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<article article-type="research-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/issn2226-2016.2025.4.102-111</article-id><article-id custom-type="elpub" pub-id-type="custom">jkto-57</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>ОРИГИНАЛЬНОЕ ИССЛЕДОВАНИЕ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ORIGINAL RESEARCH</subject></subj-group></article-categories><title-group><article-title>Влияние ВИЧ инфекции на результаты двухэтапного эндопротезирования тазобедренного сустава при септическом коксите</article-title><trans-title-group xml:lang="en"><trans-title>Influence of HIV infection on the outcomes of two-stage hip arthroplasty in septic coxitis</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>Зубиков</surname><given-names>В. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Zubikov</surname><given-names>V. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Зубиков Владимир Сергеевич - д.м.н., профессор, ведущий научный сотрудник научного отдела костно-суставной патологии.</p><p>Москва, ул. Достоевского, д. 4, к. 2, 127473</p></bio><bio xml:lang="en"><p>Vladimir S. Zubikov - Federal State Budgetary Institution "National Medical Research Center for Phthisiopulmonology and Infectious Diseases" of the Ministry of Health of the Russian Federation.</p><p>4, st. Dostoevsky, Moscow, 127473</p></bio><email xlink:type="simple">zubikovladimir@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>Перецманас</surname><given-names>Е. О.</given-names></name><name name-style="western" xml:lang="en"><surname>Peretzmanas</surname><given-names>E. O.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Перецманас Евгений Оркович - д.м.н., руководитель научного отдела костно-суставной патологии.</p><p>Москва, ул. Достоевского, д. 4, к. 2, 127473</p></bio><bio xml:lang="en"><p>Evgeniy O. Peretsmanas - Dr. Sci. (Med.) Federal State Budgetary Institution "National Medical Research Center for Phthisiopulmonology and Infectious Diseases" of the Ministry of Health of the Russian Federation.</p><p>4, st. Dostoevsky, Moscow, 127473</p></bio><email xlink:type="simple">peretsmanas58@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>Герасимов</surname><given-names>И. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Gerasimov</surname><given-names>I. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Герасимов Илья Александрович - к.м.н., врач травматолог-ортопед отделения для лечения больных с туберкулезом внелегочной локализации.</p><p>Москва, ул. Достоевского, д. 4, к. 2, 127473</p></bio><bio xml:lang="en"><p>Ilya A. Gerasimov - Federal State Budgetary Institution "National Medical Research Center for Phthisiopulmonology and Infectious Diseases" of the Ministry of Health of the Russian Federation.</p><p>4, st. Dostoevsky, Moscow, 127473</p></bio><email xlink:type="simple">1987cotvot@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>Рукин</surname><given-names>Я. A.</given-names></name><name name-style="western" xml:lang="en"><surname>Rukin</surname><given-names>Ya. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Рукин Ярослав Алексеевич - д.м.н., ведущий научный сотрудник научного отдела костно-суставной патологии, ФГБУ «НМИЦ фтизиопульмонологии и инфекционных заболеваний» Минздрава России; профессор кафедры травматологии, ортопедии и ВПХ Института хирургии ФГАОУ ВО "РНИМУ им. Н.И. Пирогова" МЗ РФ.</p><p>Москва, ул. Достоевского, д. 4, к. 2, 127473; Москва, ул. Островитянова, д. 1, 117513</p></bio><bio xml:lang="en"><p>Yaroslav A. Rukin - Dr. Sci. (Med.) Federal State Budgetary Institution "National Medical Research Center for Phthisiopulmonology and Infectious Diseases" of the Ministry of Health of the Russian Federation; Pirogov Russian National Research Medical University.</p><p>4, st. Dostoevsky, Moscow, 127473; 1/6 Ostrovitianova St, Moscow, 117513</p></bio><email xlink:type="simple">yar.rukin@gmail.co</email><xref ref-type="aff" rid="aff-2"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБУ «Национальный медицинский исследовательский центр фтизиопульмонологии и инфекционных заболеваний» Министерства здравоохранения Российской Федерации</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Federal State Budgetary Institution "National Medical Research Center for Phthisiopulmonology and Infectious Diseases" of the Ministry of Health of the Russian Federation</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ФГБУ «Национальный медицинский исследовательский центр фтизиопульмонологии и инфекционных заболеваний» Министерства здравоохранения Российской Федерации; ФГАОУ ВО "Российский Национальный Исследовательский Медицинский Университет им. Н.И. Пирогова" Министерства здравоохранения Российской Федерации</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Federal State Budgetary Institution "National Medical Research Center for Phthisiopulmonology and Infectious Diseases" of the Ministry of Health of the Russian Federation; Federal State Autonomous Educational Institution of Higher Education Pirogov Russian National Research Medical University of the Ministry of Health of the Russia</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>13</day><month>03</month><year>2026</year></pub-date><volume>0</volume><issue>4</issue><fpage>102</fpage><lpage>111</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Зубиков В.С., Перецманас Е.О., Герасимов И.А., Рукин Я.A., 2026</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="ru">Зубиков В.С., Перецманас Е.О., Герасимов И.А., Рукин Я.A.</copyright-holder><copyright-holder xml:lang="en">Zubikov V.S., Peretzmanas E.O., Gerasimov I.A., Rukin Y.A.</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/57">https://www.jkto.moscow/jour/article/view/57</self-uri><abstract><sec><title>Введение</title><p>Введение. Двухэтапное эндопротезирование при деструктивной форме септического коксита (CK) с использованием цементных артикулирующих спейсеров с антибиотиками в настоящее время используется весьма ограниченным кругом авторов в отличие от похожей тактики, применяющейся при лечении перипротезной инфекции. Данные по эффективности метода на основе анализа значимого по объему клинического материала представлены лишь в единичных работах, и полностью отсутствуют данные о применении метода у больных с ВИЧ инфекцией.</p></sec><sec><title>Цель исследования</title><p>Цель исследования. Оценка эффективности метода двухэтапного эндопротезирования с использованием артикулирующих цементных спейсеров, насыщенных антибактериальными препаратами, при лечении деструктивных форм септического коксита, включая случаи с ВИЧ-инфекцией.</p></sec><sec><title>Материал и методы</title><p>Материал и методы. В исследование включено 50 пациентов с септическим кокситом, которым в 51 случае выполнялась санация тазобедренного сустава с использованием цементных артикулирующих спейсеров с антибиотиками. Больные были разделены на группы. В 1-ю группу вошли 40 пациентов (41 случай), не страдающих ВИЧ инфекцией, во 2-ю группу – 10 пациентов с ВИЧ инфекцией. В 1-й группе больных, интактных по ВИЧ инфекции, второй этап хирургического лечения выполнен в 37 (90,2 %) случаях, а во 2-й группе, с ВИЧ инфекцией – в 8 (80 %).</p></sec><sec><title>Результаты</title><p>Результаты. Положительным результатом проведенного хирургического лечения считали выполнение двух этапов хирургического лечения при отсутствии инфекции установленного эндопротеза, а также восстановление опороспособности конечности. Таким образом, в 1-й группе положительные результаты получены в 34 (82,9 %) из 41 случая. Во 2-й группе - только в   4-х (40 %) из 10 случаев. Функциональные результаты по системе HHS оценивали в отдельных группах только у пациентов, которым выполнены оба этапа хирургического лечения, включая случаи с тяжелыми инфекционными осложнениями, где эндопротез был удален. Оценка в баллах по системе ННS в первой группе больных (n = 37) дала существенное улучшение средних показателей: с 39,1±10,7 (до начала хирургического лечения) до 89,8±11,2 (после получения окончательного результата). Подобная оценка во 2-й группе у больных с ВИЧ инфекцией (n=8) дала следующие данные: 38,3±6,7 (до хирургического лечения) и 51±7,8 (после оценки окончательного результата).</p></sec><sec><title>Заключение</title><p>Заключение. Результаты исследования показали достаточную эффективность двухэтапного эндопротезирования тазобедренного сустава при деструктивной форме септического коксита у больных без ВИЧ инфекции. У ВИЧ инфицированных больных результаты были существенно хуже в связи с большим количеством инфекционных осложнений как на первом, так и на втором этапе хирургического лечения.</p></sec></abstract><trans-abstract xml:lang="en"><sec><title>Introduction</title><p>Introduction: Two-stage total hip arthroplasty for destructive septic coxitis using cemented articulating spacers with antibiotics is currently used by a very limited number of authors, in contrast to a similar approach used to treat hip periprosthetic infection. Data on the effectiveness of this method, based on the analysis of significant clinical observations, are presented only in a few studies, and there are no data on its use in patients with HIV infection.</p></sec><sec><title>Purpose of the study</title><p>Purpose of the study. Evaluation of the effectiveness of a two-stage hip arthroplasty using articulating cement spacers with antibiotics in the treatment of destructive forms of septic coxitis, including cases with HIV infection.</p></sec><sec><title>Materials and Methods</title><p>Materials and Methods. The study included 50 patients with septic coxitis, 51 of whom underwent hip joint debridement using cemented articulating spacers with antibiotics. The patients were divided into groups. Group 1 included 40 patients (41 cases) who were HIV-negative, and Group 2 included 10 patients with HIV infection. In Group 1, the second stage of surgical treatment was performed in 37 (90.2%) patients, while in Group 2, the second stage of surgical treatment was performed in 8 (80%) patients.</p></sec><sec><title>Results</title><p>Results. A positive outcome of the surgical treatment was considered to be the completion of two stages of surgical treatment in the absence of infection of the hip endoprosthesis, as well as the restoration of the weight-bearing ability of the limb. Thus, in the Group 1, positive results were obtained in 34 (82.9%) of 41 cases. In the Group 2 - only in 4 (40%) of 10 cases. Functional results according to the HHS system were assessed only in patients who underwent both stages of surgical treatment, including cases with severe infectious complications, where the endoprosthesis was removed. The assessment in points according to the HHS system in the first group of patients (n = 37) gave a significant improvement in the average indicators: from 39.1 ± 10.7 (before surgical treatment) to 89.8 ± 11.2 (after obtaining the final result). A similar assessment in the 2nd group of patients with HIV infection (n=8) yielded the following data: 38.3±6.7 (before surgical treatment) and 51±7.8 (after assessing the final result).</p></sec><sec><title>Conclusion</title><p>Conclusion. The study demonstrated the reasonable effectiveness of two-stage hip arthroplasty for destructive septic coxitis in patients without HIV infection. In HIV-infected patients, the results were significantly worse due to the higher incidence of infectious complications in both the first and second stages of surgery.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>септический коксит</kwd><kwd>двухэтапное эндопротезирование тазобедренного сустава</kwd><kwd>цементный артикулирующий спейсер с антибиотиками</kwd><kwd>ВИЧ инфекция</kwd></kwd-group><kwd-group xml:lang="en"><kwd>septic coxitis</kwd><kwd>two-stage hip arthroplasty</kwd><kwd>cemented articulating spacer with antibiotics</kwd><kwd>HIV infection</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Ross J. J. Septic arthritis of native joints. Infect Dis Clin North Am. 2017; 31 (2): 203–218. https://doi.org/10.1016/j.idc.2017.01.001</mixed-citation><mixed-citation xml:lang="en">Ross J. J. Septic arthritis of native joints. 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