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<article article-type="review-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">jkto</journal-id><journal-title-group><journal-title xml:lang="ru">Кафедра травматологии и ортопедии</journal-title><trans-title-group xml:lang="en"><trans-title>Department of Traumatology and Orthopaedics</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2226-2016</issn><publisher><publisher-name>ПРОФИЛЬ — 2С</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10/17238/issn2226-2016.2026.1.59-70</article-id><article-id custom-type="elpub" pub-id-type="custom">jkto-126</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОБЗОР ЛИТЕРАТУРЫ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>LITERATURE REVIEW</subject></subj-group></article-categories><title-group><article-title>Современные аспекты лечения перипротезной инфекции : обзор литературы</article-title><trans-title-group xml:lang="en"><trans-title>Current aspects of periprosthetic joint infection treatment : a literature review</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Суфиянова</surname><given-names>А. Ф.</given-names></name><name name-style="western" xml:lang="en"><surname>Sufiyanova</surname><given-names>A. F.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Алия Филюсовна Суфиянова, лаборант-исследователь</p><p>лаборатория «Аддитивные технологии»</p><p>450008; Республика Башкортостан; Уфа</p></bio><bio xml:lang="en"><p>Aliya F. Sufiyanova, Research Assistant</p><p>Laboratory of Additive Technologies</p><p>450008; Republic of Bashkortostan; Ufa</p></bio><email xlink:type="simple">afsufiyanova@bashgmu.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Билялов</surname><given-names>А. Р.</given-names></name><name name-style="western" xml:lang="en"><surname>Bilyalov</surname><given-names>A. R.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Азат Ринатович Билялов, кандидат медицинских наук, доцент, доцент кафедры</p><p>кафедра травматологии и ортопедии</p><p>450008; Республика Башкортостан; Уфа</p></bio><bio xml:lang="en"><p>Azat R. Bilyalov, Candidate of Medical Sciences, Associate Professor</p><p>Department of Traumatology and Orthopedics</p><p>450008; Republic of Bashkortostan; Ufa</p></bio><email xlink:type="simple">azat.bilyalov@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Акбашев</surname><given-names>В. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Akbashev</surname><given-names>V. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Владислав Николаевич Акбашев, ассистент</p><p>кафедра травматологии и ортопедии</p><p>450008; Республика Башкортостан; Уфа</p></bio><bio xml:lang="en"><p>Vlad N. Akbashev, Assistant</p><p>Department of Traumatology and Orthopedics</p><p>450008; Republic of Bashkortostan; Ufa</p></bio><email xlink:type="simple">Vlad-akb@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Галаутдинов</surname><given-names>М. Ф.</given-names></name><name name-style="western" xml:lang="en"><surname>Galautdinov</surname><given-names>M. F.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Марс Фларитович Галаутдинов, заведующий лабораторией</p><p>лаборатория «Аддитивные технологии»</p><p>450008; Республика Башкортостан; Уфа</p></bio><bio xml:lang="en"><p>Mars F. Galautdinov, Head of the Laboratory</p><p>Laboratory of Additive Technologies</p><p>450008; Republic of Bashkortostan; Ufa</p></bio><email xlink:type="simple">mfgalautdinov@bashgmu.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБОУ ВО БГМУ МИНЗДРАВА РОССИИ (Башкирский государственный медицинский университет)</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Federal State Budgetary Educational Institution of Higher Education "Bashkir State Medical University" of the Ministry&#13;
of Health of the Russian Federation</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2026</year></pub-date><pub-date pub-type="epub"><day>12</day><month>08</month><year>2026</year></pub-date><volume>0</volume><issue>1</issue><fpage>59</fpage><lpage>70</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Суфиянова А.Ф., Билялов А.Р., Акбашев В.Н., Галаутдинов М.Ф., 2026</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="ru">Суфиянова А.Ф., Билялов А.Р., Акбашев В.Н., Галаутдинов М.Ф.</copyright-holder><copyright-holder xml:lang="en">Sufiyanova A.F., Bilyalov A.R., Akbashev V.N., Galautdinov M.F.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.jkto.moscow/jour/article/view/126">https://www.jkto.moscow/jour/article/view/126</self-uri><abstract><sec><title>   Введение</title><p>   Введение: Перипротезная инфекция – это одно из наиболее тяжёлых осложнений после эндопротезирования суставов. По различным данным, частота ППИ составляет до 2 % после первичного эндопротезирования и до 4–6 % после ревизионных вмешательств. Возрастающее число операций по замене суставов, а также рост устойчивости микроорганизмов к антибиотикам требуют постоянного совершенствования подходов к диагностике и лечению ППИ. Настоящий обзор посвящён современным стратегиям борьбы с данным осложнением, включая как традиционные, так и инновационные подходы.</p><p>   Цель работы – на основании анализа современной научно-медицинской литературы обобщить современные подходы к диагностике и лечению перипротезной инфекции, рассмотреть эпидемиологию, методы лечения и алгоритмов ее диагностики.</p></sec><sec><title>   Материалы и методы</title><p>   Материалы и методы. Для проведения обзора литературы по перипротезной инфекции, методам ее диагностики и лечения был осуществлен систематический поиск научных публикаций в базах данных eLIBRARY, PubMed, Google Scholar. Были отобраны исследования, обзоры и метаанализы, опубликованные за последние 10 лет. В общей сложности было проанализировано 47 научных исследований.</p><p>   Результаты и обсуждение. Проведённый анализ показал, что частота перипротезной инфекции составляет 1–2 % после первичного эндопротезирования и около 4 % после ревизионной артропластики. Основными возбудителями ППИ являются коагулазонегативные стафилококки (до 43 % случаев) и золотистый стафилококк (до 23 %). До 30 % инфекций остаются не идентифицированными вследствие образования биоплёнок и предшествующей антибиотикотерапии. Лидирующим методом лечения хронической перипротезной инфекции является двухэтапная ревизионная артропластика с применением антибактериальных цементных спейсеров, включая их современные модификации. Однако они также имеют ограничения использования. Комплексное применение современных стратегий лечения, включая хирургические вмешательства, антибактериальную терапию и использование спейсеров из различных материалов, представляет собой перспективное направление в терапии хронической перипротезной инфекции.</p><p>   Особого внимания требует разработка методов комплексной диагностики и лечения перипротезной инфекции.</p></sec><sec><title>   Заключение</title><p>   Заключение. На основании данных 47 научных статей получены сведения об эпидемиологии перипротезной инфекции, классификации основных видов возбудителей, методах ее диагностики и алгоритмах лечения. Обзор консолидирует современные знания и последние инновации в диагностике и лечении ППИ, заполняя пробел в русскоязычной литературе.</p></sec></abstract><trans-abstract xml:lang="en"><sec><title>   Introduction</title><p>   Introduction: Periprosthetic joint infection (PJI) remains one of the most serious complications following total joint arthroplasty, with an incidence of up to 2 % after primary and 4–6 % after revision procedures. Increasing antimicrobial resistance and the complexity of treatment necessitate continuous refinement of diagnostic and therapeutic strategies.</p></sec><sec><title>   Aim</title><p>   Aim. To provide a comprehensive review of current diagnostic methods and treatment approaches for PJI, with a particular focus on recent spacer innovations. This article is the first Russian-language review to systematize up-to-date global data and technological advances in the field.</p></sec><sec><title>   Materials and Methods</title><p>   Materials and Methods. A systematic search was conducted in PubMed, eLIBRARY, and Google Scholar databases, focusing on publications from the past 10 years. Inclusion criteria followed the PRISMA protocol. Forty-seven articles, including clinical studies, meta-analyses, and reviews, were analyzed.</p><p>   Results and discussion. Coagulase-negative staphylococci and Staphylococcus aureus remain the most frequent pathogens, often protected by biofilms. Diagnostic criteria from MSIS and ICM include biomarkers (e. g., alpha-defensin), leukocyte esterase, and synovial fluid analysis. Two-stage revision arthroplasty with antibiotic-loaded cement spacers remains the standard of care. The review highlights novel spacer modifications, including personalized 3D-printed designs, embedded drug reservoirs, and magnetically controlled delivery systems. The potential role of bacteriophage therapy in multidrug-resistant infections is also discussed.</p></sec><sec><title>   Conclusion</title><p>   Conclusion. This review consolidates current knowledge and recent innovations in PJI diagnosis and treatment, addressing a gap in Russian-language literature. The integration of advanced materials, technologies, and diagnostic tools represents a promising direction for improving patient outcomes</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>перипротезная инфекция</kwd><kwd>осложнения эндопротезирования</kwd><kwd>биопленки</kwd><kwd>коагулазонегативные стафилококки</kwd><kwd>спейсеры</kwd><kwd>ревизионное эндопротезирование</kwd></kwd-group><kwd-group xml:lang="en"><kwd>osteoarthritis</kwd><kwd>diagnostic biomarkers of osteoarthritis</kwd><kwd>inflamaging</kwd><kwd>chondrocytes</kwd><kwd>synovial cells</kwd><kwd>hyaluronic acid</kwd><kwd>sirtuins</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">Исследование не имело спонсорской поддержки</funding-statement><funding-statement xml:lang="en">The study had no sponsorship</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Izakovicova P., Borens O., Trampuz A. 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