- Coxarthrosis: General
- Coxarthrosis: causes
- Coxarthrosis: examinations
- Coxarthrosis: therapy
- Additional information
Under Coxarthrose one understands a wear of the hip joint. The hip osteoarthritis occurs especially in older people. In the x-ray you can see how much osteoarthritis has changed the hip joint and adjacent bone structures. In extreme cases, the joint must be replaced by a prosthesis. Here you read everything important about the development and treatment of coxarthrosis.
ICD codes for this disease: ICD codes are internationally valid medical diagnosis codes. They are found e.g. in doctor's letters or on incapacity certificates. M16
In the case of coxarthrosis (coxarthrosis) the hip joint wears off. This consists of two parts:
- Acetabulum (formed by the pelvic bone)
- Hip joint head (formed by the femur)
Coxarthrosis is a common disease in Germany, whose risk increases with age. In certain pre-existing conditions, however, arthrosis in the hip can occur even in very younger people.
Danger: Even if the X-ray shows a hip joint arthrosis, the affected person does not necessarily have complaints. Then there is a purely radiological (ie X-ray) visible hip osteoarthritis.
The case is different for a clinically defined hip osteoarthritis. It shows clear signs of wear in imaging and causes pain to those affected.
Hip and hip joint can be damaged by various diseases. In some cases, a hip osteoarthritis then develops. These possible triggers of coxarthrosis include bone fracture, inflammation and inflammatory joint disease and metabolic diseases.
Coxarthrosis often develops even with a deformed hip. The femoral head is not located correctly in the hip socket. This is the case with hip dysplasia (malformation of the hip joint), Morbus Perthes and Epiphyseolysis capitis femoris. These diseases already exist at birth or occur in childhood or adolescence. But they often lead to a hip joint arthrosis only many years later.
If a coxarthrosis is suspected, the doctor will first ask for the medical history (anamnesis). For this purpose, he talks extensively to the patient and asks, for example, the following questions:
- How many meters can you walk without pain?
- Can you bend down to the ground?
- Do you have problems climbing stairs?
- Is it difficult for you to put on stockings or shoes?
- Are you in pain while sitting or lying down?
- Do you or did you have pre-existing diseases or injuries in the hip area?
This is followed by a physical examination. The doctor examines the gait pattern of the patient and checks the flexibility in the hip joint. Imaging procedures such as X-rays show signs of wear in the hip joint in Coxarthrose.
If you want to know more about how a coxarthrosis or other forms of arthrosis are detected, read the article Osteoarthritis.
Doctors recommend some general measures for coxarthrosis as well as other types of arthrosis. This includes, for example, relieving the affected joint. In the case of an arthrosis hip, for example, this means reducing existing overweight. Then there is less body weight on the hip joint.
It is also important to move the Coxarthrosis hip regularly without any load. Swimming is especially suitable for this.
Physiotherapy and medications also help reduce the symptoms of coxarthrosis.
More about general measures and conservative therapies for coxarthrosis and other types of osteoarthritis can be found in the article Osteoarthritis.
Artificial hip joint in Coxarthrosis
Sometimes the symptoms of pronounced arthrosis in the hip can not be improved with conservative measures. Then it may be useful to use an artificial hip joint. You can either replace only the femoral head, only the hip socket or both against a prosthesis.
The available hip prostheses differ in several ways: shape, material and type of anchorage in healthy bone. Which prosthesis is most suitable in a particular case depends on various factors. For example, the age of the patient, the bone structure, the stage of the disease and possible allergies to certain prosthetic materials play a role.
Artificial hip joint: Anchoring
For younger people, preference is given to using cementless prostheses. In older patients, however, artificial hip joints are cemented more frequently.
Cementless prostheses have the advantage of being easier to replace.This is especially important for younger people. Because an artificial hip joint is not indefinitely durable and must then be replaced. To anchor the prosthesis, a solid bone structure is necessary, which is usually given in younger people. Older patients, on the other hand, are more likely to suffer from osteoporosis. Therefore, a cement-free prosthesis often can not be adequately fixed.
There are also combined prostheses (hybrid prostheses) for patients with an arthrosis hip. These consist for example of a cemented prosthesis socket and a cement-free socket.
Artificial hip joint: materials
A hip prosthesis can consist of different materials. The type of material affects the durability and resilience of the artificial hip joint.
The small sliding washer between the femoral head and the socket usually consists of the plastic polyethylene or ceramic. The other parts of the prosthesis may be made of different metals (such as titanium, chromium, cobalt) or ceramic. The combination of materials is called sliding pairing. A hip prosthesis in Coxarthrose very often has the sliding metal-polyethylene. The metal condyle slides in the polyethylene-lined pan.
Polyethylene is a very soft material that can be worn faster in active people. For such coxarthrosis patients, therefore, a metal-metal sliding pair can be selected. In this case, however, more metal can enter the body. For patients with metal allergies they are therefore not suitable. In addition, click sounds may occur.
A ceramic bearing does not cause metal allergies and is rarely worn out. However, it breaks faster. It is therefore used only in selected cases of coxarthrosis.
Artificial hip joint: aftertreatment
As a rule, a hip operation is followed by rehabilitation. There, the hip joint is loaded and moved to exact specifications, the muscles are trained specifically. How fast and how much the hip may be loaded depends, among other things, on the operation chosen. A targeted rehabilitation should prevent possible complications. Thus, the coxarthrosis patient can resume his usual activities as quickly as possible.
Artificial hip joint: complications
The fitting of a hip prosthesis in coxarthrosis patients can lead to complications:
- Immediately after surgery, a blood clot can easily form. This can clog a vessel (thrombosis, embolism). This can usually be prevented by using suitable blood-thinning medications.
- Some coxarthrosis patients injure a nerve during the procedure. This can change the feeling on the leg.
- Often the legs are not the same length after the operation. Many hip osteoarthritis patients should wear compensating soles after surgery.
- In some operated coxarthrosis patients ossified the hip joint. It can then move only limited.
- In some patients, the artificial joint replacement loosens and must be replaced.
- The femoral head can slip out of the pan. Doctors call this a dislocation. In addition, the bone may break around the prosthesis (periprosthetic fracture).
A hip operation at Coxarthrose So there are many risks and should therefore be well considered.
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Keep your joints fit - that's how it works
Climbing stairs, playing sports with friends or gardening - when the joints hurt, that is hardly possible. Especially problems with the knee are particularly common fault: painful knee joints limit the everyday life of some 20 million Germans partly strong. It is all the more important to keep the joints fit until old age. How to do it and what to do if you are already in pain, read here.
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Stay in motion
"Who restates rust" says a proverb. And that's right - who wants to keep his body and especially the joints fit, should move regularly. This stretches the ligaments, strengthens the muscles and promotes mobility. No top athletic performance is necessary, it is enough to walk short distances or ride a bike and leave the car to stand.
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Beware of "knee press sports"
Sport is good for the joints - but it depends on what activities you are pursuing. Especially for people with sensitive knees, it is advisable to avoid so-called "knee-press sports" such as football, tennis or skiing. Jogging also puts a heavy strain on the joints. More suitable are Nordic Walking (on soft ground), swimming or cycling.
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Onion vegetables for the joints
The right diet also helps: A study showed that garlic, onions and leek protect against joint wear. Thus, the onion vegetables apparently contain components that reduce harmful enzymes on cartilage tissue.
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82 percent of all Germans walk around in badly fitting shoes, according to the Federal Association of the German Footwear Industry. And that permanently damages the knee joints in particular. But not only shoes that do not fit properly cause problems - even high heels can cause pain. To protect the knees and back, the ladies should switch to flat and comfortable shoes.
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Too many kilos on the hips damage the joints. If overweight permanently overloads them, cartilage wear or even ligament damage may result. Because overweight not only massively damages the joints but the entire body, you should pay attention to a healthy weight.
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Painkiller in moderation
If pain limits everyday life, medications can relieve the symptoms. However, this does not solve the causes. It is better to have persistent complaints clarified by a specialist. This can, for example, show those affected exercises that contribute to the health of the joints.
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Heat or cold?
Do your joints hurt frequently? Then everything will do you good, which particularly stimulates the joint metabolism. Warming applications have proved successful, for example in the form of warm peat packs or circulation-promoting baths, for example with rosemary. In acute inflammation, on the other hand, cold is often more pleasant.
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Leech for osteoarthritis
A circulation-stimulating stimulus therapy often helps very well with pain from joint wear and tear. These include dry cupping, autologous blood treatments and leech therapy. The saliva that the animals give into the skin also has an anti-inflammatory effect.
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Beware of one-sided stress
Avoid asymmetric and monotonous strains, such as those caused by wearing heavy shoulder bags. Too long sitting or standing is not favorable for the joints: the articular cartilage is best nourished whenever the fluid in the joint remains in motion.
- The Tübingen hip concept (for arthrosis): From science to practice, Arnd Rüskamp et al., 2014, Hellblau-Verlag; Edition: 1