Технологии стимуляции репаративных процессов у детей с рассекающим остеохондритом коленного сустава. Обзор литературы
- Авторы: Плигина Е.Г.1,2, Керимова Л.Г.2, Буркин И.А.2, Ковалюнас И.С.1,2
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Учреждения:
- Научно-исследовательский клинический институт педиатрии и детской хирургии им. акад. Ю.Е. Вельтищева Российского национального исследовательского медицинского университета им. Н.И. Пирогова
- Детская городская клиническая больница № 9 им. Г.Н. Сперанского
- Выпуск: Том 12, № 2 (2022)
- Страницы: 187-200
- Раздел: Обзоры
- URL: https://bakhtiniada.ru/2219-4061/article/view/123592
- DOI: https://doi.org/10.17816/psaic1006
- ID: 123592
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Аннотация
Рассекающий остеохондрит коленного сустава, болезнь Кенига, — заболевание коленного сустава, результирующееся нарушением конгруэнтности суставных поверхностей и остеоартрозом. Частота встречаемости заболевания достигает 15 % в структуре патологии коленного сустава у детей. Сравнительная эффективность различных методов лечения детей с болезнью Кенига, от консервативной терапии до ортобиологических технологий, — актуальный предмет дискуссий специалистов.
Оценена эффективность современных методов лечения детей с болезнью Кенига и установлены ведущие тенденции использования биотехнологии для дальнейших экспериментальных и клинических исследований.
Поиск литературы проведен в электронных базах PubMed, Web of Science, Scopus, MEDLINE, eLibrary, РИНЦ, Cyberleninka. Анализу подвергнуты 2300 ссылок, просмотрено 283 статьи, отобрано в обзор 90 публикаций по ортопедии и биотехнологии.
Показания к консервативному лечению у детей с болезнью Кенига в настоящее время ограничены I–II стадией процесса. Хирургические методы занимают доминирующее положение при необходимости купирования болей и стимуляции регенерации патологического очага. Однако отдаленные результаты терапии свидетельствуют о замещении зоны некроза грубоволокнистой соединительной тканью, значительно уступающей гиалиновому хрящу по биомеханическим характеристикам, что определяет высокий риск развития остеоартроза. Активно развивающееся направление ортобиологии позволяет с использованием собственных тканей пациента активировать процессы репаративной регенерации с купированием клинических проявлений и благоприятными непосредственными результатами.
В соответствии с установленными тенденциями развития регенераторной медицины, фокус внимания исследователей смещен в плоскость ортобиологических технологий, обеспечивающих высокую долю благоприятных непосредственных результатов вмешательств. Однако ограниченное количество публикаций и отсутствие отдаленных результатов терапии не соответствуют критериям доказательности эффективности технологий.
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Елена Григорьевна Плигина
Научно-исследовательский клинический институт педиатрии и детской хирургии им. акад. Ю.Е. Вельтищева Российского национального исследовательского медицинского университета им. Н.И. Пирогова; Детская городская клиническая больница № 9 им. Г.Н. Сперанского
Автор, ответственный за переписку.
Email: elenapligina@mail.ru
ORCID iD: 0000-0002-8508-7349
SPIN-код: 5309-0417
канд. мед. наук, ст. научн. сотр. отдела хирургии детского возраста, врач – травматолог-ортопед
Россия, Москва; МоскваЛейла Гадировна Керимова
Детская городская клиническая больница № 9 им. Г.Н. Сперанского
Email: Leila.kerimova@yahoo.com
ORCID iD: 0000-0002-4399-7002
SPIN-код: 8245-1046
врач – травматолог-ортопед
Россия, МоскваИгорь Александрович Буркин
Детская городская клиническая больница № 9 им. Г.Н. Сперанского
Email: iburkin@mail.ru
ORCID iD: 0000-0003-0328-1963
SPIN-код: 5524-0651
канд. мед. наук, заведующий отделением травматологии
Россия, МоскваИгорь Станиславович Ковалюнас
Научно-исследовательский клинический институт педиатрии и детской хирургии им. акад. Ю.Е. Вельтищева Российского национального исследовательского медицинского университета им. Н.И. Пирогова; Детская городская клиническая больница № 9 им. Г.Н. Сперанского
Email: igorkovalyunas@mail.ru
ORCID iD: 0000-0002-9411-4062
SPIN-код: 1105-6393
научн. сотр. отдела хирургии детского возраста, врач-хирург детский
Россия, Москва; МоскваСписок литературы
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