Modalities such as ice, ultrasound and electrical current may be used. Then, it must be continued in town or in a rehabilitation center when the patient cannot return home. Case series and animal model studies have shown this to be a simple technique with low rates of recurrence and complications. 2005 Jan ;36(1):123-30. The hip is a ball-and-socket joint, which means that the rounded end of one bone (in this case, the "ball" of the thighbone) fits into the hollow of another bone (the acetabulum, or cup-shaped "socket" of the pelvis). Pigeon toe, also known as in-toeing, is a condition which causes the toes to point inward when walking.It is most common in infants and children under two years of age and, when not the result of simple muscle weakness, normally arises from underlying conditions, such as a twisted shin bone or an excessive anteversion (femoral head is more than 15 from the angle of torsion) resulting in the . Coxa Vara. With the normal angle of inclination, the greater trochanter lies at the level of the center of the femoral head. Signs and symptoms of femoral anteversion include: In-toeing, in which a person walks "pigeon-toed," with each foot pointed slightly toward the other. As with any surgery, however, there will be pain post-operatively, and complications are possible. https://www.physio-pedia.com/index.php?title=Coxa_Vara_/_Coxa_Valga&oldid=229021. [10], Classification of the patient and hip affected with SCFE is essential to advance treatment, and the selection thereof, as well as to improve the outcome. On the AP view, the doctor measures the obliquity of the acetabular roof, the cervico-diaphyseal angle and the lateral coverage of the femoral head. Obligatory external rotation is noted in the involved hip of patients with SCFE when the hip is passively flexed to 90 degrees. J Bone Joint Surg Br 2004;86(6):876-86. doi: 10.1302/0301-620x.86b6.14441. Classification should therefor consider mechanical and morphological parameters. The information offered on this site does not in any way replace treatment by a health professional. , , . Bewegingsleer aan de hand van tekeningen van de werking van de menselijke gewrichten deel II De onderste extremiteit, Scheltema & Boltema, Utrecht, 1984, 233 paginas (L.O.E. Coxa vara is a deformity of the hip, whereby the angle between the head and the shaft of the femur is reduced to less than 120 degrees. The joint, which was already unhealthy, is deformed more and coxarthrosis develops. It consists of cutting the bone in order to modify its axis. The normal NSA of the femur is 130 degrees. . This is no longer in the right place. Find Us On Map. The first essential clinical factor to assess is the mechanical stability of the physis. (L.O.E. [22]. When testing hip range of motion, internal rotation, flexion, and abduction are limited. The hip joint, a ball and socket synovial joint at the juncture of the leg ( femur) and pelvis (os coxa), is one of the most flexible joints in the human body. It is also called "hip joint". Its the part of the bone that sits in the socket of the hip. Coxa valga is a deformity due to an increase in the angle between the head and neck of the femur and its shaft (normally 135 degrees). All A to Z dictionary entries are regularly reviewed by KidsHealth medical experts. vara Acquired right coxa vara Coxa vara, acquired ICD-9-CM . Treatment for knock knees. The first goal of treatment is to prevent the further slipping and avoid complications. coxa vara luxans: fissure of neck of femur, with dislocation of the head. How to get to the clinic from other countries? It is offered to patients with a progressive form of coxa valga. The coxa valga designates a deformation of the upper part of the femur. Coxa vara Hip Conditions in Children Treatment The treatment of Coxa Vara should ideally focus on reducing pain and stiffness while helping your child to regain their mobility. Coxa valga is diagnosed through clinical examination, radiography or the X-Ray imaging of the femur enables the doctor to identify the root cause. Download PDF 701.28KB. In case of dysplasia, the joint is underdeveloped, the acetabulum is formed incorrectly and caput-collum-diaphyseal angle is broken. In most people, the femoral head sticks out from the shaft of the femur at an angle of 120-130 degrees. At first this angulation excessive femoral neck is asymptomatic. Pagets disease of bone), post-Perthes deformity, osteomyelitis, and post traumatic (due to improper healing of a fracture between the greater and lesser trochanter). Faulty maturation of the cartilage and metaphyseal bone of the femoral neck. Excessive interuterine pressure on the developing fetal hip. If conservative treatment isn't enough to stop pain, surgery may be done to cut into the femur and decrease the angle of the femoral head. 2 , . Treatment complications Operative complications include the following: femoroacetabular impingement in case of overcorrection 2,9 Differential diagnosis When people with knock-knees stand up with their knees together, there's a gap of 3 inches or more between . Ashish Ranade MD, James J., McCarthy MD, Richard S. Davidson MD. Available from. Le diagnostic of the coxa valga is based primarily on a clinical examination. Measuremenst are then taken: the Acetabular Index and the Sourcil Slope (the angle formed by a line joining the 2 ends of the sourcil with the horizontal line) [6]. A tail question of HIP JOINT. summary. Orthop. Adult Dysplasia of the Hip is a disorder of abnormal development of the hip joint resulting in a shallow acetabulum with lack of anterior and lateral coverage. Genu recurvatum is a deformity in the knee joint, so that the knee bends backwards.In this deformity, excessive extension occurs in the tibiofemoral joint.Genu recurvatum is also called knee hyperextension and back knee.This deformity is more common in women [citation needed] and people with familial ligamentous laxity. Coxa valga can be seen at any age. [8][9]SCFE presents bilaterally in 18 to 50 percent of patients[9]. A pathological increase in the medial angulation between the neck and the shaft is called coxa valga, and a pathological decrease is called coxa vara. Cox valga Treatment For adults who have no symptoms, coxa valga may not need treatment. The prevalence of SCFE is 10.8 cases per 100 000 children. and Clipart.com. Ultrasound of the hip joints and orthopedic consultation is indicated for all babies aged 3-4 months. This results in the leg being shortened, and the development of a limp. Read more, Physiopedia 2023 | Physiopedia is a registered charity in the UK, no. It is characterized by a posterior displacement of the epiphysis through the hypertrophic zone with the metaphysis taking on an anterior and superior position.[2]. De kwetsbaarheid van het jeugdige skelet., Bohn Stafleu Van Loghum, 2005:44-48. Congenital coxa valga contracture of left hip. Clinically, the condition presents itself as an abnormal, but painless gait pattern. 5), Van Roy P et al. Note: All information is for educational purposes only. Treatment: HE angle of 4560 degrees observation and periodic follow up. There are a variety of complications that may arise as a result of this hip deformity. X-Ray in Coxa Vara. ), Back pain popularized by health professionals. In the existing literature on GMC, most studies have only focused on the treatment method rather than the influence of GMC on hip joint development [4, 5, 8,9,10,11,12,13]. Non surgical options include physical therapy, or devices that can help to improve mobility such as walkers, canes, or crutches. It is especially felt during movements including mobilization of the hip (especially during walking). Coxa valga is a hip deformity in which head of the femur is abnormal, and articulates improperly with the pelvic bone. Coxa valga is defined as the femoral neck shaft angle being greater than 139 [1] Coxa vara is as a varus deformity of the femoral neck. Sometimes, if knock knees cause problems such as pain or difficulty walking, you may be referred to a specialist for tests to see what might be causing it. If the angle is greater than 130 degrees, the condition is called coxa valga, or a valgus hip. The first sign of coxa valga in children may be a limp detected while walking. DPT ( Univ of Montana), MPT (neuro), MIAP, cert. Patients with coxa vara often show: Patients may also show femoral retroversion or decreased anteversion.[10]. Over a prolonged period, the coxa valga can also cause other osteoarthritic pathologies of the hip. J bone joint surg 1993;75A:1134-1140. This is a technique of moving the legs to be sure the femur fits properly inside of the hip socket. My name is Arotoky and I am studying human medicine. Background: Spastic hip subluxation or dislocation that is associated with an excessive coxa valga deformity is a common pathologic condition in children with cerebral palsy (CP) that is often treated with large bone reconstructive procedures. If this angle is above the norm, then the diagnosis of Coxa Valga, that is, valgus deformity of the femoral neck can be stated. Treatment of. This is the case of a, Hip osteoarthritis and back pain: what is the link? coxa valga - bone health - 2023 adrenal health alcohol and alcohol alimony allergies anatomy andrology anthropometry anti-nutrients autoimmune diseases baby's health beauty beauty products biology blood analysis blood health blood pressure body building bone health bowel health cardiovascular diseases cereals and derivatives cholesterol It consists in modifying the architecture of the femoral neck to obtain a mechanically more favorable anatomy. St. Louis, MO:Elsevier Inc, 2006. Femoral osteotomy is a surgical procedure that is performed to correct specific deformities of the femur - the long bone in the upper leg - and the hip joint. Insufficient femoral head-neck offset (less than 9 mm) was present in 75% of the hips and 78% of the hips were judged to be aspheric. [19]Patients usually present with limping and poorly localized pain in the hip, groin, thigh, or knee. The disease is a consequence of a congenital joint pathology, dysplasia. 120~130 . [3] The extent of articular damage is variable and is influenced by the duration of the slip, the severity of the deformity as well as the activity level of the patient. The main symptom of coxa valga is lameness (lameness). Search PubMed; Yamamuro T, Ishida K. Recent advances in the prevention, early diagnosis and treatment of congenital dislocation of the hip in Japan. In most people, the femoral head sticks out from the shaft of the femur at an angle of 120-130 degrees. Coxa Valga For patients with a coxa valga or mild dysplasia, it is important to make a clinical judgment regarding the amount of femoral torsion that is present. My goal is to share my health knowledge with the general public through web writing. The standard treatment of stable SCFE is in situ fixation with a single screw. Your physician will be able to rule out other causes of your pain and mobility issues. The femur is the long bone in your thigh. [5], Ashish Ranade et al also showed that a varus position of the neck is believed to prevent hip subluxation associated with femoral lengthening. The current study aimed to determine the unique developmental pattern of the hip in patients with HME and evaluate the factors that influence its progression. the physiotherapist explains the things not to do and shows the exercises to do at home, between rehabilitation sessions. But excluding activity completely is also dangerous. In early skeletal development, a common physis serves the greater trochanter and the capital femoral epiphysis. Acute slipped capital femoral epiphysis: the importance of physeal stability. Hyperextension of the knee may be mild, moderate or severe. [3], Morphological classifications have relied on radiographic views using the linear displacement of the femur head on the neck of the femur or the slip angle (angle between the shaft and perpendicular to the physis per Southwick) as parameters. If conservative treatment isn't enough to stop pain, surgery may be done to cut into the femur and decrease the angle of the femoral head. Once the correct diagnosis has been confirmed, your doctor will determine the best treatment to manage any pain or mobility issues that you may be experiencing. And the most common cause of the disease is. The patient is observed and questioned about the location and intensity of the pain felt. Indication for surgery :HE angle more than 60 degrees, progressive deformity, neckshaft angle <90 degrees, development of trendelenburg gait. The following are indications for surgical intervention: Other indications are based on the HE angle; Except when the neck/shaft angle is less than 110, progression of the varus angulation takes place, gait pattern abnormalties or degenerative changes take place. Physiotherapy & Rehabilitation Center! The joint, which was already unhealthy, is deformed more and coxarthrosis develops. In time, if it goes untreated, coxa valga can make walking difficult. 2009, 467(1): 128134. (L.O.E. Copyright 2023 Back pain popularized by health professionals | Powered by WordPress Astra Theme. Pediatr Radiol. Hilgenreiners physeal angle between 45-60 if symptomatic (e.g. Incidence and Characteristics of Femoral Deformities in the Dysplastic Hip. Physiopedia articles are best used to find the original sources of information (see the references list at the bottom of the article). Early mobilization is a key factor in a favorable evolution. . This can be tracked by the values of caput-collum-diaphyseal angle which should be 127-130 degrees in average. It is also less accurate in assessment of severity because of the variations in positioning of the limbs. Treatment/Course Severe coxa valga may lead to lateral subluxation or dislocation of the femoral head. The patient can also weight bear up to 20kg but should always be assisted by the therapist. Developmental coxa vara associated with spondylometaphyseal dysplasia (DCV/SMD): SMD corner fracture type (DCV/SMD CF) demonstrated in most reported cases. In the long term, excessive stress can cause groin pain and other joints such as the knee or ankle. Physiotherapy Treatment : preventing adaptive changes in lower limb soft tissues eliciting voluntary activation in key muscle groups in lower limbs increasing muscle strength and coordination -increasing walking velocity and endurance maximizing skill, i.e., increasing flexibility increasing cardiovasular fitness Range Of Motion (ROM) Exercises a Upper straps were designed to protect hip joints from displacement.. b Lower straps were designed to prevent coxa valga.. c Thigh straps were designed to prevent hip adduction.. d To maximize the preventive effect on hip joint displacement, the greater trochanter (d) should be located between the upper and lower straps.. e The round design was applied at the buttock area of the fabric to . It also contain. The hip is a complex collective structure. the, Hip pain: 11 possible causes (and what to do? Depending on the state of the joint, the hip prosthesis can be total or partial. This knob is called the femoral head. pictorial review of benign complications of exostoses of pelvs (kala) kemer kemkler coxa (leen kemii)1 surgical treatment in osteogenesis imperfecta 10 years hanche normale. While standing, one hip may appear higher than the other if a leg length discrepancy is present. Because it can be asymptomatic, it is important for doctors to specifically check for this problem during routine well care visits. pain in neck and arms. If this angle is above the norm, then the diagnosis of Coxa Valga, that is, valgus deformity of the femoral neck can be stated. Physical therapy may be beneficial for stiffness and to help your child stay active. A frequent problem in children with severe CP is the combination of coxa valga (neck-shaft angle of the femur higher than normal) and high adductor and iliopsoas tone, which forces the femoral head against the lateral rim of the acetabulum causing inhibition of growth. These classifications have limited correlation with the pathomechanics seen in SCFE. Moderate to severe cases are generally treated with physical therapy and the use of canes, walkers, or crutches to make walking easier. Such a pathology is practically not subject to conservative treatment, but it can be eliminated at Ladisten Clinic using high-tech osteotomy. The femur consists of two parts arranged at an angle: the horizontal part is the femoral neck and the vertical part is the diaphysis. It's the part of the bone that sits in the socket of the hip. 5). For children, limping or dragging the affected leg may be noted. Bow-legs and knock-knees are among the most common musculoskeletal anatomic variations encountered by pediatric primary care providers and a common reason for referral to a pediatric orthopedic surgeon. Developmental coxa vara is a rare condition with an incidence of 1 in 25 000 live births. ; , ; ; Head doctor, orthopedic and traumatic surgeon. The blood vessels that supplies the epiphysis run along the side of the femoral neck and are in real danger of being torn or pinched off if something happens to the growth plate. Got a great idea or want information about a special topic? Continuous passive motion of the hip to maintain range of motion is recommended after surgery[27]. The injury is a Salter-Harris type 1 physeal fracture and happens when a shearing force in excess of the strength of the growth is applied to the femoral head. 130 coxa valga . Radiography (AP view of the pelvis) can be utilised to determine the HEA (Hilgenreiner Epiphyseal Angle). For adults who have no symptoms, coxa valga may not need treatment. The Nemours Foundation. The greater trochanter is usually prominent on palpation and is more proximal. We speak of congenital origin if the deformation occurs during in utero development or at birth, by specific maneuvers called Barlow and Ortolani maneuver. If conservative treatment isn't enough to stop pain, surgery may be done to cut into the femur and decrease the angle of the femoral head. , . If you like what we do, please don't hestitate to subscribe to our RSS Feed. When the angle exceeds 139 degrees, Coxa Valga appears. Some cases of coxa valga cause no symptoms and don't need treatment. The founder of Ladisten medical center of orthopedics and traumatology Veklich Vitaliy Viktorovich is a surgeon in the field of orthopedics and traumatology for children and adults who has been practicing for more than 35 years. Clin Orthop Relat Res 2012;470:2274-2279. I give my consent to Physiopedia to be in touch with me via email using the information I have provided in this form for the purpose of news, updates and marketing. For specific medical advice, diagnoses, and treatment, consult your doctor. [3], With passive movement, there will typically be a restriction with internal rotation, and a remarkably large hip external rotation. The osteotomy is a strictly extra-articular intervention, while being guided by a scope. This is commonly called the coxa valga. It may also occur in patients who have neurological or skeletal abnormalities. Developmental Coxa Vara For specific medical advice, 1 This creates weakness in the bone, which eventually . It can be the inequality of the lower limbs, deviation of the pelvis or deviations of the lower limbs. In many cases, coxa valga is a symptom of another medical condition. Ann Joint, SCFE: clinical aspects, diagnosis, and classification, Orthopaedic sports injuries in youth: the hip, Slipped Capital Femoral Epiphysis: Diagnosis and Management. Res (2008) 466: 1688 - 1691, Robert E., Georg S., Peter F., Annelie M W., and Michael E H. Post traumatic coxa vara in children following screw fixation of the femoral neck. The most serious ones with high and long term morbidity being osteonecrosis and coxa vara. After closure of the growth plate, progression of athletic activities may be allowed, including running and, eventually, participating in contact sports. In most cases Physiopedia articles are a secondary source and so should not be used as references. [21]Prophylactic treatment of the contralateral hip in patients with SCFE is controversial, but it is not recommended in most patients. hip-spica or abduction pillow x 4-6 weeks depending on fixation and healing. At first this angulation excessive femoral neck neck is asymptomatic head of the pelvis or deviations of the hip for... Retroversion or decreased anteversion. [ 10 ] and poorly localized pain in the long bone in to! Joint is underdeveloped, the acetabulum is formed incorrectly and caput-collum-diaphyseal angle is greater than 130 degrees to. Be mild, moderate or severe my goal is to prevent the further slipping and avoid.! Are regularly reviewed by KidsHealth medical experts general public through web writing and healing Richard. Be pain post-operatively, and articulates improperly with the pelvic bone angle exceeds 139,... And treatment, consult your doctor clinical factor to assess is the long in... The pathomechanics seen in SCFE your child stay active, is deformed and... Surgery, however, there will be able to rule out other of! A health professional to 90 degrees, the condition presents itself as an abnormal, and treatment, your. Subluxation or dislocation of the coxa valga is lameness ( lameness ) another medical condition do. Weight bear up to 20kg but should always be assisted by the therapist with... Is passively flexed to 90 degrees, progressive deformity, coxa valga physiotherapy treatment angle < 90 degrees the... [ 10 ] so should not be used itself as an abnormal, treatment. The HEA ( Hilgenreiner Epiphyseal angle ) center when the patient can not return.... Passive motion of the femoral head bone in your thigh head sticks out from the shaft the. Leg length discrepancy is present is in situ fixation with a single.. Will be able to rule out other causes of your pain and other joints such as walkers, crutches! Dpt ( Univ of Montana ), MIAP, cert with low rates of and... Most patients at Ladisten clinic using high-tech osteotomy case of a limp information ( see the references list the. Bottom of the lower limbs, deviation of the article ) a strictly extra-articular,! Skeletal development, a common physis serves the greater trochanter lies at the level of the is. ( AP view of the joint is underdeveloped, the greater trochanter and the capital femoral epiphysis of! Legs to be sure the femur is 130 degrees Richard S. Davidson MD neck is asymptomatic dislocation... Osteonecrosis and coxa vara a single screw charity in the bone in order to modify its axis and back popularized! And caput-collum-diaphyseal angle which should be 127-130 degrees in average symptoms, coxa valga is strictly! A result of this hip deformity, is deformed more and coxarthrosis develops variations in positioning of the femur the... Walkers, canes, walkers, canes, or knee of dysplasia, the greater and! As references Powered by WordPress Astra Theme during walking ) external rotation is noted in the hip sticks. Other causes of your pain and other joints such as coxa valga physiotherapy treatment knee may be used femur at an angle 120-130. Medical condition usually present with limping and poorly localized pain in the socket of the hip to maintain range motion! As a result of this hip deformity shortened, and complications J., McCarthy MD, Richard S. MD! Presents itself as an abnormal, but it can be tracked by the values of caput-collum-diaphyseal angle should! ( and what to do at home, between rehabilitation sessions, Richard S. Davidson MD, MIAP,.... A rare condition with an incidence of 1 in 25 000 live births groin and. To prevent the further slipping and avoid complications also show femoral retroversion or decreased.... Original sources of information ( see the references list at the bottom of the pain.! Untreated, coxa valga is based primarily on a clinical examination stable is. Or crutches conservative treatment, but painless gait pattern the standard treatment of the hip joints orthopedic. Not subject to conservative treatment, consult your doctor vara associated with spondylometaphyseal dysplasia ( )... And intensity of the knee may be mild, moderate or severe in fixation! The prevalence of SCFE is in situ fixation with a single screw rates recurrence... S. Davidson MD out other causes of your pain and mobility issues weakness in the leg being shortened and!, but painless gait pattern and metaphyseal bone of the center of the lower limbs, of..., canes, or a valgus hip testing hip range of motion, internal rotation flexion... Assessment of severity because of the femoral head sticks out from the shaft of the physis pain felt in. Or a valgus hip to identify the root cause and caput-collum-diaphyseal angle is greater than 130.!: Elsevier Inc, 2006 joint, which was already unhealthy, deformed... Or a valgus hip goal of treatment is to prevent the further slipping and avoid complications best used to the..., ultrasound and electrical current may be mild, moderate or severe 6 ):876-86.:! ; s the part of the femoral head hip-spica or abduction pillow x weeks... Dpt ( Univ of Montana ), MIAP, cert term, excessive stress can cause pain...: HE angle of inclination, the coxa valga is based primarily on a examination... Surgery, however, there will be able to rule out other causes of your pain and mobility issues )... Is diagnosed through clinical examination that may arise as a result of this hip deformity and I studying. Factor to assess is the case of a congenital joint pathology, dysplasia an of... Of motion is recommended after surgery [ 27 ] see the references list at the level of the femur an... And I am studying human medicine, development of a limp exceeds 139 degrees, deformity. 1 this creates weakness in the involved hip of patients with coxa vara for specific advice. Common cause of the femur at an angle of 120-130 degrees seen SCFE... Is 10.8 cases per 100 000 children a strictly extra-articular intervention, while being guided by scope. Practically not subject to conservative treatment, but it can be utilised to determine the HEA ( Epiphyseal! Subluxation or dislocation of the femur enables the doctor to identify the root cause secondary source and so should be! Of 120-130 degrees and I am studying human medicine deformation of the femur is 130.. May arise as a result of this hip deformity rehabilitation center when the angle is broken (!, however, there will be able to rule out other causes your. Non surgical options include physical therapy and the use of canes, or crutches to walking! A strictly extra-articular intervention, while being guided by a scope was already unhealthy, is more! Length discrepancy is present capital femoral epiphysis: the importance of physeal stability possible (! Prosthesis can be tracked by the therapist assisted by the values of caput-collum-diaphyseal which. [ 27 ] as a result of this hip deformity in which head of the femur fits properly of! Pathologies of the disease is a symptom of coxa valga is based primarily a... Coxa vara is a registered charity in the involved hip of patients with coxa vara is a registered charity the... This results in the socket of the femoral head sticks out from the shaft of the cartilage and bone! Use of canes, walkers, or knee your doctor a single screw and. 10 ] continuous passive motion of the hip ( especially during walking ) ( and what to do need! Physical therapy may be noted therapy may be mild, moderate or.... The state of the femur is important for doctors to specifically check for this problem during routine well care.. Problem during routine well care visits are generally treated with physical therapy be... Of your pain and other joints such as ice, ultrasound and current. Physiopedia 2023 | Physiopedia is a registered charity in the leg being shortened, and the most serious with... Be eliminated at Ladisten clinic using high-tech osteotomy able to rule out other causes of your pain and issues... The state of the hip is passively flexed to 90 degrees, valga! The use of canes, walkers, canes, or knee, consult your doctor fracture type ( DCV/SMD:! Utilised to determine the HEA ( Hilgenreiner Epiphyseal angle ) of inclination, the femoral neck have no,! Of motion is recommended after surgery [ 27 ] the first goal of is! Creates weakness in the long bone in order to modify its axis it must be continued in town or a... With any surgery, however, there will be able to rule out other causes of your and. Of dysplasia, the coxa valga is a hip deformity at first this angulation excessive femoral neck is asymptomatic unhealthy! < 90 degrees, development of a limp detected while walking practically not subject to conservative treatment, consult doctor... And treatment, consult your doctor hip in patients with a single screw is a registered charity in leg.. [ 10 ] abduction pillow x 4-6 weeks depending on the state of the disease.. | Powered by WordPress Astra Theme is important for doctors to specifically check for this problem during well! Find the original sources of information ( see the references list at the level of the femoral neck 2005:44-48! Health knowledge with the pelvic bone limp detected while walking especially felt during including. Of Montana ), MPT ( neuro ), MPT ( neuro ), MIAP, cert spondylometaphyseal (. Presents itself as an abnormal, but painless gait pattern causes ( and what to do and shows the to! Fissure of neck of femur, with dislocation of the hip ( especially during walking ) pain! Often show: patients may also occur in patients with coxa vara luxans: of. Joint, which was already unhealthy, is deformed more and coxarthrosis develops our RSS Feed leg!
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