgery is up to 3 months; the ability to move and walk appears in a week at best. Additional support (crutches) is required to be able to move. There are much more effective methods of treatment that do not require hospitalization and a period of rehabilitation.

Revision endoprosthetics

Performed if severe complications arise during rehabilitation:

Broken prosthetic leg.
Loosening of the joint.
The appearance of scar-adhesive tissue.
Penetration of infection and accumulation of pus.

The main difficulty is the lack of bone tissue, since it was removed during the main operation. The expert has to clean the area and re-fix the implant. It is impossible to re-install the prosthesis during sepsis, since the infection quickly enters the organs and penetrates the blood (a complication that is extremely rare).

Treatment of coxarthrosis using MBST therapy

Treatment of coxarthrosis of the hip joint can be carried out using unique and unparalleled magnetic resonance therapy. The technique is based on the restoration of cartilage tissue by applying a magnetic field to the damaged area, followed by a reaction from hydrogen atoms. As a result of the impact, the regenerative capabilities of the body are enhanced, degenerative processes that destroy bones and joints are reduced and then completely stopped, and the damaged structure of ligaments, bones, tendons and cartilage is healed more quickly.

MBST therapy, used in the ArthroMedCenter clinic, is a technology that consistently demonstrates amazing effectiveness in the treatment of diseases of the musculoskeletal system. The effectiveness of the technique is in no way inferior to traditional surgical intervention, while in a number of factors it is simply superior to it. MBST has nothing to do with surgical methods in particular and non-invasive treatment methods in general.

By influencing cartilage tissue, MBST therapy helps restore its energy potential, as a result of which regenerative processes are activated, restoring cartilage tissue to its original state. After just 3 months, they are restored by about 30%, which is quite enough for the normal functioning of the joint. But the process does not stop there, continuing for another 9 months, until the damaged area is completely regenerated.

The course of treatment is prescribed by the attending physician - it is individual and depends on the complexity of the disease, its degree and the physiological characteristics of the patient’s body. The standard program includes 5 – 7 procedures.

Types of prostheses

There are several options for endoprostheses

to
restore the pelvis
. They are classified depending on the main parameters:

By type of construction:
Two-way, replacing the head and cavity.
By fixation method:
With cementation. Used for older patients with a sedentary lifestyle.
Combined type.
By material type:
Ceramic. Non-toxic and durable, the most expensive of all possible, universal, can be installed by everyone without exception.
Metal-plastic. Installed on elderly patients who do not lead an active lifestyle, the most short-lived option.
Ceramic-plastic. Inexpensive option, short service life, rapid wear.

Prosthetic techniques also differ:

Complete prosthetics. Used for reduced bone quality.
Superficial – the head of the bone is covered with a metal cap.

Since the prosthetic joint must be mobile and withstand significant loads, increased demands are placed on prostheses:

Reliable fixation and high strength.
Functionality.
No effect on body tissue.
Safety and quality of the material.
Compliance with the requirements related to the characteristics of the patient.

Prevention of coxarthrosis

Prevention of osteoarthritis of the hip joint is important for people over 40 years of age, athletes and relatives of people with already diagnosed coxarthrosis or a fracture of the femoral neck. Doctors recommend that the risk group watch their figure, protect themselves from injuries (for example, wear shoes with non-slip soles in winter) and exercise regularly. At the first symptoms of arthrosis of the hip joint, contact an orthopedist. Treatment of the disease must be carried out by a specialist doctor who is experienced and attentive to any changes in the patient’s well-being.

Get a free consultation from our specialists. Call now or fill out the form on our website! +7 (495) 104-44-16

Orthopedics and traumatology services at CELT

The administration of CELT JSC regularly updates the price list posted on the clinic’s website. However, in order to avoid possible misunderstandings, we ask you to clarify the cost of services by phone: +7

Service name	Price in rubles
Appointment with a surgical doctor (primary, for complex programs)	3 000
X-ray of the hip joint	2 400
MRI of hip joints (2 joints)	8 000
MSCT of the hip joint	7 500

All services

Make an appointment through the application or by calling +7 +7 We work every day:

Monday—Friday: 8.00—20.00
Saturday: 8.00–18.00
Sunday is a day off

The nearest metro and MCC stations to the clinic:

Highway of Enthusiasts or Perovo
Partisan
Enthusiast Highway

Driving directions