mossjМосковский хирургический журналMoscow Surgical Journal2072-3180ООО «ПРОФИЛЬ – 2С»10.17238/2072-3180-2025-1-178-184mossj-926Research ArticleЛИТЕРАТУРНЫЕ ОБЗОРЫLITERARY REVIEWSКлиническая эффективность применения мезенхимальных стволовых клеток в лечении пациентов с аваскулярным некрозом головки бедренной костиClinical efficacy of mesenchymal stem cells in the treatment of patients with avascular necrosis of the femoral headhttps://orcid.org/0000-0002-6281-0020ЧерныхА. В.ChernykhA. V.

Черных Александр Васильевич, доктор медицинских наук, профессор, заведующий кафедрой оперативной хирургии с топо­графической анатомией

394036, ул. Студенческая, д. 10, Воронеж

Chernykh Alexander Vasilyevich, Doctor of Medical Sciences, Professor, Head of the Department of Operative Surgery with Topo­graphic Anatomy

394036, Studentskaya str., 10, Voronezh

chernyh@vrngmu.ruhttps://orcid.org/0009-0003-6415-8296ПлотниковД. С.PlotnikovD. S.

Плотников Денис Сергеевич, врач-травматолог, Хирургиче­ское отделение

398046, ул. Петра Смородина, д. 13, Липецк

Plotnikov Denis Sergeevich, Traumatologist, Surgical Depart­ment

398046, Peter Smorodina str., 13, Lip­etsk

pds@vrngmu.comГейдароваС. И.GeydarovaS. I.

Гейдарова София Игоревна, студент

394036, ул. Студенческая, д. 10, Воронеж

Geydarova Sofia Igorevna, student

394036, Studentskaya str., 10, Voronezh

sofiko22112003@bk.ruhttps://orcid.org/0000-0003-3656-5954ОстроушкоА. П.OstroushkoA. P.

Остроушко Антон Петрович, кандидат медицинских наук, до­цент кафедры общей и амбулаторной хирургии

394036, ул. Студенческая, д. 10, Воронеж

OstroushkoAnton Petrovich, Candidate of Medical Sciences, As­sociate Professor of the Department of General and Outpatient Medicine

394036, Studentskaya str., 10, Voronezh

anton@vrngmu.ruhttps://orcid.org/0000-0002-3307-1425ЛаптиёваА. Ю.LaptiyovaA. Yu.

Лаптиёва Анастасия Юрьевна, кандидат медицинских наук, ассистент кафедры общей и амбулаторной хирургии

394036, ул. Студенческая, д. 10, Воронеж

Laptiyova Anastasia Yurievna, Candidate of Medical Sciences, As­sistant of the Department of General and Outpatient Surgery

394036, Studentskaya str., 10, Voronezh

laptievaa@mail.ruФГБОУ ВО «Воронежский государственный медицинский университет им. Н.Н. Бурденко» Минздрава РоссииРоссияVoronezh State Medical University named after N.N. Burdenko, Ministry of Health of the Russian FederationRussian FederationЛипецкая городская поликлиника № 2РоссияLipetsk City Polyclinic No. 2Russian Federation20251903202501178184Copyright © Черных А.В., Плотников Д.С., Гейдарова С.И., Остроушко А.П., Лаптиёва А.Ю., 20252025Черных А.В., Плотников Д.С., Гейдарова С.И., Остроушко А.П., Лаптиёва А.Ю.Chernykh A.V., Plotnikov D.S., Geydarova S.I., Ostroushko A.P., Laptiyova A.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.mossj.ru/jour/article/view/926Введение

Введение. Аваскулярный некроз головки бедренной кости (АНГБК) встречается у 10-18 % пациентов травматологического профиля. Обширная исследовательская деятельность за последнее время изучила потенциал лечения АНГБК с использованием мезенхимальных стволовых клеток (МСК) и показала результаты, убеждающие в эффективности и безопасности метода.

Цель

Цель. Изучить клиническую эффективность применения мезенхимальных стволовых клеток в лечении пациентов с аваскулярным некрозом головки бедренной кости.

Материалы и методы

Материалы и методы. Выполнен обзор данных в PubMed, Cochrane Library, Science Direct, eLIBRARY. Также представлено описание клинического случая лечения пациента с АНГБК с применением мезенхимальных стволовых клеток.

Результаты

Результаты. В последние годы хорошо зарекомендовало себя в клинической практике применение стромально-васкулярной фракции, содержащей МСК жирового происхождения. МСК лучше всего подходят для ранней терапии АНГБК, как этапа консервативного лечения пациентов с целью улучшения результатов и получения возможности стабилизации и регресса некротических изменений костной ткани. При наличии у пациентов запущенных стадий применение МСК позволяет снизить боль и повысить функциональность конечности, улучшить качество жизни, отсрочить выполнение тотального эндопротезирования тазобедренного сустава.

Заключение

Заключение. За последнее десятилетие был изучен потенциал МСК, что демонстрирует многообещающий потенциал. Несмотря на существующие разногласия, представляется, что общие результаты применения МСК для лечения аваскулярного некроза головки бедренной кости положительны не только с точки зрения эффективности, но и безопасности. Однако для надёжной интерпретации результатов их нужно определять в динамике.

Introduction

Introduction. Avascular necrosis of the femoral head (ANFH) is a common problem that occurs in 10-18 % of patients with a trauma profile. Extensive research has recently explored the potential of treating ANFH using mesenchymal stem cells and has shown results convincing of the effectiveness and safety of the method.

The purpose of the study

The purpose of the study. To study the clinical efficacy of mesenchymal stem cells in the treatment of patients with avascular necrosis of the femoral head.

Materials and methods

Materials and methods. The data is reviewed in PubMed, CochraneLibrary, ScienceDirect, eLibrary. A clinical case of treatment of a patient with avascular necrosis of the femoral head using mesenchymal stem cells is described.

Results

Results. MSCs are best suited for early therapy of ANFH, as a stage of conservative treatment of patients in order to improve the results of complex treatment and to obtain the possibility of stabilization and regression of necrotic changes in bone tissue. If patients have advanced stages, the use of MSCs can reduce pain and increase limb functionality, improve quality of life, and delay the need for total hip replacement.

Conclusion

Conclusion. Extensive research over the past decade has explored the potential of the MSC and shown promising results. Despite the existing controversies, it seems that the overall results of using MSC for the treatment of avascular necrosis of the femoral head are positive not only in terms of efficacy, but also safety. However, for reliable interpretation of the results, they need to be determined over time.

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