jktoКафедра травматологии и ортопедииDepartment of Traumatology and Orthopaedics2226-2016ПРОФИЛЬ — 2С10/17238/issn2226-2016.2025.3.83-90jkto-56Research ArticleОБЗОР ЛИТЕРАТУРЫLITERATURE REVIEWОрганосохраняющие методы хирургического лечения взрослых пациентов молодого возраста с наличием фемороацетабулярного импиджмента, дисплазии тазобедренного сустава и ретроверсии вертлужной впадины. Литературный обзорHip preservation surgery for young adults with femoroacetabular impingement, hip dysplasia, and acetabular retroversion. Literature reviewhttps://orcid.org/0009-0007-2847-9745ЧеркасовВ. С.CherkasovV. S.

Черкасов Виталий Сергеевич, врач-травматолог-ортопед отделения ортопедии

119415, ул. Лобачевского 42с2, г. Москва

Cherkasov Vitaly S., traumatologist-orthopedist, orthopedics department

119415, ulitsa Lobachevskogo, 42/2, Moscow

cherkasov.ortho@yandex.ruhttps://orcid.org/0000-0002-1130-040XПлиевД. Г.PlievD. G.

Плиев Давид Гивиевич, канд. мед. наук, заведующий травматолого-ортопедическим отделением №19

195427, ул. академика Байкова,д. 8, г. Санкт-Петербург

Pliev David G., Ph.D. in traumatology, head of traumatology and orthopedics department №19; head of the scientific department of hip pathology

195427, ulitsa akademika Baykova, 8, Saint Petersburg

dgpliev@rniito.ruhttps://orcid.org/0000-0003-4536-6834КоваленкоА. Н.KovalenkoA. N.

Коваленко Антон Николаевич, канд. мед. наук, врач травматолог-ортопед травматолого-ортопедического отделения № 19

195427, ул. академика Байкова, д. 8, г. Санкт-Петербург

Kovalenko Anton N., Ph.D. in traumatology, traumatologistorthopedist, traumatology and orthopedics department №19; researcher, scientific department of hip pathology

195427, ulitsa akademika Baykova, 8, Saint Petersburg

dr.ankovalenko@ya.ruhttps://orcid.org/0000-0002-1819-8890СинеокийА. Д.SineokiyA. D.

Синеокий Андрей Дмитриевич, канд. мед. наук, врач травматолог-ортопед травматолого-ортопедического отделения № 19

195427, ул. академика Байкова, д. 8, г. СанктПетербург

Sineokiy Andrey D., Ph.D. in traumatology, traumatologist-orthopedist, traumatology and orthopedics department №19

195427, ulitsa akademika Baykova, 8, Saint Petersburg

Sineoky_91@mail.ruhttps://orcid.org/0000-0003-1948-0895ГуацаевМ. С.GuatsaevM. S.

Гуацаев Максим Сосланович, врач травматолог-ортопед травматолого-ортопедического отделения № 19

195427, ул. академика Байкова, д. 8, г. Санкт-Петербург

Guatsaev Maxim S., traumatologist-orthopedist, traumatology and orthopedics department №19

 195427, ulitsa akademika Baykova, 8, Saint Petersburg

mguatsaev@inbox.ruhttps://orcid.org/0000-0001-7507-7772АйрапетовГ. А.AirapetovG. A.

Айрапетов Георгий Александрович, д. м. н., заместитель главного врача по травматологии и ортопедии

117198, ул. Миклухо-Маклая, д. 6, г. Москва

Airapetov Georgy A., doctor of traumatology and orthopedics, deputy chief physician for traumatology and orthopedics; professor, department of traumatology and orthopedics

 117198, ulitsa Miklukho-Maklaya, 6, Moscow

airapetovga@yandex.ruhttps://orcid.org/0009-0008-4190-3114ДзампаевК. А.DzampaevK. A.

Дзампаев Констатин Асланович, ординатор кафедры травматологии и ортопедии

117198, ул. Миклухо-Маклая, д. 6, г. Москва

Dzampaev Konstantin A., resident, department of traumatology and orthopedics

 117198, ulitsa Miklukho-Maklaya, 6, Moscow

Kostya199921@gmail.comГосударственное бюджетное учреждение здравоохранения города Москвы «Городская клиническая больница № 31 имени академика Г.М. Савельевой Департамента здравоохранения города Москвы»РоссияState Budgetary Healthcare Institution of the City of Moscow “City clinical hospital №31 named after academician G.M. Savelyeva of the Moscow Healthcare Department”Russian FederationФедеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр травматологии и ортопедии им. Р.Р. Вредена» Минздрава РоссииРоссияFederal State Budgetary Institution “R.R. Vreden National medical research center of traumatology and orthopedics” of the Ministry of Health of the Russian FederationRussian FederationГосударственное бюджетное учреждение здравоохранения города Москвы «Городская клиническая больница № 31 имени академика Г.М. Савельевой Департамента здравоохранения города Москвы»; Федеральное государственное автономное образовательное учреждение высшего образования "Российский университет дружбы народов имени Патриса Лумумбы"РоссияState Budgetary Healthcare Institution of the City of Moscow “City clinical hospital №31 named after academician G.M. Savelyeva of the Moscow Healthcare Department”; Federal State Autonomous Educational Institution of Higher Education “Peoples' Friendship University of Russia named after Patrice Lumumba”,Russian FederationФедеральное государственное автономное образовательное учреждение высшего образования "Российский университет дружбы народов имени Патриса Лумумбы"Россия3Federal State Autonomous Educational Institution of Higher Education “Peoples' Friendship University of Russia named after Patrice Lumumba”,Russian Federation202513032026038390Copyright © Черкасов В.С., Плиев Д.Г., Коваленко А.Н., Синеокий А.Д., Гуацаев М.С., Айрапетов Г.А., Дзампаев К.А., 20262026Черкасов В.С., Плиев Д.Г., Коваленко А.Н., Синеокий А.Д., Гуацаев М.С., Айрапетов Г.А., Дзампаев К.А.Cherkasov V.S., Pliev D.G., Kovalenko A.N., Sineokiy A.D., Guatsaev M.S., Airapetov G.A., Dzampaev K.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.jkto.moscow/jour/article/view/56Введение

Введение. Органосохраняющая хирургия тазобедренного сустава у взрослых пациентов молодого возраста с наличием различной патологии тазобедренного сустава (фемороацетабулярный импиджмент, симптоматическая дисплазия, ретроверсия вертлужной впадины) является актуальной темой в современной ортопедической хирургии, направленной на предотвращение раннего остеоартроза и сохранение качества жизни.

Цель исследования

Цель исследования. Систематизировать данные о современном состоянии методов  лечения, входящих в понятие органосохраняющая хирургия тазобедренного сустава, оценить их эффективность, осложнения и перспективы развития.

Материалы и методы

Материалы и методы. Проведен анализ научных работ из баз PubMed, Scopus, Web of Science, e-Library. Отбор статей осуществлялся по критериям релевантности, уровня доказательности, клинической значимости. Включены метаанализы, рандомизированные исследования, обзоры и оригинАльные работы.

Результаты

Результаты. Артроскопия эффективна при лечении фемороацетабулярного импиджмента, но ограничена при выраженной ретроверсии вертлужной впадины и дисплазии. Хирургический вывих бедра (по Ganz) повзоляет осуществлять коррекцию при выраженной Cam деформации или массивного разрыва губы вертлужной впадины с минимальным риском аваскулярного некроза хирургам, не владеющим артроскопией тазобедренного сустава. Периацетабулярная остеотомия (ПАО) – золотой стандарт лечения симптоматической дисплазии, демонстрирующий хорошую выживаемость сустава через 15 лет. Основные осложнения: неврологические нарушения, ошибки коррекции, переломы таза. Современные технологии (3D-планирование) позволяют точность вмешательств. Однако, несмотря на прогресс, остаются вызовы: стандартизация протоколов, минимизация осложнений, индивидуализация подходов. Интеграция цифровых технологий и биомеханических исследований позволит расширить показания к органосохраняющим операциям.

Introduction

Introduction: Hip preservation techniques for young adults with structural abnormalities (FAI, dysplasia, retroversion) aim to prevent joint degeneration. T his review assesses surgical innovations, outcomes, and unresolved challenges in the field.

Materials and Methods

Materials and Methods: A literature search across PubMed, Scopus, Web of Science, e-Library.  identified 45 studies. Inclusion criteria: focus on joint preservation surgery, comparative analysis of techniques (PAO, arthroscopy, surgical dislocation), and ≥5-year follow-up. Excluded: case reports, animal studies.

Results

Results: Hip arthroscopy shows favorable short-term outcomes for FAI (mHHS 85.9±12.1), yet 4.2 % require conversion to arthroplasty. Surgical dislocation of the hip allows surgeons who do not have hip arthroscopy to correct pronounced deformity with femoroacetabular impingement, as well as to suture a massive rupture of the acetabulum lip with minimal risk of avascular necrosis but correlates with pseudarthrosis and heterotopic ossification. PAO provides 91.3% (95 % Cl: 87.7–94.8 %) of 10-year survivorship; however, The survival of the hip joint after periacetabular osteotomy was influenced by the presence of correction errors and the initial condition of the hip joint.

The following issues also remain unresolved: standardization of protocols, minimization of complications, individualization of approaches. The integration of digital technologies and biomechanical research will expand the indications for organ-preserving operations.

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