Introduction

Osteoarthritis is one of the most common chronic degenerative joint diseases of our time-and the hip joint is particularly often affected. When patients complain about persistent groin pain, increasing movement restrictions or a "stiff feeling" in the hip area, the so -called coxarthrosis - the arthrosis of the hip joint is often behind it.

But what exactly happens in the joint? How does a formerly healthy, pain -free hip joint wear more and more over the years - up to the complete loss of the joint function? The course of the disease is complex and affects not only the cartilage, but also the structures of the bone underneath, the joint capsule and even the muscles. Terms such as sclerosis , osteophytes , cysts and slump in the articular surface describe the pathological changes that occur in the course of this disease.

In this detailed article, we explain step by step how arthrosis of the hip joint develops - from the first cartilage damage to severe coxarthrosis in the final stage. We will ask the questions:

• What function does the cartilage in the joint fulfill?
• Why does the bone begin to react with increasing cartilage wear?
• What are sclerosing , how do osteophytes , and what do rubble cysts ?
• the joint surface break in at the last stage of arthrosis - and what does that mean for the everyday life of those affected?

Anatomy of the hip joint - a perfect interaction

Before we can understand the pathological changes in hip arthrosis , it is important to know the normal anatomy of the hip joint. Because only those who know how a healthy joint work can understand what goes wrong with osteoarthritis .

The hip joint - structure and function

The hip joint is a so -called ball joint . It is made up of two central bone components:

• the hip head (Caput femoris), the spherical upper part of the thigh bone (femur)
• the hip pan (acetabulum), a semicircular proportion of the pelvic nose (pelvis)

The hip head sits like a ball in the pan of the pelvis. Both structures are covered with a smooth, white articular cartilage - a layer of hyaline cartilage tissue a few millimeters thick. This cartilage layer has a central protective function.

🧠 The role of the articular cartilage - protection, sliding ability, shock absorption

The articular cartilage fulfills several vital tasks in the hip joint:

1. Shock absorption : Each step enormous forces act on the hip joint- 3 to 5 times the body weight. The cartilage distributes these forces evenly and prevents pressure on the bones below.
2. Minimal friction : thanks to its smooth surface, the cartilage allows an almost smooth sliding of the hip head and pan.
3. Protection of the bone layer : The cartilage acts like a natural buffer between the bone surfaces and prevents direct bone contact.

The articular cartilage itself is not supplied with blood . It receives his nutrients exclusively from the articular fluid (Synovia), which is produced joint capsule This liquid supplies the cartilage with oxygen and nutrients - especially when moving. , regular, joint -gentle activity is crucial for maintaining cartilage.

What makes the cartilage so special - and so vulnerable?

The hyaline cartilage consists of:

• Chondrocytes (cartilage cells)
• Water (70–80 % of the cartilage mass)
• Collagen fibers type II (for tensile strength)
• Proteoglycanes (for elasticity and water storage)

This complex matrix gives the cartilage elasticity and compressive strength - a unique combination in the human body. At the same time, however, this also means: if the cartilage is damaged, it can hardly regenerate himself because it lacks blood supply and stem cell supplies. arthrosis over the years .

⚠️ Early damage to the cartilage remains unnoticed for a long time

Since the cartilage not sensitive to pain , the first stages of osteoarthritis are usually symptom -free . Only when the cartilage has been broken down so much that the bone underneath - with sclerosis, osteophytes and cyst formation - occurs pain, rigidity and movement restrictions.

Summary - anatomy & cartilage at a glance

Hip head:

If the body weight carries, the movable ball forms

Hip pan:

Fixed bracket in the pool, leads and stabilizes

Joint cartilage:

Shock absorbers, sliding surface, protection against bone contact

Joint fluid:

Diet of the cartilage, friction reduction

→ Even slight damage to the cartilage can coxarthrosis .

What happens to osteoarthritis in the hip joint? - Understand the coxarthrosis

The osteoarthritis of the hip joint , referred to medically as coxarthrosis , describes a creeping wear process that runs in several stages . It is a degenerative joint disease in which the cartilage - the natural protective layer over the bone - is increasingly destroyed. But osteoarthritis is much more than "only" cartilage breakdown: the bone, the joint capsule, the joint fluid and the surrounding structures change - and lead to significant restrictions in everyday life with progress.

🧩 What is the difference between osteoarthritis and arthritis?

Before we get deeper, it is important arthrosis from the arthritis :

Definition arthrosis, wear -related reduction in cartilage and joint structural arthritis inflammatory joint disease (e.g. rheumatism, infection, gout)

→ While the focus is on wearing mechanism in arthrosis inflammatory reaction dominates in arthritis . However, in the late course of a coxarthritis, secondary inflammation occur through grated cartilage and junction - one then speaks of activated osteoarthritis.

🔎 Primary and secondary coxarthrosis - what are the causes?

The causes of osteoarthritis in the hip joint are complex. Basically, a distinction is made between primary and secondary coxarthrosis :

🟡 Primary coxarthrosis

• Cause unknown (idiopathic)
• Usually occurs from the age of 50
• Probably age -related degeneration, genetic factors, reduced ability to regenerate

🔴 Secondary coxarthrosis

• Clear triggering factors available:
• Hip dysplasia (innate bliss of the hip pan)
• Perthes' disease , epiphysiolysis capitis femoris (growth disorders)
• Injuries (e.g. hip head break, dislocation)
• Obesity , leg long differences , false loads
• Rheumatic diseases or hip head necrosis

→ In both cases, the process results in a common end point: increasing destruction of the articular cartilage with reactions of the underlying bone .

🧬 Which risk factors favor coxarthrosis?

The development of hip arthrosis is favored by different risk factors:

• Age : With increasing age, the cartilage's ability to regenerate decreases.
• Genetics : Family accumulation indicates hereditary factors.
• Obesity : significantly increases the mechanical pressure on the hip joint.
• Misposition : z. B. X or O-leg position, hip dysplasia
• Professional burden : Long -term lifting heavy loads or working in a deep crouch
• Sports with high impact load : z. B. football, marathon run

→ The combination of several factors significantly increases the risk.

🧠 What happens first with osteoarthritis in the hip joint? - the beginning in the cartilage

In the early stages of arthrosis, there are microscopic changes in cartilage tissue - still without clinical symptoms. The cartilage layer initially loses water content, which reduces its elasticity. The mechanical loads in the joint can then no longer be checked sufficiently.

🔬 The first changes:

• Reduction of the proteoglycanes
• Cell changes of the chondrocytes
• Wurding the cartilage surface (fibrillation)
• Microrises and divisions within the cartilage tissue
• Locally progressive thinning

These processes lead to a disturbance of the biomechanical balance in the joint. The cartilage begins to wear out , especially when the load is one -sided - for example in the area of ​​the pan roof (superolateral).

📉 How the wear is developed - a vicious circle

With progressive cartilage breakdown, the entire joint system gets out of balance. A cycle arises:

1. Mechanical overload
2. Cartilage
3. Joint inflammation (activated osteoarthritis)
4. Reaction of the bone (sclerosis, osteophytes, cysts)

The cartilage abrasion particles stimulate the joint mucosa, which leads to synovitis - i.e. inflammation of the joint capsule. This produces increasingly and changed synovia, which also accelerates cartilage reduction. The sliding ability decreases, pain occurs - initially only in the event of stress, later also at peace.

🦴 What happens to the bone under the cartilage? - The beginning of the conversion processes

If the cartilage becomes thinner, the bone below is immediately exposed to the load - without damping. The body reacts to this:

• Hardening and compression of the bone = sclerosis
• Formation of bone undresses = osteophytes
• Development of cavities in the bone = cysts

These changes are the first visible signs of advanced coxarthrosis in the X -ray image - even if the patient does not yet feel any pronounced symptoms.

The stages of coxarthrosis - from the first cartilage damage to the break -in

The coxarthrosis , i.e. the arthrosis of the hip joint, is typically run in several clearly distinguishable stages . These are characterized by progressive changes in the cartilage, but also on the bone. The reaction of the bone to the wear of the cartilage is particularly crucial - because here there is sclerosis , osteophyte formation , cyst formation and finally the break -in surface .

In the following, the four typical stages of coxarthrosis are described in detail with all characteristic characteristics and structural changes.

🔹 Stage I - Early Stadium: The beginning of cartilage damage

In the first stage, there are microscopic changes in the cartilage tissue. Radiologically, the coxarthrosis at this stage is usually not yet visible or can only be recognized as a minimal joint splitting decay .

Changes in the joint:

• The cartilage loses water and becomes brittle.
• The sliding ability decreases.
• First roughening of the cartilage surface (fibrillation).
• Partly synovial irritation with the beginning of joint inflammation.

Symptoms:

• Usually no or only low symptoms.
• Morning pain.
• Pain after loading (e.g. going longer, standing).

Important: The bone is not yet affected at this stage. However, there is already a biomechanics disorder that accelerates the further course.

🔹 Stage II - Advanced stage: Start of the bone reactions

At this stage, the body begins to react to the increasing cartilage abrasion and the lack of damping by cartilage tissue. There are structural conversion processes in the subchondral bone.

✅ Sclerosis: The first answer of the bone

Sclerosis is a hardening and compression of the subchondral bone directly below the damaged cartilage surface.

Why does sclerosis arise?

• Due to the lack of buffing, mechanical loads have a direct effect on the bones.
• The bone reacts to this with increased lime storage and conversion to withstand the increased load.
• The dense bone structure appears in the X -ray image as a bright line under the cartilage (subchondral sclerosis).

Consequence: The bone becomes more stable but less elastic - which further deteriorates the shock absorption. In addition, sclerosis increases the risk of subsequent cyst formation.

✅ Osteophytes: The attempt to enlarge the articular area

Osteophytes are bony buildings on the joints that arise when the body tries to distribute the load over a larger area.

Protection function:

• Enlargement of the articular surface.
• Load distribution with unstable joint mechanics.

Problem:

• The osteophytes often grow so far that they restrict mobility.
• They can press into soft tissues or neighboring structures (e.g. joint capsule, nerves) and cause pain there.

✅ JONSE SCHLATE:

• The joint gap appears increasingly narrower in the X -ray image.
• Sign for reduced or missing cartilage.

Symptoms:

• Increasing pain in the event of stress.
• First movement restrictions.
• Stay pain, stiffness.

🔹 Stage III - late stage: cyst formation and structural instability

In the third stage, the coxarthrosis has already developed far. The cartilage surface is very broken down, the bone continues to react. So -called scree cysts - liquid -filled cavities in the bone.

✅ How do cysts arise?

• The sclerosis leads to a shielding of the load.
• Printing peaks are concentrated on narrowly limited areas.
• Microrises and the smallest bleeding lead to the formation of cysts.

Rubble cyst:

• Mostly in the area of ​​the hip head and/or the hip pan.
• Well recognizable in the X -ray or MRI.
• Can merge together and form large cavities.

Consequence:

• The bone loses load capacity.
• Danger of microfractures.
• Massive stress pain.

Symptoms:

• Severe pain too.
• Pronounced restrictions on movement.
• Muscle tension, gait disorders.

🔹 Stage IV - final stage: Burglary of the joint area

The cartilage is completely broken down in the final stage. the articular surface is .

✅ What happens during the break -in?

• The bone plate that carries the joint collapses.
• The hip joint becomes unstable.
• The contact between the thigh head and pan is deformed.

Consequences:

• Sudden worsening of the pain.
• Massive loss of mobility.
• Inflammatory reactions, closed posture, muscular dysbalance.

Therapeutic consequence:

• Conservative therapies no longer help at this stage.
• An artificial hip joint (endoprosthesis) is necessary.

How the cartilage builds up - the cascade begins

The meaning of the cartilage in the hip joint

The cartilage in the hip joint is a smooth, elastic layer that covers the hip head and the hip pan. It acts as a natural shock absorber and a layer of the slide , which minimizes the friction between the bones and enables even load distribution. The cartilage mainly consists of water, collagen fibers and prototoglycans - molecules that bind water and ensure elasticity.

First damage to the cartilage - micro damage and mechanical stress

microcisisions initially create in the cartilage . These lead to a disturbed structure and function. The cartilage gradually loses its ability to store water, which greatly reduces its elasticity.

Acceptance of prototoglycans and water storage

With the degeneration, the content of protoglycans in the cartilage. This means that the cartilage can bind less water, becomes drier, brittle and less elastic. As a result, the cartilage function of the cartilage continues, and the loads are transferred unevenly to the bones below.

Fibrillation, cracks and replacement of the cartilage

fibrillation shows - the roughening of the cartilage surface. Over time, deeper cracks and abrasions arise. Large parts of the cartilage finally dissolve from the bone and a direct bone-on-bone contact area that causes pain and inflammation is created.

Loss of shock -damping function

The loss of the cartilage layer leads to an increased load on the bone, which is now in contact with the counter -bone without the protective barrier. This changed pressure distribution is the starting point for the next reactions of the bone, like sclerosis .

How the bone reacts - the sclerosis arises

What does sclerosis in connection with coxarthrosis?

In orthopedics, sclerosis describes compression and hardening of the subchondral bone , i.e. the bone that is located directly under the articular cartilage. In the context of hip arthrosis - the coxarthrosis - sclerosis is a typical reaction of the bone to the increasing stress, which it is exposed to due to cartilage wear . The term "sclerosis" is derived from the Greek "scleros", which means "hard" - and that is exactly what happens: the bone hardens as a protective measure.

Why does the bone react with sclerosis?

In a healthy hip joint, the hyaline joint cartilage all shock and pressure loads when walking, running or jumping. This buffer function protects the bone below.

With the beginning of cartilage regeneration - through aging, overload or other factors - the cartilage loses its elasticity and thickness. It can no longer distribute the load sufficiently. This increasingly exposes the underlying bone to mechanical stress .

The body reacts to this overload with an increase in the bone : it builds up more bone material in order to be able to carry the load better. A more compact, denser bone structure is created - the sclerosis.

Follow the sclerotic changes in the hip joint

First of all, this reaction makes sense: the bone becomes stronger to withstand the increasing pressure. But in the long term, this adaptation brings considerable disadvantages :

• Reduced shock absorption : The sclerotic bone is less elastic. This leads to poorer suspension and increases the load on the rest of the cartilage and adjacent joint areas.
• Pain : The increased density of the bone goes hand in hand with increased sensitivity to pressure. Patients often report deeply sitting pain in the groin or in the buttocks , especially under stress.
• Promotion of further damage : The changed biomechanics in the joint further accelerates the dismantling process. Sclerosis is not only a consequence, but also the cause of the progression of osteoarthritis.

Where does sclerosis typically appear?

In the context of coxarthrosis, sclerotic changes often show in two areas:

• In the hip head (femoral head) : Especially the load -bearing zones that come under pressure with every movement are affected.
• In the panco roof of the hip pan (acetabulum) : Here too, the stress due to body weight is greatest, especially in the event of malposition or asymmetrical load.

These sclerotic zones are clearly visible on X -ray shots : the bone appears particularly bright (radiiodes) because it is denser than the surrounding, healthy bone.

Importance of sclerosis in the overall course of the hip artificial throat

Sclerosis represents a decisive turning point in the course of the osteoarthritis. It marks the transition from cartilage wear towards the active conversion phase in the bone . As soon as sclerosis occurs, arthrosis has usually reached a more advanced stage - and there is an increased risk of developing further degenerative changes such as osteophyte formation, cyst formation and ultimately the slump in the articular surface .

Osteophyte formation - when the bone builds "protective walls"

What are osteophytes?

Osteophytes are bony or cultivation, which form in the framework of osteoarthritis - especially in the case of coxarthrosis - on the edges of a joint. They arise as a reactive conversion processes of the bone for chronic stress, instability or cartilage loss. Colloquially, they are also referred to as "bone growths" or "bone pure".

How do osteophytes arise?

The wear of the articular cartilage means that the load is no longer evenly distributed over the articular surfaces. This leads to mechanical overload on the joints. The body reacts to this with an adaptive measure : it tries to increase the contaminated surfaces and better distribute the mechanical load.

This is done by growing new bone material - osteophytes form. This process is part of the so -called reactive osteoarthritis changes and often an indication of an advanced disease stage.

The meaning behind the osteophytes: protective mechanism with side effects

In the short term, the body pursues a goal with osteophyte formation:

• Surface enlargement for pressure distribution
• Stabilization of the joint with increasing instability

But long -term osteophytes lead to functional problems :

• Restriction of mobility : The bony extensions protrude into the joint room and block normal movements, e.g. B. when bending or spreading the leg.
• Pain : Especially when osteophytes press on surrounding soft tissues such as capsules, tendons or nerves, considerable pain can occur.
• Inflammation : Mechanical friction can result in local irritation - a so -called "activated arthrosis" with swelling, overheating and increased sensitivity to pain.

Where do osteophytes typically appear in the hip joint?

With coxarthrosis , osteophytes develop primarily at the following locations:

• On the hip head (Caput femoris) : especially on the edges of the cartilage that are overloaded
• On the edge of the pan (Labrum acetabular) : So -called marginal osteophytes are often created here
• In the transition to the thigh neck : these osteophytes can lead to a bottleneck in the joint, which is called impingement

The localization and expression of the osteophytes give the experienced orthopedic surgeon important indications of the stage and the dynamics of osteoarthritis.

How do you recognize osteophytes?

The imaging diagnostics , especially conventional X -rays , are very suitable for proving osteophytes. They appear as:

• lace or bulging dresses on the joints
• easy to differentiate, X -rays structures outside the regular joint column

In advanced cases, osteophytes can become so large that they partially or completely bridge the joint gap - a sign of a pronounced coxarthrosis .

Clinical importance of osteophytes

While small osteophytes often do not cause symptoms, larger rejections can cause considerable restrictions. She:

• Reduce the range of motion
• reinforce mechanical friction
• favor inflammatory stimulus states
• can make surgical interventions more difficult, e.g. B. in the implantation of a hip prosthesis

Therefore, osteophytes are not only diagnostic characteristic, but also therapeutically relevant.

Cyst formation - scree cysts as a sign of advanced osteoarthritis

What are subchondral cysts?

Subchondral cysts - often also referred to as scree cysts - are fluid -filled cavities in the bone below the articular cartilage. They typically occur with advanced osteoarthritis , especially in coxarthrosis , and are a sign of the continued mechanical overload and structural disintegration of the joint.

These cysts are mostly in the subchondral bone , i.e. in the area of ​​the bone directly under the articular cartilage. Frequently affected localizations are the hip head and the hip pan (acetabulum) .

How do scree cysts develop?

The pathogenesis of the subchondral cysts is complex and multifactorial. The central mechanisms are:

1. Printing and shock load due to cartilage loss: The loss of the shock-damping cartilage layer is increasingly loaded by the underlying bone. Sclerosis is created. Below this layer there is a long -term underlying because the sclerosis shields the load. Especially in areas with sclerosis , there are microresses in the bone tissue.
2. In pressing articular fluid: This crack can joint fluid (Synovia) into the bones. There she accumulates and forms a liquid -filled cave - the scree cyst.
3. Degeneration and degradation processes: inflammatory processes and enzymatic changes contribute to further tissue reduction. The cysts can increase and partially merge together.
4. Pressure relief from cyst formation: The body tries to compensate for the mechanical stress through cavity formation - which, however, undermines the stability of the bone structure in the long term.

Interaction of sclerosis and cyst formation

It is particularly noteworthy that sclerosis and cyst formation often next to each other in the same bone area . This initially appears contradictory:

• Sclerosis stands for compression and reinforcement of the bone structure
• Cyst formation, on the other hand, means loss of substance and the development of cavities

In fact, these are complementary processes :

• The sclerosis tries to browse the stress
• Cyst formation occurs if this compensation is no longer sufficient and the bone is structurally failed

The result is an unstable, porous bone structure that increasingly loses its load -bearing capacity.

Symptoms through scree cysts

Split cysts usually do not cause isolated symptoms, but increase the overall problem of coxarthrosis:

• Increasing pain , especially when burdened
• Instability of the joint
• Reduction of bone -fitting capacity
• Risk of the articular burglary (Chapter 9)

How do you recognize rubble cysts?

The imaging diagnosis is crucial:

• X -ray : shows the cysts as sharply limited, radiolucate (transparent) area in the bone
• MRI : Even more sensitive - here you can also see smaller cysts and the soft tissue changes associated with them
• CT : Helpful to assess the bone structure and cyst extension

Importance of the cysts for the forecast of hip artificial throats

Subchondral cysts are considered to be deteriorating for the forecast in osteoarthritis. Your presence usually speaks for:

• An advanced stage of illness
• High mechanical load in the joint
• impending slump in the articular surface

Therapeutically, only an operational renovation - mostly by replacing the hip joint - makes sense at this stage.

The slump in the articular surface - the fatal end point

What happens when the articular surface broke up?

The slump in the articular surface is the most serious and last stage of coxarthrosis. It describes the breakdown of the bone surface in the area of ​​the previously created cysts and sclerosed areas. Due to the loss of the sustainable bone structure and the massive damage to the articular cartilage, there is a direct bone-on-bone friction , which is extremely painful and massively restricts the function of the hip joint.

Mechanism of the articular burglary

• Due to the previously created subchondral cysts, the bone becomes increasingly porous and unstable.
• The accompanying sclerosis creates a compression in some areas, but cannot compensate for the structural weakness by the cysts.
• In the event of a load, parts of the articular surface collapse, which leads to a sudden stability.
• This instability leads to a sudden deterioration in the joint function and severe pain.

Consequences of the joint slump

• Massive loss of mobility: patients can hardly move the hip joint, walking is severely restricted or impossible.
• Severe pain: the bones causes permanent and intense pain, often at rest.
• Gear disorders: Even simple movements become agony, often a rollator or wheelchair is necessary.
• Secondary changes: muscle atrophies, protective contents and incorrect loading of other joints are the result.

Clinical importance and therapy

The break -in of the articular surface usually means the end of all conservative treatment options. A hip pulp (hip-Tep) is usually inevitable to relieve the pain, to restore mobility and to significantly improve the quality of life.

Summary

• The slump in the articular surface is the final stage of coxarthrosis.
• It arises from instability as a result of cyst formation and sclerosis.
• Leads to extreme painfulness and loss of mobility.
• A hip prosthesis is usually the only permanent solution.

How everyday life changes - symptoms in the course of coxarthrosis

Pain - the central key symptom

The course of the hip arthrosis is characterized by an increasing pain intensity, which typically shows itself in different forms:

• Attack pain: At the beginning, affected movements often feel stinging or pulling pain that improve again after a short movement.
• Strain pain: With the progression of arthrosis, pain increases when walking, climbing stairs or standing for a longer period.
• Rest pain: Pain occurs in peace or at night in the final stage, those affected often suffer from sleep disorders.

Movement restrictions and functional consequences

The mobility of the hip joint continues to decrease due to cartilage loss, osteophytes and cyst formation:

• Difficulties putting on shoes and socks or bending down.
• Problems getting up from sitting .
• Restricted ability to run or stand longer distances.
• Stiffness in the morning and after phases of rest.

Sonior farming and muscular consequences

In order to avoid pain, patients often occupy protective postures that relieve the affected leg. However, this leads to:

• Uneven strain on other joints (e.g. knee, spine).
• Muscle loss (muscle atrophy) in the area of ​​the hip and the thigh.
• Increased fall risk due to reduced stability.

Psychological effects

Chronic pain and restricted mobility can:

• frustration and social isolation .
• Depression and fears, especially if everyday life is severely impaired.
• The loss of independence and quality of life.

Diagnostics of hip arthrosis (coxarthrosis)

History and clinical examination

The first step to diagnose coxarthrosis is the detailed medical history in which the doctor collects important information:

• Complaints: Start, course, pain character (e.g. start -up pain, stress pain)
• Movement restrictions: Which movements are painful or limited?
• Pre -loading: injuries, operations, family osteoarthritis diseases

Typical characters are checked during the physical examination:

• Extent of movement: restrictions on flexion, abduction and rotation of the hip joint
• Pain release: in certain movements or pressure on the joint
• Gangbild: already or shorten the stride length
• Muscle status: atrophies or weaknesses of the hip muscles

Imaging procedures

Imaging examinations are crucial for the exact assessment of the joint changes.

roentgen

• Standard procedure for diagnostic protection
• Typical findings for coxarthrosis:
• Dimensions of the joint gap through cartilage loss
• Sclerosis in the subchondral bone of the hip head and hip pan
• Osteophyte formation on the gelkrand
• Subchondral cysts as radiolucated areas
• Also helps with the stages of osteoarthritis

Magnetic resonance imaging (MRI)

• More sensitive than X -rays, especially in early stages
• Representation of cartilage defects, soft tissue changes and joint effusion
• Visualization of cysts and bone marrow edema

Computer tomography (CT)

• In addition to assessing the bone structure
• Helpful for complex deformities or before operations

Laboratory tests

• No specific laboratory values ​​are increased in arthrosis.
• Inflammation parameters (e.g. CRP, BSG) can be determined to delimit inflammatory joint diseases.

Diagnostic protection and stages division

By combining anamnesis, clinical examination and imaging, the diagnosis of coxarthrosis can be made with great certainty. The stages are division (e.g. according to Kellgren and Lawrence) based on the X -ray findings and is important for therapy planning.

Therapy options for hip arthrosis

Conservative therapy

In the early and medium stage of coxarthrosis, conservative treatment focuses on relieving pain, maintaining mobility and slowing down the progress of the disease.

Painkillers

• Nsar (non -steroidal anti -rheumatics) such as ibuprofen or diclofenac for pain relief and anti -inflammatory inhibition.
• Paracetamol as an alternative in contraindications.
• Topical painkillers (e.g. pain plasters or gels) for local application.

physical therapy

• Strengthening the muscles around the hip joint to stabilize.
• Improvement of mobility and joint function.
• Training of joint -friendly movement patterns.

Weight loss

• Reduce the load on the hip joint and slow down the cartilage breakdown.

Injection therapies

• Hyaluronic acid injections: improvement of gliding in the joint.
• Cortisone injections: short-term inhibition of inflammation and pain reduction.

When no longer helps conservative measures?

• With advanced coxarthritis with a clear joint slump, severe pain in peace and massively restricted mobility.
• If the quality of life suffers strongly and everyday activities are hardly possible.

Operative therapy: hip endoprosthesis (hip-tep)

The hip prosthesis is the proven therapy in the final stage of coxarthrosis and is used if conservative measures are no longer sufficient.

Goal of the hip-Tep

• Pain freedom or significant pain relief.
• Restoration of mobility and function.
• Improvement of quality of life and mobility.

Operation and prosthesis types

• Different prosthesis types (cemented, cement -free, hybrid) depending on the patient and bone quality.
• Minimally invasive access to protect the soft tissues.
• Individual adaptation to anatomical conditions.

Post-treatment

• Early mobilization and physiotherapy.
• Control of wound healing and prosthetic situation.
• Long -term aftercare to secure the function.

The therapy of hip arthrosis is individual and depends on the stage of illness and symptoms. Modern hip prostheses today enable quick and sustainable return to an active life.

Conclusion

What happens in the joint in coxarthrosis?

The osteoarthritis of the hip joint, also coxarthrosis , is a complex degenerative process that begins with progressive wear by the protective cartilage. In the healthy joint, this cartilage serves as an elastic layer of slide, which protects bones from direct contact and cushions loads.

Over time, mechanical overload, micro -injuries and biological changes occur in a gradual cartilage breakdown. The cartilage loses its ability to store water and elasticity, cracks and finally exposed bone surfaces are created.

The bone reacts to the lack of damping through compression, the so -called sclerosis , especially in the hip head and in the hip pan. osteophytes form as bony decays on the joints, which enlarge the joint surface and distribute pressure, but lead to movement restrictions in the long term.

The increased load creates small cavities in the bone, the so -called subchondral cysts or rubble cysts . These are an expression of increasing instability and structural weakness.

In the last stage, the articular surface breaks in at the cystic places, which leads to a sudden and massive deterioration with severe pain, loss of mobility and functional restriction. Here, the use of a hip prosthesis essential to restore the quality of life.

The further the disease progresses, the more limited the therapy options without surgery.

Modern medicine and opportunities

Thanks to modern diagnostics and innovative surgical methods, the endoprosthetics today enables many affected people to improve the quality of life and mobility significantly.

Individual and professional support from experienced specialists, such as those in the Endoprotheticum Mainz by Prof. Dr. Karl Philipp Kutzner is offered, is crucial for the success of the treatment.