Цель: разработать и предложить оригинальный метод лечения костно-хрящевых дефектов гиалинового хряща на примере коленного сустава. Материалы и методы: проспективное исследование проводилось на экспериментальных животных (овцы) в количестве 30 особей, возраст которых составил от 1 года до 3.5 лет, вес от 18 до 28 кг. Все особи разделены на 3 репрезентативные группы по 10 особей в зависимости от метода восполнения дефекта сустава. Во всех группах выполнялся полнослойный дефект гиалинового хряща с захватом поверхностной части субхондральной кости диаметром 4.5 мм по внутренней поверхности мыщелка бедра, несущей нагрузку и замещался различными способами. Выделенные костно-хрящевые фрагменты исследовали визуально, оценивая характер краёв дефекта суставного хряща, состояние его кровенаполнения, глубину дефекта, степень закрытия дефекта формирующимся фибрознохрящевым слоем. Область дефекта субхондральной пластинки изучали морфологически с использованием световой микроскопии. Результаты: результаты в группе без замещения дефекта сопоставимы с аналогичными исследованиями других авторов, что свидетельствует о невозможности организма самостоятельно восполнить имеющийся костнохрящевой дефект. Наилучшие результаты показаны в третьей группе, где костно-хрящевой дефект практически полностью заместился макроскопически, а микроскопически удалось проследить архитектонику новообразованной гиалиновоподобной ткани, что свидетельствует о хороших ранних результатах применения описываемой методики. Выводы: Предложенный оригинальный метод лечения костно-хрящевых дефектов коленного сустава позволил получить хорошие результат в ранние сроки. Необходимо дальнейшее наблюдение за поведением регенерата во всех экспериментальных группах.Ключевые слова: костно-хрящевой дефект, мембрана для регенерации, эксперимент Для цитирования: Айрапетов Г.А., Загородний Н.В., Воротников А.А. Экспериментальный метод замещения костно-хрящевых дефектов суставов (ранние результаты).

To improve the treatment results of patients with osteochondral defects of large joints. Materials and methods: A prospective study was conducted on 30 animals (60 knee joints) aged 1.5-3 years. All animals were divided into 3 groups of 10 each, depending on the method of replacement of the osteo-chondral defect. Results: 6 months after intervention using the proposed method, a good prognosis can be given and good long-term results expected despite the full axial load on the joint a few hours after the operation.

Relevance. Koenigs disease, or osteochondritis dissecans of the knee joint, has been known since the end of the 16th century. The incidence is high (18-30 cases per 100 thousand of the population), while there is no common opinion on the management tactics and the treatment method for this pathology. Incorrect treatment choice as well as the lack of active management tactics provokes inevitably the transformation of primary pathology in early deforming arthrosis, followed by a pronounced decrease in joint function and the working capacity of an adult patient. Material and methods: electronic scientific library PubMed, SciVerse (Science Direct), and Scopus were the open Internet tools we searched for literature sources. For data search we used following keywords: dissecting osteochondritis, Koenigs disease, osteochondritis dissecans. The article presents the main results in the publications of domestic and foreign experts with an emphasis on the diagnosis and treatment of dissecting osteochondritis. In some cases, their own comments about the diagnosis and treatment are made. Conclusion. In our opinion, the surgical objectives are to restore the congruency of the articular surfaces by improving vascularization of the affected area, tight fixation of the unstable fragment and protecting the supporting part of the loaded condyle section in the postoperative period. Due to the rarity of such a pathology and the lack of research with a high level of evidence base, further development of treatment methods is actual.

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To improve the treatment results of patients with osteochondral defects of large joints. Materials and methods: A prospective study was conducted on 30 animals (60 knee joints) aged 1.5-3 years. All animals were divided into 3 groups of 10 each, depending on the method of replacement of the osteo-chondral defect. Results: 6 months after intervention using the proposed method, a good prognosis can be given and good long-term results expected despite the full axial load on the joint a few hours after the operation.

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the 1 st MTP joint arthrodesis and three among them were re-operated.

BACKGROUND: Dissecting osteochondritis of the knee joint is one of the common diseases accompanied by damage to the articular cartilage. Existing conservative and surgical methods of treating osteochondral defects of the hyaline cartilage do not give full satisfactory results of restorative treatment. OBJECTIVE: This study aimed to evaluate the effectiveness of the combined method proposed for the treatment of full-layer osteochondral defects of the knee joint. MATERIALS AND METHODS: The experiment was conducted on 27 Romanov sheep aged 5 months to 1 year and weighing 2035 kg. All animals were conditionally divided into three experimental groups of nine animals, each of which intraoperatively modeled the osteochondral defect of the medial condyle of both hind limbs. Moreover, the left knee joint was assigned to the experimental group, whereas the right knee joint was assigned to the control group. Thus, in first experimental group, microfracturing was performed on the left knee joint in addition to the osteochondral defect of the femoral condyle; in the second experimental groups, microfracturing and platelet-rich plasma (PRP) administration; in the third experimental group, microfracturing, and PRP administration after 3 weeks. From each group, three animals were sacrificed at 1, 3, and 6 months. Results were evaluated by macro- and microscopic examination. RESULTS: In the first experimental group, cartilage regeneration was slow. In the second experimental group using PRP, more intensive regeneration of cartilage tissue occurred. In the third experimental group, cartilage tissue regeneration occurred more intensively. CONCLUSION: During the experiment, in which several methods of treating osteochondral defects of the knee joint were employed, the most effective was the combined method of microfracturization and PRP administration 3 weeks after surgery.