ymjЯкутский медицинский журналYakut Medical Journal1813-19052312-1017ЯНЦ КМП10.25789/YMJ.2018.62.35ymj-1284Research ArticleНАУЧНЫЕ ОБЗОРЫ И ЛЕКЦИИSCIENTIFIC REVIEWS AND LECTURESСовременное состояние вопроса об инъекционной терапии повреждений и заболеваний коленного суставаThe current issue of the injectable therapy of the knees injuries and diseasesАйрапетовГ. А.AirapetovG. A.

Airapetov Georgii Alexandrovich – docent of the department of traumatology and orthopedics, candidate of the medical sciences

(89624466728)

StavropolRussia. 

airapetovGA@yandex.ruВоротниковА. А.VorotnikovA. A.

Vorotnicov Alexandr Anatolievich – head of the department of traumatology and orthopedics, doctor of the medical sciences, professor

Stavropol

vorotnikovaa@mail.ruКоноваловЕ. А.KonovalovE. A.

Konovalov Evgeniy Alexandrovich – assistant of the department of traumatology and orthopedics

Stavropol. Russia

Konovalov_Evg@mail.ruАйрапетоваЛ. В.AirapetovaL. V.

Airapetova Lilit Viacheslavovna – resident of the department of gynecology and obstetrics

Stavropol

Airapetovalv@mail.ruSSMURussian FederationSSMU Russian Federation20180909202502114116Copyright © Айрапетов Г.А., Воротников А.А., Коновалов Е.А., Айрапетова Л.В., 20252025Айрапетов Г.А., Воротников А.А., Коновалов Е.А., Айрапетова Л.В.Airapetov G.A., Vorotnikov A.A., Konovalov E.A., Airapetova L.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://ymj.elpub.ru/jour/article/view/1284

По данным литературы, остеоартрозом страдает от 9 до 13% населения планеты. неправильное или несвоевременное лечение может довольно быстро приводить к агрессивным хирургическим вмешательствам. В статье описаны современные подходы к инъекционной терапии повреждений и заболеваний коленного сустава.

Today, there is a high significance of the consequences of injuries and diseases of the musculoskeletal system economically, medically and socially because of the high costs of treatment and rehabilitation, as well as a long period of incapability to treatment or permanent disability. There is a significant increase in the incidence of degenerative-dystrophic diseases of large joints everywhere. According to the literature, 9 to 13% of the world’s population suffers from osteoarthritis. Incorrect or untimely treatment can quickly lead to aggressive surgical interventions. The article describes modern approaches to injectable therapy of the knees injuries and diseases.

гонартрозконсервативное лечение остеоартрозагиалуроновая кислотаплазмаобогащенная тромбоцитамиgonarthrosisconservative treatment of osteoarthritishyaluronic acidplate rich plasmReferencesБагирова Г.Г. Избранные лекции по ревматологии: учеб. пособие / Г.Г. багирова. – М.: Медицина, 2008. – С. 253.Bagirova G. G. Izbranny`e lekcii po revmatologii: ucheb. Posobie [Selected lectures on rheumatology: manual]. Izdanie Moskow: Medicina, 2008, p. 253.Каледа М.И. Современный взгляд на внутрисуставное применение глюкокортикоидов в комплексной терапии ювенильных артритов / М.И. Каледа, И.П. никишина // Педиатрия. журнал им. Г.Н. Сперанского. – 2016. – № 95. – С. 55-64.Kaleda M.I. Nikishina I.P. Sovremenny`j vzglyad na vnutrisustavnoe primenenie glyukokortikoidov v kompleksnoj terapii yuvenil`ny`x artritov [modern view to the intraarticular injection of glucocorticoids in complex treatment of juvenile osteoarthritis]. Pediatriya. Zhurnal im. G.N. Speranskogo, 2016, № 95, p. 55-64.Мазуров В.И. Остеоартроз: учеб. / В.И. Мазуров, И.а. Онущенко. – СПб., 1999. – С.116.Mazurov V. I., Onushhenko I. A. Osteoartroz: ucheb. [Osteoarthritis]. Izdanie SPb, 1999, p. 116.Маланин Д.А. Обогащенная тромбоцитами аутологичная плазма в лечении пациентов с гонартрозом III стадии / Д.А. Маланин, В.В. Новочадов, С.А. Демкин [и др.] // Травматология и ортопедия России. – 2014. – №3 (73). – С.52-59.Malanin D.A., Novochadov V.V., Demkin S.A., i dr. Obogashhennaya trombocitami autologichnaya plazma v lechenii pacientov s gonartrozom III stadii [Platelet rich plasma for treatment the patients with osteoarthritis 3 gr]. Travmatologiya i ortopediya Rossii, 2014, 3 (73), p. 52-59.Насонова В.А. Ревматические заболевания в российской Федерации в начале XXI века глазами статистики / В.А. Насонова, О.М. Фоломеева, Ш.Ф. Эрдес // Тер. архив. – 2009. – №81(6). – С. 5-10.Nasonova V.A., Folomeeva O.M., E`rdes Sh.F. Revmaticheskie zabolevaniya v Rossijskoj Federacii v nachale XXI veka glazami statistiki [Rheumatoid disease in Russia Federation at the beginning XXI statistic review]. Ter. Arxiv, 2009, 81(6), p. 5-10.Химич С.Д. Местное применение хондропротекторов в комплексном лечении гонартроза І–ІІ степени / Химич С.Д. // Медицина транспорта Украины. – 2010. – 1. – С. 53–56.Ximich S. D. Mestnoe primenenie xondroprotektorov v kompleksnom lechenii gonartroza І–ІІ stepeni [Local application of the chondroprotectors in complex treatment of the osteoarthritis 1-2 gr]. Medicina transporta Ukrainy, 2010, p. 53–56.Хитров Н.А. Полиморфизм болевого синдрома при остеоартрозе, обезболивающая и противовоспалительная терапия / Н.А. Хитров // Трудный пациент. – 2011. – №9(4). – С.49–53.Xitrov N. A. Polimorfizm bolevogo sindroma pri osteoartroze, obezbolivayushhaya i protivovospalitel`naya terapiya [polymorphism of the pain syndrome in osteoarthritis, analgesic and anti-inflammatory]. Trudny`j pacient, 2011, 9 (4), p. 49–53.Чичасова Н.В. Клиническое обоснование применения различных форм препарата терафлекс при остеоартрозе / Н.В. Чичасова // Современная ревматология. – 2010. - №4. – С.59–64.Chichasova N. V. Klinicheskoe obosnovanie primeneniya razlichny`x form preparata terafleks pri osteoartroze [The clinical Rationale for the use of various forms of teraflex of osteoarthritis]. Sovremennaya Revmatologiya, 2010, 4, p. 59–64.Albert W. Tucker. The Evaluation of refrigerated and Frozen Osteochondral Allografts in the Knee / Albert W. Pearsall, Sudhakar G. Madanagopal, Joseph A. // Tucker Surgical Science. – 2011. – 2. – P. 232-241.Albert W. Tucker. The Evaluation of refrigerated and Frozen Osteochondral Allografts in the Knee Albert W. Pearsall, Sudhakar G. Madanagopal, Joseph A. Tucker Surgical Science, 2011, 2, p. 232- 241.Andia I. Platelet-rich plasma: underlying biology and clinical correlates /Andia I, Abate M. // Regen Med. – 2013. – 8(5). – P. 645-658.Andia I. Platelet-rich plasma: underlying biology and clinical correlates Andia I, Abate M. Regen Med, 2013, 8(5), p. 645-658.Andia I. Knee osteoarthritis: hyaluronic acid, platelet-rich plasma or both in association? Expert / Andia I, Abate M. // Opin Biol Ther. – 2014. – 14(5). – P. 635-649.Andia I. Knee osteoarthritis: hyaluronic acid, platelet-rich plasma or both in association? Expert Andia I, Abate M. Opin Biol Ther, 2014, 14(5), p. 635-649.Andia I. Platelet-rich plasma for managing pain and inflammation in osteoarthritis. Nat Rev Rheumatol /Andia I, Maffulli N. // 2013. – 9(12). – P. 721-730.Andia I. Platelet-rich plasma for managing pain and inflammation in osteoarthritis. Nat Rev Rheumatol Andia I, Maffulli N, 2013, 9(12), p. 721-730.Bannuru R.R. Therapeutic trajectory following intra-articular hyaluronic acid injection in knee osteoarthritis-meta-analysis / Bannuru R.R., Natov N.S., Dasi U.R. // Osteoarthritis Cartilage. – 2011. – 19(6). – P. 611-619.Bannuru R.R. Therapeutic trajectory following intra-articular hyaluronic acid injection in knee osteoarthritis-metaanalysis Bannuru R.R., Natov N.S., Dasi U.R. Osteoarthritis Cartilage, 2011, 19(6), p. 611-619.Bannuru R.R. Therapeutic trajectory of hyaluronic acid versus corticosteroids in the treatment of knee osteoarthritis: a systematic review and meta-analysis / Bannuru R.R., Natov N.S., Obadan I.E. [et al.] // Arthritis Rheum. – 2009. – 61. – P. 1704-1711.Bannuru R.R. Therapeutic trajectory of hyaluronic acid versus corticosteroids in the treatment of knee osteoarthritis: a systematic review and meta-analysis Bannuru R.R., Natov N.S., Obadan I.E., et al. Arthritis Rheum, 2009, 61, p. 1704-1711.Bellamy N. Viscosupplementation for the treatment of osteoarthritis of the knee / Bellamy N, Campbell J, Robinson V. // Cochrane Database Syst Rev. – 2006. – 2. – P. 118-124.Bellamy N. Viscosupplementation for the treatment of osteoarthritis of the knee. Bellamy N, Campbell J, Robinson V. Cochrane Database Syst Rev, 2006, 2, p. 118-124.Bozic K.J. Medicare and the orthopaedic surgeon: challenges in Providing, Financing, and Accessing Muscoskeletal care for the elderly / Bozic K.J., Cramer B., Albert T.J. // Bone Joint surg [Am]. – 2010. – 92. – P. 1568-1574.Bozic K. J. Medicare and the orthopaedic surgeon: challenges in Providing, Financing, and Accessing Muscoskeletal care for the elderly Bozic K. J., Cramer B., Albert T. J. Bone Joint surg [Am], 2010, 92, p. 1568– 1574.Castaneda S. Subchondral bone as a key target for osteoarthritis treatment / Castaneda S., Roman-Blas J.A., Largo R. // Biochem Pharmacol. – 2012. – 83(3). – P. 315–23.Castaneda S. Subchondral bone as a key target for osteoarthritis treatment Castaneda S, Roman-Blas JA, Largo R. Biochem Pharmacol, 2012, 83(3), p. 315– 23.Chang K.V. Comparative effectiveness of platelet-rich plasma injections for treating knee joint cartilage degenerative pathology: a systematic re-view and meta-analysis / K.V. Chang, C.Y. Hung, F. Aliwarga [et al.] // Arch Phys Med Rehabil. – 2014. – 95(3). – P.562-575.Chang K.V. Comparative effectiveness of platelet-rich plasma injections for treating knee joint cartilage degenerative pathology: a systematic review and meta-analysis Chang K.V, Hung CY, Aliwarga F, et al Arch Phys Med Rehabil, 2014, 95(3), p. 562-575.Chen W.H. Synergistic anabolic actions of hyaluronic acid and platelet-rich The Conservative Management of Osteoarthritis — Hyaluronic Acid, Platelet Rich Plasma or the Combination// Chen W.H, Lo W.C, Hsu W.C [et al.] / Bioma-terials. – 2014. – 35(36). – P. 9599-9607.Chen W.H. Synergistic anabolic actions of hyaluronic acid and plateletrich The Conservative Management of Osteoarthritis — Hyaluronic Acid, Platelet Rich Plasma or the Combination Chen W.H, Lo W.C, Hsu W.C, et al. Biomaterials, 2014, 35(36), p. 9599-9607.Duymus T.M. «Choice of intra-articular injection in treatment of knee osteoarthritis: platelet-rich plasma, hyaluronic acid or ozone options» / Duymus T.M., S. Mutlu, B. Dernek // Knee Surgery, Sports Traumatology, Arthroscopy. – 2016. – 2. – P. 122-128.Duymus T. M. Choice of intraarticular injection in treatment of knee osteoarthritis: platelet-rich plasma, hyaluronic acid or ozone options. Duymus T. M., S. Mutlu, B. Dernek Knee Surgery, Sports Traumatology, Arthroscopy, 2016, 2, p. 122-128.Goldring M.B. Osteoarthritis / Goldring M.B., Goldring S.R. // J. CellPhy-siol. – 2007. – 213 (3). – P. 626–34.Goldring M. B. Osteoarthritis Goldring M. B., Goldring S.R. J. CellPhysiol, 2007, 213 (3), p. 626–34.Guler O. Comparison of short-term results of intraarticular platelet-rich plasma (PRP) and hyaluronic acid treatments in early-stage gonarthrosis patients / O. Guler, S. Mutlu, M. Isyar // Eur. J. Orthop Surg Traumatol. – 2014. – 5. –P.84-89.Guler O. Comparison of short-term results of intraarticular platelet-rich plasma (PRP) and hyaluronic acid treatments in early-stage gonarthrosis patients Guler O, Mutlu S, Isyar M. Eur. J. Orthop Surg Traumatol, 2014, 5, p. 84-89.Hsieh Y.S. Effects of different molecular weight hyaluronan products on the expression of urokinase plasminogen activator and inhibitor and gelatinases during the early stage of osteoarthritis / Hsieh Y.S., Yang S.F., Lue K.H. [et al.]// J. Orthop Res. – 2008. – 26. – P. 475-484.Hsieh Y. S. Effects of different molecular weight hyaluronan products on the expression of urokinase plasminogen activator and inhibitor and gelatinases during the early stage of osteoarthritis Hsieh Y. S., Yang S.F., Lue K.H., et al. J. Orthop Res, 2008, 26, p. 475-484.Khoshbin A. The efficacy of plateletrich plasma in the treatment of symptomatic knee osteoarthritis: a systematic review with quantitative synthesis/ Khoshbin A., Leroux T., Wasserstein D. [et al.] // Arthroscopy. – 2013. – 29(12). – P. 2037-2048.Khoshbin A. The efficacy of platelet-rich plasma in the treatment of symptomatic knee osteoarthritis: a systematic review with quantitative synthesis Khoshbin A, Leroux T., Wasserstein D., et al. Arthroscopy, 2013, 29(12), p. 2037-2048.Maheu E. Efficacy and safety of hyaluronic acid in the management of osteoarthritis: evidence from real-life setting trials and surveys / Maheu E., Rannou F. // Seminars in Arthritis and Rheumatism. – 2016. – 45. – P. 28–33.Maheu E. Efficacy and safety of hyaluronic acid in the management of osteoarthritis: evidence from real-life setting trials and surveys Maheu E., Rannou F. Seminars in Arthritis and Rheumatism, 2016, 45, p. 28–33.Miller L.E. US-Approved Intra-Articular Hyaluronic Acid Injections are Safe and Effective in Patients with Knee Osteoarthritis: Systematic Review and MetaAnalysis of Randomized, Saline-Controlled Trials / Miller L.E., Block J.E.// Clin Med Insights Arthritis Musculoskelet Disord. – 2013. – 6. – P. 57-63.Miller L. E. US-Approved IntraArticular Hyaluronic Acid Injections are Safe and Effective in Patients with Knee Osteoarthritis: Systematic Review and MetaAnalysis of Randomized, SalineControlled Trials Miller L. E., Block J.E. Clin Med Insights Arthritis Musculoskelet Disord, 2013, 6, p. 57-63.Pourcho A.M. Intraarticular PlateletRich Plasma Injection in the Treatment of Knee Osteoarthritis: Review and Recommendations / Pourcho A.M., Smith J., Wisniewski S.J. // Am J Phys Med Rehabil. – 2014. – 4. – P. 54-58.Pourcho A.M. Intraarticular Platelet-Rich Plasma Injection in the Treatment of Knee Osteoarthritis: Review and Recommendations Pourcho A.M., Smith J., Wisniewski S.J. Am J Phys Med Rehabil, 2014, 4, p. 54-58.Raynauld J.P. Safety and effi-cacy of longterm intraarticular steroid injections in osteoarthritis of the knee: a randomized, doubleblind, placebo-controlled trial / Raynauld J.P., Buckland-Wright C., Ward R. [et al.] // Arthritis Rheum. – 2003. – 48. – P. 370-377.Raynauld J. P. Safety and efficacy of longterm intraarticular steroid injections in osteoarthritis of the knee: a randomized, double-blind, placebo-controlled trial Raynauld J. P., Buckland-Wright C., Ward R., et al. Arthritis Rheum, 2003, 48, p. 370-377.Rodriguez-Merchan E.C. Intraarti-cular Injections of Platelet-rich Plasma (PRP) in the Management of Knee Osteoarthritis / RodriguezMerchan E.C. // Arch Bone Jt Surg. – 2013. – 1. – P. 5-8.Rodriguez-Merchan E.C. Intraarticular Injections of Platelet-rich Plasma (PRP) in the Management of Knee Osteoarthritis Rodriguez-Merchan E.C. Arch Bone Jt Surg, 2013, 1, p. 5-8.Sinusas K. Osteoarthritis: diagno-sis and treatment / Sinusas K. // Am Fam Physician. – 2012. – 85. – P. 49-56.Sinusas K. Osteoarthritis: diagnosis and treatment Sinusas K. Am Fam Physician, 2012, 85, p. 49-56.Strand V. A multicenter, randomi-zed controlled trial comparing a single intra-articular injection of Gel-200, a new cross-linked formulation of hyaluronic acid, to phosphate buffered saline for treatment of osteoarthritis of the knee / Strand V., Baraf H.S., Lavin P.T. // Osteoarthritis Cartilage. – 2012. – 20. – P.350-356.Strand V. A multicenter, randomized controlled trial comparing a single intra-articular injection of Gel-200, a new cross-linked formulation of hyaluronic acid, to phosphate buffered saline for treatment of osteoarthritis of the knee Strand V., Baraf H. S., Lavin P. T. Osteoarthritis Cartilage, 2012, 20, p. 350-356.Z´oboli A.A. Prospective randomized clinical trial single and weekly viscosupplementation / Z´oboli A.A., Rezende M.U., Campos G.C. // Acta Ortopedica Brasileira. – 2013. – 21(5). – P.271–275.Z´oboli A.A. Prospective randomized clinical trial single and weekly viscosupplementation Z´oboli A.A., Rezende M.U., Campos G.C. Acta Ortopedica Brasileira , 2013, 21(5), p. 271–275.

The authors declare that there are no conflicts of interest present.