vestimИзвестия Национальной академии наук Беларуси. Серия медицинских наукProceedings of the National Academy of Sciences of Belarus, Medical series1814-60232524-2350The Republican Unitary Enterprise Publishing House "Belaruskaya Navuka"10.29235/1814-6023-2018-15-4-429-441vestim-458Research ArticleКЛИНИЧЕСКАЯ И ЭКСПЕРИМЕНТАЛЬНАЯ МЕДИЦИНАCLINICAL AND EXPERIMENTAL MEDICINEКлеточные технологии в лечении некроза головки бедренной костиCell technologies in the treatment of femoral head osteonecrosisМурзичА. Э.MurzichA. E.

канд. мед. наук, заведующий лабораторией

Ph. D. (Med.), Head of the Department

mae77@list.ruЭйсмонтО. Л.EismontO. L.

д-р мед. наук, доцент, заместитель директора

D. Sc. (Med.), Assistant Professor, Deputy director

oleismont@mail.ruИсайкинаЯ. И.IsaykinaJ. I.

канд. биол. наук, заведующий лабораторией

Ph. D. (Biol.), Head of the Laboratory

yaninai@gmail.comБукачД. В.BukachD. V.

науч. сотрудник

Researcher

dzmitry.bukach@gmail.comСироткинР. С.SirotkinR. S.

мл. науч. сотрудник

Researcher

rafaello.84@mail.ruРеспубликанский научно-практический центр травматологии и ортопедии, МинскRepublican Scientific-Practical Centre of Traumatology and Orthopedics, MinskРеспубликанский научно-практический центр детской онкологии, гематологии и иммунологии, д. Боровляны, Минский районRepublican Research Center for Pediatric Oncology, Hematology and Immunology, Borovliany, Minsk Region201814012019154429441Copyright © Мурзич А.Э., Эйсмонт О.Л., Исайкина Я.И., Букач Д.В., Сироткин Р.С., 20192019Мурзич А.Э., Эйсмонт О.Л., Исайкина Я.И., Букач Д.В., Сироткин Р.С.Murzich A.E., Eismont O.L., Isaykina J.I., Bukach D.V., Sirotkin R.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vestimed.belnauka.by/jour/article/view/458

Представлен аналитический обзор литературы и проанализированы собственные результаты хирургического лечения пациентов с остеонекрозом головки бедра у взрослых с применением малоинвазивных технологий. С помощью клинических шкал, рентгенографии, МРТ оценено состояние тазобедренного сустава 46 пациентов, которым была выполнена «core» декомпрессия в сочетании с костной пластикой (группа А, 31 пациент) и с применением мононуклеарных клеток костного мозга (группа Б, 15 пациентов). Процент прогрессирования остеонекроза в течение периода наблюдения до 3 лет в группе А был выше, чем в группе Б, где был использован концентрат костного мозга (38,7 и 26,7 % соответственно). Использованные методы лечения остеонекроза головки бедра малотравматичны, не имеют осложнений и позволяют отдалить выполнение эндопротезирования тазобедренного сустава. Применение аутологичных клеток костного мозга в дополнение к декомпрессии очага некроза создает предпосылки для улучшения результата костной регенерации некротической области.

The review of the literature data and our results of surgical treatment of femoral head osteonecrosis in adult patients with the minimally invasive technologies are presented in this article. Using clinical scales, X-rays, MRI, the hip joint condition of 46 patients who underwent “core” decompression in combination with bone plastic (group A, 31 patients) and bone marrow mononuclear cells (group B, 15 patients) were evaluated. The percentage of osteonecrosis progression during the observation period up to 3 years in group A was higher than in group B, where the bone marrow concentrate was used (38.7 and 26.7 %, respectively). The methods of treatment used for femoral head osteonecrosis are not traumatic, have no complications and allow delaying hip replacement. The use of autologous bone marrow cells, in addition to decompression of the necrosis focus, creates the prerequisites for a better outcome of bone regeneration of the necrotic area.

 

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