tibljТуберкулез и болезни легкихTuberculosis and Lung Diseases2075-12302542-1506Медицинские знания и технологии10.58838/2075-1230-2025-103-6-58-65tiblj-1933Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESОпыт двухэтапного эндопротезирования коленного сустава при туберкулезном и неспецифическом гонитеTwo-Stage Knee Arthroplasty in Tuberculous and Non-Specific Gonitishttps://orcid.org/0000-0002-2211-8400ЗубиковВ. С.ZubikovV. S.

Зубиков Владимир Сергеевич - Д. м. н., профессор, ведущий научный сотрудник научного отдела костно-суставной патологии

127473, Москва, ул. Достоевского, д. 4, к. 2Тел.: +7 (495) 631-15-15

Vladimir S. Zubikov - Doctor of Medical Sciences, Professor, Leading Researcher of Research Departmentof Osteoarticular Pathology

Build. 2, 4 Dostoevskiy St., Moscow, 127473Phone: +7 (495) 631-15-15

zubikovladimir@gmail.comhttps://orcid.org/0000-0003-4388-155XГерасимовИ. А.GerasimovI. A.

Герасимов Илья Александрович - К. м. н., врач-травматолог-ортопед отделения для больных туберкулезом внелегочной локализации

127473, Москва, ул. Достоевского, д. 4, к. 2Тел.: +7 (495) 631-15-15

Ilya A. Gerasimov - Candidate of Medical Sciences, Traumatologist and Orthopedist of Extrapulmonary Tuberculosis Department

Build. 2, 4 Dostoevskiy St., Moscow, 127473Phone: +7 (495) 631-15-15

ilya-1559@rambler.ruhttps://orcid.org/0000-0001-7140-3200ПерецманасЕ. О.PeretsmanasE. O.

Перецманас Евгений Оркович - Д. м. н., руководитель научного отдела костно-суставной патологии

127473, Москва, ул. Достоевского, д. 4, к. 2Тел.: +7 (495) 631-15-15

Evgeniy O. Peretsmanas - Doctor of Medical Sciences, Head of Research Department of Osteoarticular Pathology

Build. 2, 4 Dostoevskiy St., Moscow, 127473Phone: +7 (495) 631-15-15

peretsmanas58@mail.ruФГБУ «Национальный медицинский исследовательский центр фтизиопульмонологии и инфекционных заболеваний» МЗ РФРоссияNational Medical Research Center of Phthisiopulmonology and Infectious Diseases, Russian Ministry of HealthRussian Federation20251001202610365865Copyright © Зубиков В.С., Герасимов И.А., Перецманас Е.О., 20262026Зубиков В.С., Герасимов И.А., Перецманас Е.О.Zubikov V.S., Gerasimov I.A., Peretsmanas E.O.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.tibl-journal.com/jour/article/view/1933Цель исследования

Цель исследования: оценка применения двухэтапного эндопротезирования при лечении деструктивной формы септического гонита туберкулезной и неспецифической этиологии, включая ВИЧ-позитивных пациентов.

Материалы и методы

Материалы и методы. В исследование вошли 15 пациентов с деструктивной формой септического гонита как неспецифической или/и туберкулезной этиологии, которым проводилось хирургическое лечение. У 7/15 (46,67%) пациентов была туберкулезная этиология заболевания, у 8 (53,33%) – неспецифическая, ВИЧ-позитивный статус имели 5/15 (33,33%) пациентов. У пациентов планировалось двухэтапное эндопротезирование с использованием цементных артикулирующих спейсеров, насыщенных антимикробными препаратами по лекарственной чувствительности возбудителя. У 10 пациентов (66,67%) выполнен полный цикл двухэтапного эндопротезирования, в 5 случаях (33,33%) – только первый этап.

Результаты

Результаты. Во всех 15 случаях у пациентов получена стойкая эрадикация инфекции. У 10 пациентов, закончивших весь цикл хирургического лечения, по шкале KSS получено статистически значимое улучшение показателей с 35,4 ± 15,4 до 78,2 ± 15,1 (p<0,05), сроки наблюдения – от 1 года до 14 лет. Не отмечено значимого влияния ВИЧ-инфекции на полученные результаты лечения.

The objective

The objective: to evaluate the use of two-stage arthroplasty in the treatment of a destructive form of septic gonitis of tuberculous and non-specific etiology including HIV-positive patients.

Subjects and Methods

Subjects and Methods. 15 patients with a destructive form of septic gonitis of both non-specific and tuberculous etiology were enrolled in the study, all those patients underwent surgical treatment. In 7/15 (46.67%) patients, the disease was caused by M. tuberculosis, in 8 (53.33%) it was a non-specific disease, and 5/15 (33.33%) patients were HIV-positive. The patients were planned to undergo a two-stage endoprosthetics using cemented articulating spacers saturated with antimicrobial drugs, according to the drug susceptibility of the pathogen. 10 patients (66.67%) underwent a full cycle of two-stage endoprosthetics, and 5 cases (33.33%) underwent the first stage only.

Results

Results. In all 15 cases, sustained eradication of the infection was achieved. In 10 patients who completed the entire cycle of surgical treatment, a statistically significant improvement in the KSS scores was obtained from 35.4 ± 15.4 to 78.2 ± 15.1 (p<0.05), the observation period ranged from 1 year to 14 years. No significant impact of HIV infection on the treatment results was observed.

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