ABSTRACT
Coxarthrosis is the most frequently occurring hip disease, is the most common type of osteoarthritis in general and is the second most frequent cause of chronic invalidity. Causes are inherited hip diseases (e.g. dysplasia), growth diseases (e. g. Perthes' disease, slipped capital femoral epiphysis), injuries (fractured femur, fractures of the femoral head or acetabulum, necrosis of the femoral head), and inflammatory, rheumatic or metabolic diseases. Hip deformities such as hip dysplasia or protrusio acetabuli lead to increased mechanical deterioration as a result of the pathological anatomy and hence to a chronically progressing degeneration (coxarthrosis). Primary coxarthrosis usually begins between the 50th and 60th year of life; the secondary disease can develop even earlier depending on cause.
Subject(s)
Osteoarthritis, Hip/etiology , Cartilage, Articular/physiopathology , Humans , Middle Aged , Osteoarthritis, Hip/physiopathology , Risk Factors , Weight-Bearing/physiologyABSTRACT
The principal symptom of coxarthrosis is mostly pain in the groin. The patient often has a limping gait. The patient notices an increasing restriction in the mobility of the hips and the ability to walk. It must be borne in mind that knee pain can also be the only primary symptom of hip disease. Standard radiographs should be always taken from two different views. Magnetic resonance imaging and computed tomography are still reserved for special problems in the diagnosis of coxarthrosis.
Subject(s)
Osteoarthritis, Hip/diagnosis , Diagnosis, Differential , Femur Head Necrosis/diagnosis , Gait , Humans , Inguinal Canal , Magnetic Resonance Imaging , Pain/etiology , Physical Examination , Range of Motion, Articular/physiology , Tomography, X-Ray ComputedABSTRACT
Conservative measures generally have priority over surgical procedures. Firstly, an analgesic and antiphlogistic therapy during the acute pain phase is very effective. Secondly, retaining or improving mobility is important. The indication for surgery for hip arthritis exists when the clinical and subjective symptoms in conjunction with the radiological finding can no longer be adequately controlled by conservative measures. Surgical interventions are basically either joint-replacing or joint-saving. The goal of all corrective osteotomies is to improve the hip joint congruency and thus delay the replacement of the hip with an artificial joint. Established prosthetic models show long-term results of 15-20 years with a survival rate of more than 90%.
Subject(s)
Osteoarthritis, Hip/therapy , Adrenal Cortex Hormones/therapeutic use , Anesthetics, Local , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Arthrodesis , Arthroplasty, Replacement, Hip , Glucosamine/therapeutic use , Humans , Hyaluronic Acid/therapeutic use , Injections, Intra-Articular , Osteoarthritis, Hip/diagnostic imaging , Osteotomy , Physical Therapy Modalities , Radiography , RadiotherapyABSTRACT
More than 20% of the population of over 60-year olds suffers from degenerative joint diseases of the lower extremities. The cause of primary osteoarthritis of the knee is still unknown. A multifactorial genesis is presumed that includes genetic, nutritional, hormonal and age-related factors. On the other hand, secondary osteoarthritis is a sequela of predisposing factors. The most frequent are axial deformities, pre-existing conditions or injuries. Pre-osteoarthritis appears as dysplasias and dystopias (abnormal presentation) of the patella and axial misalignments, incongruities and joint damage after fractures. The result is the mechanical destruction of the cartilage that, in turn, initiates a vicious circle of further cartilage loss.
