Treatment of coxarthrosis (osteoarthrosis of the hip) abroad

Coxarthrosis is degenerative-dystrophic damage of the hip joint. Illness is  accompanied by premature degeneration of the tissue of the joint. It is most common for people of active working age.


Coxarthrosis is the also widely spread and a harsh form a degenerative-dystrophic joints disease. Majority of patients become disabled because of the hip joint arthritis. 


Coxarthrosis treatment abroad

Causes of coxarthrosis

Main cause of this illness is the mismatch of physical exertion on the hip joint to its functional capabilities. Risk factors for the disease are:

  • Middle age
  • Genetic predisposition
  • Obesity
  • Sports or professional overload of the hip joint
  • Injuries
  • Flat feet


Coxarthrosis symptoms


Symptoms of coxarthrosis

Clinical signs of coxarthrosis largely correspond to the stage of the pathological process. 

  • Stage 1. Pain in the hip joint is of low intensity and appears only after continuous physical work. Long walks lead to limping that disappears after rest. Painful sensations are absent completely while walking less than 2 kilometres. Restricted joint mobility is subjectively observed while coming up the stairs. Work capacity has not yet been affected. The amplitude of the movements is reduced by no more than 15 degrees.
  • Stage 2. Getting up, walking, changing body position brings about pain in the hip joint. Pain can irradiate to the knee area. Nightly pain attacks are possible.Patients are often forced to use a walking cane when walking. They need to stop and have a break after walking every 0.5-1 kilometre. Joint function is considerably reduced. The amplitude of the movement is reduced by 20-35 degrees. 
  • Stage 3. Constant, excruciating pain in the hip joint disturbs a patient even while resting. Pain is increased acutely while walking and any intention to move a joint. There is a shortening of the limb. Walking is possible only for a few meters. The movements in the joint are only of swinging nature. A person loses his ability to be self sufficient.


Coxarthrosis diagnostics


Diagnostics of coxarthrosis

Diagnosis is easily established with the help of an X-ray. Other visualisation techniques can be used to obtain detailed information about the stage of the joint’s damage while determining the therapeutic tactics and to define prognosis for further work capacity. MRI is the most informative technique among all. 


Diagnosis criteria according to the laboratory and X-ray information are: 

  • Narrowing of the joint space
  • Presence of the femur or acetabulum osteophytes
  • Sedimentation rate of erythrocytes is below 20 mm / h


Diagnosis is considered to be confirmed if 2 of 3 criteria listed are present.


Clinical diagnosis criteria are:

  • Reduction of external hip rotation
  • The morning stiffness is less than 1 hour
  • Painful sensations during internal hip rotation
  • The patient's age is less than 50 years


They treat diagnosis a true on if a patient feels pain in the hip joint within 2 weeks minimum and if 3 of 4 clinical criteria are present. 


Coxarthrosis treatment abroad


Treatment of coxarthrosis abroad

Stable clinical effect can be reached only with the help of surgery. The other techniques give only temporary effect like improvement of the life quality.


Conservative treatment methods used here are: 

  • Prescription medication (non-steroidal anti-inflammatory drugs, chondroprotectors)
  • Hyaluronic acid injected into the joints
  • Spa treatment
  • Exercise therapy
  • Physiotherapy
  • Massage


Coxarthrosis hip replacement


Significant and prolonged clinical improvement is reached with the help of surgeries. Basic kinds of surgical interventions are:


Decompression myotomy affects the elderly in age if the amplitude of movements in the joint is satisfactory.  A surgeon cuts off the small and large trochanter of the femur, cuts the femoral fascia and the adductor muscles of the thigh. This allows you to eliminate muscle contractions and reduce the pain caused by muscle spasm. Traction (extension) of the limb and joint training are carried out within 2 weeks after the operation. 


Cartilage replacement techniques have limitations associated to the large size of the joint surface. Cartilage replacement can be either autologous or from a donor. Surgeries applied are:

  • Mosaic chondroplasty uses patient’s own biological material, which is taken from different parts of the body
  • Allograft transplantation means that the donor’s biological material is used
  • Autotransplantation of crushed cartilage with gel


Arthroplasty of the hip joint is a surgery performed to correct the joint structure. The doctor removes cartilaginous and bony growths, foci of necrosis and smoothes the surfaces of the joint. The defect of the bone tissue is replaced with ceramic implants. 


Endoprosthetics of the hip joint is, currently, considered as the gold standard for the treatment of coxarthrosis. They implant an artificial joint instead of the damaged one. As a result of the operation, pain disappears and mobility of the limb returns. The patient can lead a normal lifestyle and restore capacity to work.  


Coxarthrosis latest treatment techniques


Latest coxarthrosis treatment techniques

At the moment, new ways of joint cartilage restoration has been invented and successfully implemented in German hospitals. 


Bone marrow stimulation techniques are used for the cartilage tissue recreation from its own stem cells. This is a whole group of methods aimed at the creation of the special bone tissue defects around the damaged cartilage, which means that stem cells come out from the bone marrow, differentiate into the chondrocytes and cover the defect of the joint surface. 


These techniques are:

  • Tunneling
  • Formation of micro-fractures
  • Transplantation of the periosteum
  • Matrix-induced chondrogenesis


Cellular technology & tissue engineering. Matrix-induced autologous chondrocytes implanatation remains the cutting-edge and effective technique of the coxarthrosis. Essence of the technique is that patient’s own cartilage tissues are cultivated to receive a large number of the cells. As a result, the problem of autologous material deficiency for transplantation is solved. 


A patient undergoes two surgeries. Cartilage tissues are obtained during first procedure. Then chondrocytes are differentiated from the sample while they are being cultivated within several weeks. They fix the cells with a matrix. Second procedure’s goal is to insert the matrix with the cells into the joint and thus, to form a new cartilage of these cells. Prolonged remission comes as a result of surgeries. Joint function restores and pain disappears. 


Coxarthrosis prognosis


Prognosis for coxarthrosis

If not treated, coxarthrois will lead to disability. Today, conservative treatment techniques help to improve the quality of one’s life. Sometimes, they also help to slow down the tempo of pathology progression. 

A stable condition can be realised with the help of special surgery. Modern hip joint endoprostheses can serve for dozens of years without the need to be replaced. Methods of tissue engineering and cell therapy, which can achieve a long (5-10 years) remission of the disease are being actively introduced. 


German hospitals and Swiss clinics offer the latest coxarthrosis treatment techniques. Thanks to this treatment residents of any country are able to visit European hospitals to receive quality medical help. 



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