rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.47360/1995-4484-2024-227-236rsp-3553Research ArticleРЕВМООРТОПЕДИЯ И РЕАБИЛИТАЦИЯORTHOPEDIC RHEUMATOLOGY AND REHABILITATIONТотальное эндопротезирование коленных и тазобедренных суставов при ревматоидном артрите: тенденция настоящего времениTotal knee and hip replacement in rheumatoid arthritis: A current trendhttps://orcid.org/0000-0001-6334-2903ХлабощинаВ. Н.KhlaboshchinaV. N.

Хлабощина Виктория Николаевна

115522, Москва, Каширское шоссе, 34а

Victoria N. Khlaboshchina

115522, Moscow, Kashirskoye Highway, 34A

coral2008@mail.ruhttps://orcid.org/0000-0002-1391-0711КаратеевА. Е.KarateevА. Е.

115522, Москва, Каширское шоссе, 34а

Andrey E. Karateev

115522, Moscow, Kashirskoye Highway, 34A

https://orcid.org/0000-0001-5103-5447ПолищукЕ. Ю.PolishchukЕ. Yu.

115522, Москва, Каширское шоссе, 34а

Elena Yu. Polishchuk

115522, Moscow, Kashirskoye Highway, 34A 

https://orcid.org/0000-0002-5626-7404МакаровМ. А.MakarovМ. A.

115522, Москва, Каширское шоссе, 34а

Maxim A. Makarov

115522, Moscow, Kashirskoye Highway, 34A

ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»РоссияV.A. Nasonova Research Institute of RheumatologyRussian Federation202429042024622227236Copyright © Хлабощина В.Н., Каратеев А.Е., Полищук Е.Ю., Макаров М.А., 20242024Хлабощина В.Н., Каратеев А.Е., Полищук Е.Ю., Макаров М.А.Khlaboshchina V.N., Karateev А.Е., Polishchuk Е.Y., Makarov М.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://rsp.mediar-press.net/rsp/article/view/3553

Тотальное эндопротезирование (ТЭ) – хирургическая операция, широко используемая при тяжелом деструктивном поражении суставов. ТЭ коленного (КС) и тазобедренного (ТБС) суставов занимает важное место в комплексном лечении ревматических заболеваний, таких как ревматоидный артрит (РА) и остеоартрит (ОА), и позволяет значительно уменьшить боли и улучшить функциональный статус у пациентов с выраженными структурными изменениями суставов в случае неэффективности консервативной терапии. В последние годы в связи с развитием современной концепции активного лечения РА (treat-to-target) и внедрением новых классов базисных противовоспалительных препаратов, таких как генно-инженерные биологические препараты и ингибиторы Янус-киназ, потребность в ТЭ крупных суставов начала снижаться. В то же время старение популяции, рост числа больных ОА и отсутствие общепризнанной патогенетической терапии данного заболевания определяют увеличение числа ТЭ КС и ТБС при ОА. В настоящем обзоре представлена многолетняя динамика проведения ТЭ КС и ТБС по данным национальных регистров разных стран. Также рассмотрены вопросы риска осложнений при ТЭ КС и ТБС у больных РА и ОА, современные рекомендации по проведению противоревматической терапии при РА в периоперационном периоде.

Total joint replacement (TJR) is a surgical procedure widely used in severe destructive joint damage. TJR of the knee and hip joint (TKR and THR respectively) occupies an important place in the complex treatment of rheumatoid arthritis (RA) and osteoarthritis (OA), and can significantly reduce pain and improve function in patients with severe structural joint damage due to an ineffectiveness of conservative therapy. In recent years, due to the development of the modern concept of active treatment of RA (treat-to-target) and the introduction of new classes of anti-inflammatory drugs, such as biologic disease modifying antirheumatic drugs and JAK inhibitors, the need for TJR in RA has begun to decrease. At the same time, the aging of the population, the increase in the number of patients with OA and the lack of generally approved pathogenetic therapy determine the increase of TKR/THR incidence in this disease. This review presents the long-term dynamics of the incidence of TKR and THR according to the national registers of different countries. The issues of the complication risks in patients with RA and OA, current recommendations for anti-rheumatic therapy in RA in the perioperative period are also considered.

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