genortГений ортопедииGenij Ortopedii1028-44272542-131XЦЕНТР ИЛИЗАРОВА10.18019/1028-4427-2021-27-2-153-162genort-2614Research ArticleОригинальные статьиOriginal articlesОсобенности лечения асептического некроза таранной кости.Проект клинических рекомендацийTreatment of aseptic osteonecrosis of the talus. A draft of clinical guidelinesТоргашинА. Н.TorgashinA. N.

Торгашин Александр Николаевич, к. м. н.,

г. Москва

Alexander N. Torgashin, M.D., Ph.D.,

Moscow

Dr.torgashin@gmail.comМурсаловА. К.MursalovA. K.

Мурсалов Анатолий Камалович,

г. Москва

Anatoly K. Mursalov,

Moscow

tamerlanmursalov@gmail.comРодионоваС. С.RodionovaS. S.

Родионова Светлана Семеновна, д. м. н., профессор,

г. Москва

Svetlana S. Rodionova, M.D., Ph.D., Professor,

Moscow

Rod06@inbox.ruЗагороднийН. В.ZagorodniyN. V.

Загородний Николай Васильевич, д. м. н., профессор, член-корр. РАН,

г. Москва

Nikolay V. Zagorodniy, M.D., Ph.D., Professor, correspondent member of RAS,

Moscow

Dr.torgashin@gmail.comФедеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр травматологии и ортопедии имени Н.Н. Приорова» Министерства здравоохранения Российской ФедерацииРоссияNational Medical Research Center of Traumatology and Orthopedics n.a. N.N. PriorovRussian Federation202128042021272№ 2 (2021)153162Copyright © Торгашин А.Н., Мурсалов А.К., Родионова С.С., Загородний Н.В., 20212021Торгашин А.Н., Мурсалов А.К., Родионова С.С., Загородний Н.В.Torgashin A.N., Mursalov A.K., Rodionova S.S., Zagorodniy N.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.ilizarov-journal.com/jour/article/view/2614

Клинические рекомендации представляют собой адаптированный для использования в нашей стране алгоритм, основанный на работах, систематизированных по уровню доказательности, отражающих современные подходы к диагностике и лечению асептического некроза костей (остеонекроза) разной локализации.

Цель

Цель. Создание алгоритма диагностики и лечения асептического некроза костей на основе оценки уровня доказательности литературных данных.

Материалы и методы

Материалы и методы. Клинические рекомендации представляют собой систематизированный на основе уровня доказательности алгоритм ведения пациентов с асептическим некрозом костей, отражающий современные подходы к диагностике, лечению и реабилитации, которые базируются на данных литературы и собственном опыте авторов. Поиск в электронных базах данных производили на платформах Medline, Embase, Web of Science и Cochrane Library. Предпочтение отдавалось работам с высоким уровнем достоверности доказательств.Ссылки на источники информации приведены в порядке их упоминания в тексте. Глубина поиска составляла 50 лет, ввиду наличия систематических обзоров литературы в рамках предшествующих международных клинических рекомендаций. При включении в клинические рекомендации конкретных медицинских методик, касающихся диагностики, консервативного или хирургического лечения асептического некроза, указывался уровень убедительности доказательств, целесообразности их применения с учетом унифицированной шкалы оценки качества доказательств и силы рекомендаций применения медицинских технологий GRADE.

Результаты

Результаты. В клинических рекомендациях отражены аспекты клинического, инструментального и лабораторного обследования пациентов с остеонекрозом, варианты лечения в зависимости от локализации процесса и стадии заболевания.

Заключение

Заключение. Клинические рекомендации по оказанию медицинской помощи пациентам с асептическим некрозом костей составлены в соответствии с требованиями к разработке клинических рекомендаций медицинскими профессиональными некоммерческими организациями.

Clinical guidelines are an algorithm adapted for use in our country, based on the works systematized by the level of evidence, reflecting current approaches to the diagnosis and treatment of aseptic bone necrosis (osteonecrosis) of various localizations. Purpose of the study. Creation of an algorithm for diagnosis and treatment of osteonecrosis based on the assessment of the evidence level of literature data.

Material and methods

Material and methods. The Guidelines are a systematized algorithm based on the level of evidence for the management of patients with osteonecrosis, reflecting current approaches to diagnosis, treatment and rehabilitation, which are based on literature data and the authors' own experience. Electronic databases of Medline, Embase, Web of Science, and Cochrane Library platforms were searched for related sources. Preference was given to the works with high levels of evidence. References to information sources are given in the order of their appearance in the text. The search depth was 50 years due to the availability of systematic literature reviews in the framework of previous international clinical guidelines. When specific medical procedures related to the diagnosis, conservative or surgical treatment of osteonecrosis were included in the clinical recommendations, their level of evidence was reliability, the appropriateness of their use, taking into account the unified scale for assessing the quality of evidence and the strength of the recommendations for application of medical technologies GRADE.

Results

Results. The Guidelines reflect aspects of clinical, instrumental and laboratory examination of patients with osteonecrosis, treatment options depending on the location of the process and disease stage.

Conclusion

Conclusion. Clinical recommendations on the medical assistance to patients with aseptic osteonecrosis have been compiled according to the requirements imposed on clinical recommendations developed by medical professional non-profit institutions.

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