Посттравматический гемартроз с точки зрения теории воспаления

Автор: Бердюгина Ольга Викторовна, Черешнев Валерий Александрович, Бердюгин Кирилл Александрович

Журнал: Гений ортопедии @geniy-ortopedii

Статья в выпуске: 2 т.29, 2023 года.

Бесплатный доступ

Введение. Посттравматический гемартроз отождествляется в настоящее время с внутрисуставным кровоизлиянием, однако стоит обратить внимание на то, что сопровождается он всеми пятью классическими признаками воспаления: наличием гиперемии, гипертермии, отека, боли, изменением функции сустава. Цель. На основании анализа мировой научной литературы последних лет установить, стоит ли недооценивать воспаление при посттравматическом гемартрозе. Материалы и методы. Произведен анализ научной информации из статей поисковой интернет платформы Web of Science (Clarivate Analytics, USA): базы данных Web of Science Core Collection (доступ по подписке), Publons (открытый доступ), Medline (открытый доступ). Изучены материалы научных работ базы данных Scopus (Elsevier, Netherlands). Глубина поиска составила 15 лет. Темы, не получившие освещения в литературе данного периода, изучались, в ряде случаев, до 1960-х годов. По теме исследования обнаружено свыше 200 источников. Анализу подвергалась литература, опубликованная в текущем году, - 15,0 % материалов, в последние 5 лет, включая текущий год, - 56,3 %, в последние 10 лет, включая текущий год, - 73,8 %, в последние 15 лет, включая текущий год, - 81,3 %. Результаты и обсуждение. Степень повреждения и сопуствующие факторы воспаления определяют быстрое разрешение или более тяжёлый вариант течения посттравматического гемартроза в процессе лечения. Сопряжение нескольких вариантов воспаления приводит к развитию осложнений, в частности, остеоартрит может развиваться в тех случаях, когда на момент травмы уже реализуются механизмы хронического системного воспаления низкой интенсивности, анкилоз сустава может быть следствием хронического системного воспаления низкой интенсивности с вовлечением процессов дегенерации. Синовит, как осложнение посттравматического гемартроза, с позиции теории воспаления должен дифференцироватся на наличие признаков низкосортного воспаления, хронического течения классического воспаления и предсистемного воспаления (гнойный артрит). Заключение. Анализ современной литературы показал сложность и многогранность аспектов воспаления при посттравматическом гемартрозе. Отсутствие акцентуации на оценке воспалительной реакции при реабилитации пациентов с посстравматическим гемартрозом может приводить к возникновению осложнений лечения, в частности, формировать предпосылки к развитию остеоартроза, анкилоза, синовита.

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Посстравматический гемартроз, воспаление, синовиальная мембрана, иммунология, хрящ, остеоартрит, синовит, анкилоз

Короткий адрес: https://sciup.org/142238208

IDR: 142238208 | DOI: 10.18019/1028-4427-2023-29-2-211-224

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