Coxarthrosis: when is surgery necessary?

Pain, stiffness and lameness are typical signs of hip osteoarthritis.

It begins with a pain in the groin, which goes down the thigh to the knee and becomes stronger and stronger, so much so that it is difficult to cross the legs. We are talking about coxarthrosis, a disorder that causes the progressive thinning of the cartilage that covers the head of the femur.

Over time, the underlying bone is “laid bare” and reacts by thickening and deforming with the production of osteophytes, beak-shaped growths, which limit movement. The joint capsule thickens and the muscles retract to determine the characteristic posture of those suffering from coxarthrosis.

Possible remedies

There are no drugs that can heal osteoarthritis or make it regress, but only medicines to control pain. NSAIDs, non-steroidal pain medications, are usually prescribed, but they should not be taken for long periods.

Once every 8-10 months, ultrasound-guided infiltrations of hyaluronic acid, the nutrient and lubricating of cartilage that is lacking with osteoarthritis, can be carried out.

When osteoarthritis is in the initial phase, you can slow down its evolution with some precautions: lose weight and avoid tiring the joint with sports and heavy activities.

To improve mobility, physiotherapy and moderate physical activity are useful. The most suitable sports are those without load: swimming, cycling, light walking and gentle gymnastics.

When is surgery used?

When the pain is no longer controllable and compromises the quality of life, total hip arthroplasty surgery is considered, which involves replacing damaged contact points with artificial prostheses.

“In recent years, important steps forward have been made with regard to materials, but above all in the search for less and less invasive surgical procedures that allow faster functional recovery, less pain, smaller scars and the reduction of blood loss,” explains Marta Solà, orthopedic surgeon at the Edoardo Bassini Hospital in Cinisello Balsamo.

“An incision of 6-8 cm is made on the upper front of the thigh through which the prosthesis is positioned, avoiding cutting the muscles and injuring the nerves.”

The surgery lasts about an hour and, depending on the case, is performed or not under general anesthesia. “After 24 hours the patient is able to walk with the help of the walker. The stay lasts from 4 to 6 days and then passes in a department of rehabilitation medicine for another 20 days. For a month, anticoagulant drugs should be taken and elastic stockings used to avoid the risk of thrombosis.

Within a month it is possible, with due caution, to resume everyday life. The checks are scheduled after one, three and six months from the intervention; They include, in addition to the clinical examination, also radiographic examinations to verify the fixation of the prosthesis.