Coxarthrosis

Coxarthrosis: what’s that?

Coxarthrosis, is understood as wear of the cartilage layer in the hip joint. Therefore, it is also described as hip osteoarthritis (coxa is the Latin for hip). Following gonarthrosis, coxarthrosis is one of the most frequently incurred types of arthrosis. Here, the peak age is a higher adult age:

• approx. 6 % of all females and males of 40 and older.
• approx. 16 % of all females and males of 85 and older.

After the knee joint, the hip joint is the second largest joint in the body and enables the movement of the leg towards the hip or pelvis. It is formed by the femoral head and the hip socket (acetabulum) The hip socket consists of parts of the iliac bone, pubic bone and ischium bone. The cartilage layer existing in the hip joint is already subjected to burdens from a person’s first step onwards. Therefore, it is only normal that it is subjected to a degenerative process during the course of life.

Causes of coxarthrosis

In addition to the general causes, we can distinguish between acquired and hereditary factors.

GENERAL CAUSES:

• Excess weight → exceeding the load-bearing capacity of the cartilage layer.
• Overburdening due to excessive sport.
• General wear and tear during the course of life.
• Predisposition or genetic disposition.

ACQUIRED CAUSES:

• Impaired circulation of the joint-forming structures, e.g. due to Morbus Perthes (in children) or diabetes mellitus (diabetes).
• Traumatically caused joint changes (e.g. fractures).
• Inflammatory diseases such as gout or rheumatism.

HEREDITARY MALALIGNMENT/DEVELOPMENT DURING CHILDHOOD/GROWTH:

• Coxa vara and valga → malalignment of the femoral neck fosters increases wear in the hip joint
• Hip dysplasia → the condyle head is not located correctly in the joint socket
• Leg length difference → one side of the hip joint is strained more heavily than the other
• Foot malalignment

Coxarthrosis stages

Dependent on the extent of cartilage wear, different stages are distinguished. These can be determined by the treating physician with an X-ray or MRI.

Coxarthrosis symptoms

Generally, coxarthrosis is initially symptom-free, as a so-called asymptomatic arthrosis. Frequently, symptoms are only incurred when the arthrosis has already advanced considerably, e.g. when older or as a consequence of lasting burden situations. In addition to the common accompanying symptoms such as pain (pain at rest and stress-induced pain) and restricted movement, for example the following symptoms may manifest:

• Pain in the hip joint, at rest and stress-induced, which can also radiate into the thigh and even to the knee joint.
• Restricted movement, above-all in flexion (bending).
• Assumption of a relieving posture, primarily when walking for longer periods → limping (reciprocating motion).
• Audible and tangible friction and cracking in the hip joint.

Coxarthrosis diagnosis

In addition to targeted case history, an examination of the body which also includes examination of the patient’s general gait takes place. Here, the physician can establish any possible existing scoliotic postures such as pelvic obliquity or a leg length difference.

Palpation (findings by touch) and a functional test of the hip joint are also part of the examination of the body. Palpation enables the physician to feel changes to the joints and painful regions. Functionality of the hip joint is assessed with a movability check. If pain is incurred here or restricted movement established, this can indicate coxarthrosis.

X-ray, computed tomography (CT) and possibly magnetic resonance imaging (MRI) can confirm the diagnosis.

Coxarthrosis therapy

Both conventional and operative measures can be used to treat coxarthrosis. The treating physician and the patient decide jointly which therapy is appropriate. For example, the causal factors may play a role as a basis for this decision.

CONSERVATIVE THERAPY:

It is not medically possible to reconstruct joint cartilage conservatively. Therefore, conservative therapy is limited to the targeted elimination of existing risk factors such as overweightness and inflammatory diseases. Relief of the hip joint can be achieved using various aids such as crutches, insoles or braces, e.g. the BORT CoxaPro hip brace.
The symptoms of an arthrosis can be alleviated using heat or cold therapy:

• Cold therapy: recommended for activated arthrosis (arthrosis accompanied by pain, swelling and inflammation)
• Heat therapy: recommended for non-activated arthrosis (proven arthrosis without inflammation, but possibly with pain)

Several arthroses improve both as a result of movement (without stress), remedial gymnastics and physiotherapy as well as the supporting administration of appropriate anti-inflammatory and pain therapy medication.

OPERATIVE THERAPY:

If the complaints do not improve via conservative methods, the physician may also consider operative therapy.

Often an end prosthesis (joint replacement, in this case an artificial hip) is attached to the bone.

An osteotomy can, for example, also correct hereditary dislocation in the hip joint. This results in improved joint movement.

In order to secure therapeutic success, additional rehabilitation measures such as physiotherapy or a joint-stabilising hip brace can be prescribed, both as a follow-up for conservative and operative therapy.

How can coxarthrosis be prevented?

If malalignment during childhood or growth are causal, they should be corrected as soon as possible. The earlier malalignment is corrected, the lower the risk of incurring resulting subsequent damage such as arthrosis.

GENERAL MEASURES INCLUDE:

• Reduction of possible existing overweightness.
• Regular exercise which does not result in overstress → (joint cartilage is fed by exercise).
• Good, stable footwear can also have a positive effect on joint movement in the hip joint.

How can the BORT CoxaPro hip brace relieve the complaints of a coxarthrosis?

The support material of the BORT CoxaPro hip brace consists of elastic compressing material, which stimulates circulation due to its compression effect and can contribute to pain relief.

The trochanter pad used provides an additional massage effect in the soft tissue.

The hip joint movement can be stabilised and secured via a side joint splint with flexion and extension control as well as an additional pelvic surround.