Background: the search for reliable diagnostic laboratory markers of the development of infectious and inflammatory processes is an urgent topic for scientific research. At the same time, the sensitivity and specificity indicators of currently used biomarkers of inflammation are often insufficient for timely decision-making in the treatment of patients at risk of developing such complications. To date, there is evidence of the use of a fragment of the CD14 transmembrane protein presepsin (PSP) as a new biomarker of infectious complications, which has almost 100% sensitivity and 98% specificity, which can be successfully used in predicting the risk of developing infectious complications in the postoperative period.

Objective: the aim of this clinical study is to compare the value of presepsin with traditional laboratory markers of inflammation in predicting the risk of infectious complications after sequential osteosynthesis of gunshot fractures of long tubular bones.

Materials and methods: in 113 wounded, we determined the following parameters: C-reactive protein (CRP), procalcitonin (PCT), PSP, erythrocyte sedimentation rate (ESR) and the number of leukocytes in serum/plasma. The prognostic characteristics of laboratory markers were evaluated based on the use of concentration thresholds obtained during the study of biomarkers. The prognostic value of the level of all analyzed biomarkers in relation to the occurrence of infectious complications was assessed by sensitivity and specificity based on ROC analysis and determination of the limit values of the studied markers before and after sequential osteosynthesis surgery.

Results: based on the ROC analysis, cutoff values for CRP, PSP, PCT, ESR, and leukocyte counts were established for the study patients. Moreover, CRP and ESR demonstrated the best specificity/sensitivity ratio, while procalcitonin and presepsin demonstrated the least optimal.

Conclusion: presepsin and procalcitonin did not demonstrate significant predictive value in predicting the risk of infectious complications during sequential osteosynthesis of gunshot fractures of long tubular bones. However, CRP, ESR, and dynamic leukocyte counts in a complete blood count during the postoperative period demonstrated high predictive value.

Introduction. The formation of a stump, followed by implantation of osteointegrated implants, is a serious problem. During preclinical tests, various animal models are used. We studied the features of the modeling of the stump and postoperative conducting on rabbits.

The aim of the study is to determine the features of modeling the stults of experimental animals and postoperative management for the subsequent installation of osteointegrated implants.

Materials and methods. The study included 14 rabbits of the Soviet chinchilla breed. Transtibial amputation of the hind limb was performed with the formation of the anterior and predominant size of the posterior fasciocutaneous and muscle flaps; osteotomy was performed with an oscillating saw with saline cooling. The self-tapping sleeve was inserted into the medullary canal by screw movements to the level of the saw; the wound was closed in layers without drainage. We have developed and applied an individual 3D-modeled immobilizing sleeve mounted on top of an aseptic bandage.

Results. A detailed protocol of operation and the stages of postoperative conducting animals for the subsequent installation of osteointegrated implants have been developed. A new immobilizing rear limb of the sleeve rabbit using 3D modeling and additive technologies is proposed. The advantages and disadvantages of the proposed methodology were identified.

Conclusion. A new approach to modeling of skin-muscle flaps allows minimizing tissue injuries in the postoperative period and reducing the frequency of necrosis. The manufacture of an immobilizing sleeve protects the stump from mechanical damage. The experience of forming a stump, the manufacture of implants and immobilizing devices, as well as postoperative management, can be used in preclinical studies to test new materials and structures, as well as for experiments on a large animal model.

Introduction. Knee osteoarthritis is one of the most common causes of chronic pain and functional limitation in middle-aged and elderly individuals. Although total knee arthroplasty (TKA) is a well-established and effective procedure, up to 20 % of patients remain dissatisfied with surgical outcomes, primarily due to suboptimal component positioning and soft-tissue imbalance. Robotic-assisted systems aim to improve surgical precision and reproducibility of results; however, the clinical advantages of this approach over conventional techniques remain insufficiently substantiated.

The purpose of the study. To compare the clinical and functional outcomes and safety of robotic-assisted versus conventional total knee arthroplasty in a prospective randomized trial with a 2-year follow-up.

Materials and methods. A single-center, prospective, randomized study was conducted involving 100 patients (50 per group) with grade III–IV knee osteoarthritis according to the Kellgren–Lawrence classification. The study group underwent robotic-assisted TKA using the Cuvis Joint™ system, whereas the control group received conventional manual TKA. Functional outcomes were assessed preoperatively and at 2, 6, 12 and 24 months postoperatively using the IKDC, KSS, VAS, and Lequesne scales. Statistical analysis included the Mann–Whitney U test for continuous variables and Pearson’s χ² test for categorical data, with a significance threshold of p = 0.05.

Results. Outcomes were evaluated in all 100 participants. On the IKDC scale, the robotic group showed significantly better results at 2 months (median 42 vs 36; p < 0.001), 6 months (55 vs 52; p = 0.001), and 12 months (68 vs 65; p = 0.001), with comparable results at 24 months (p = 0.141). The KSS scores remained higher in the robotic group throughout follow-up (p < 0.01). Pain intensity (VAS) and Lequesne index values were significantly lower in the robotic group from 2 months onward (p < 0.01). Median operative time was 95 minutes versus 60 minutes (p < 0.001), and intraoperative blood loss was 300 mL versus 250 mL (p = 0.022). No adverse events or complications were observed.

Conclusion. Robotic-assisted total knee arthroplasty provides greater improvement in functional outcomes and pain reduction compared with conventional manual TKA, while maintaining a comparable safety profile. The observed increase in operative time and intraoperative blood loss reflects the learning curve effect and does not diminish the overall clinical efficacy of the technique. The findings support the feasibility and clinical relevance of implementing robotic technologies in arthroplasty of large joints (particularly, knee joints).

Traditional methods of limb axis alignment—mechanical and anatomical, kinematic and functional alignment (MA and AA, KA and FA) – are all based on the level and angle of femoral and tibial resection and subsequent balancing of flexion-extension and medial-lateral interosseous gaps by releasing the knee joint capsule and ligaments, which corrects fixed deformities and brings the limb into proper alignment. FA achieves balanced flexion-extension gaps and soft tissue tension by adjusting bone resection, fine-tuning component positions, and reducing soft tissue release using a robotic system.

The purpose of this article is to provide a comparative description of various limb axis alignment techniques for total knee arthroplasty using an autonomous robotic platform based on computed tomography image analysis, preoperative individualized planning, and intraoperative soft tissue balance.

Materials and Methods: This article, using our own clinical data, presents a step-by-step technique for performing robotic total knee arthroplasty using mechanical, anatomical, kinematic, and functional limb axis alignment techniques. It also describes the principles and methods of planning and surgical technique.

Results: From October 2023 to November 2025, 472 patients underwent robotic total knee arthroplasty at the Traumatology, Orthopedics, and Joint Pathology Clinic of Sechenov University Clinical Hospital No. 1.

Conclusion: Total knee arthroplasty can be safely performed using any of the presented methods of limb alignment. However, restoring a patient's natural anatomy using traditional instruments can sometimes be challenging. Therefore, the use of robotic technologies with intraoperative visualization and implant positioning may be very promising, although they currently lack long-term benefits. This necessitates further research to identify the limitations of these methods and determine which patients will benefit most from which type of limb alignment and implant positioning.

Introduction. Articular cartilage has a very limited capacity for self-repair; therefore, its damage often leads to irreversible changes. Various technologies have been developed for cartilage restoration, including autologous chondrocyte implantation (ACI). The method is based on culturing autologous cells that produce cartilage matrix, followed by their implantation into the articular cartilage defect.

Objective. Presentation of clinical cases of the first use of human autologous chondrocytes in routine practice in Russia.

Materials and Methods. Two clinical cases of articular cartilage defects in different anatomical locations were analyzed. The follow-up period after implantation was 4 months. During routine visits, patients underwent interviews, physical examination, range-of-motion assessment, and objective clinical evaluation. MRI of the target knee joints was performed before the first surgical intervention and 4 months after second surgery. Two surgical procedures were carried out according to the described technique, with intraoperative photographic documentation of the joint before and after autologous chondrosphere implantation.

Results. During the follow-up of two clinical cases with articular cartilage defects treated with implantation of autologous chondrospheres, positive early outcomes were obtained. A reduction in pain, an increase in range of motion, and an improvement in joint function were observed. Follow-up MRI of the operated knee joints at 4 months confirmed the formation of a homogeneous regenerate and satisfactory integration of the chondrospheres with the surrounding cartilage. The postoperative period was uneventful, and the patients reported an improvement in quality of life.

Conclusion. The use of autologous chondrospheres is a promising and effective method for repairing cartilage defects of the knee joint. The technique provides lasting improvement in joint function and morphologically confirmed cartilage regeneration.

Introduction. The variety of types of small toes static deformities and the absence of a unified list of objective deformity indicators complicate it classification and affect on treatment outcomes. Thorough analysis of the hammer toe surgical treatment outcomes using a specific technique will allow us to solve of these problems. The purpose of the study: to analyze the results of using Helal osteotomy for correction of the hammer second toe.

Materials and methods. Between 2018 and 2020, we performed Helal osteotomy in 40 patients with unilateral static foot deformity. These patients had a hammer toe in combination with hallux valgus. The results of the operations were analyzed in the study.

Results. The use of Helal osteotomy allowed achieving complete correction of the hammertoe deformity of the second toe in 70% of patients. This led to an improvement in the clinical and functional parameters of the second toe. However, residual deformation of the toe was observed in 30% of cases, stiffness in the second metatarsophalangeal joint in 27.5 % of cases, and transitional metatarsalgia in 7.5% of cases. This indicates the insufficient effectiveness of the method. The main reason for the residual deformation of the second toe is the limited capabilities of the Helal osteotomy. These  capabilities allow correcting hyperextension of the toe in the metatarsophalangeal joint only within 18.67 ± 3.27 degrees. This is especially noticeable with a large angle of dorsal deviation.

Conclusion. The Helal osteotomy used to correct hammer toe deformities does not always produce the desired result. To more accurately select a treatment strategy and evaluate its success, it is necessary to develop a set of objective criteria based on clinical, radiographic and functional data. These criteria will allow classifying foot deformities, selecting the optimal treatment method and evaluating its effectiveness.

Purpose. Evaluation of the effectiveness and safety of posterolateral bilateral extrapleural access in the surgical treatment of nonspecific spondylitis of the upper thoracic spine.

Methods. The study included 12 patients with nonspecific purulent pathology of the upper thoracic spine, who were operated on with the use of posterolateral bilateral extrapleural approach. In 10 cases, in addition to pain syndrome, the clinical picture of the disease was represented by conduction symptoms, including isolated pain in 2 cases. Localization of the pathological process at Th3-Th4 vertebrae occurred in 3 patients, at the Th4-Th5 – in 5, and at the Th5-Th6 – in 4 patients.

Results. In all patients, a decrease in the intensity of pain by 5-7 points (6,2 on average) on the visual analog scale (VAS) was noted in the postoperative period. During the observation period, regression of conduction disorders was observed in 2 patients, complete recovery was observed in 5 (Frankel E). The results of the control examination revealed the suppression of the inflammatory process and complete bone consolidation in all cases (Grade I-II according to Eck et al). The duration of the operations varied from 240 to 375 min. (on average – 307 min). The volume of blood loss ranged from 300 to 1200 ml. (on average – 658 ml). Intraoperative liquorrhea was observed in 2 cases.

Conclusion. Posterolateral bilateral extrapleural access allows for radical sanitation, complete decompression and spinal fusion for nonspecific purulent lesions of the upper thoracic spine. Moving away from a standard technique by Capener N. and Larson S.J. allowed to significantly expand access options and minimize the risk of complications. Despite the complexity, duration and large volume of blood loss, the use of this method is justified for nonspecific spondylitis of the upper thoracic localization. However, at other levels, if there is an alternative in the form of ventral interventions, its use might be irrational.

This research presents a historical view to the emergence, formation, and development of Saratov Traumatology, Orthopedics and Neurosurgery Research Institute of V.I. Razumovsky Saratov State Medical University as well as to its contribution to Russian medical science and healthcare.

Introduction. Medial meniscus root injury (MMRI), a frequent knee pathology that can lead to complete loss of medial meniscus (MM) function and significant degenerative changes in the knee joint. Residual extrusion of the medial meniscus on postoperative magnetic resonance imaging (MRI) is noteworthy. Several authors have not found a correlation between surgical outcome and functional outcome. The aim of this study was to evaluate subjective and objective results after refixation of the root of the medial meniscus.

Materials and Methods. A prospective non-randomised study, 32 patients with MM root rupture who underwent root refixation with modified technique transtibial Pull-Out fixation using a were included. All patients were women, 43-72 years old, and none of them had chondromalacia not exceeding the 2nd degree according to the ICRS classification. Functional status was assessed by KOOS and VAS, and MRI was performed to evaluate meniscus excursion and the degree of MM root fusion before and after surgery. The follow-up period was 12 months.

Results. Complete healing was noted in 28 patients (87.5%) and partial healing in 4 (12.5%). The pain score decreased from 7.7 ± 0.7 VAS score to 1.8 ± 1.2. The mean KOOS score improved from 38.6 ± 12.5 points to 75.6 ± 14.4 points. The mean meniscus extrusion preoperatively was 4.06 ± 0.82 mm and postoperatively 2.67 ± 0.71 mm, which was statistically significant.

Conclusion. Meniscus root refixation performed using a modified technique allowed to achieve good results in 75.0% of cases. The degree of MM extrusion after arthroscopic fixation of its root showed a moderate close relationship with the function of the knee joint. In case of varus deformity of the lower limb with the value of the NKA angle < 175°, the functional results statistically significantly worsened and were assessed as unsatisfactory.

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.

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.

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.

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).

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.

Introduction: The resistance of pathogenic microorganisms to antibacterial therapy in cases of periprosthetic infection is the cause of the chronic course and the inability to stop the inflammatory process. The use of antibacterial coated implants opens up new opportunities for the prevention and effective treatment of postoperative complications of an infectious nature during operations using non-biotic implants.

Purpose. To carry out a comprehensive assessment of clinical and paraclinical indicators in animals with modeled gram-negative periimplant infection of the femur using intramedullary titanium rods without coating and with copper-containing coating based on amorphous nanocarbon.

Materials and methods. The research material included indicators of the severity of disorders of static-dynamic function, the severity of local signs of inflammation, the dynamics of animal body weight, as well as the pathomorphological picture of the disease course of two compared groups of animals (each group included 16 individuals) with a model of periimplant deep hip infection with an etiotropic agent in the form of a museum strain of P. aeruginosa. The evaluation of treatment outcomes took into account the sum of criteria. The criterion was expressed in scores from 0 to 4. In experimental operations, intramedullary titanium alloy implants were used without coating (control group) and coated with amorphous nanocarbon containing microparticles of copper in a certain concentration (main group). The studies were conducted on days 3, 7, 14, and 28. Clinical, electron microscopic, radiation and statistical research methods were used.

Results. It has been revealed that the use of innovative copper-coated implants for gram-negative osteomyelitis of the femur in laboratory rats achieves optimal treatment results in the absence of physical inactivity, weight loss, extensive osteolysis and an array of necrotic tissues. The total assessment of the result in animals of the control group was 11.7 points (unsatisfactory outcome), in the main group — 4.7 points (good result). Statistical calculation of the difference determined their significant reliable difference (t=11.32; df=30, p=0.01).

Conclusions. A comprehensive study of the inflammatory response when using coated implants based on amorphous nanocarbon with copper particles in conditions of experimental gram-negative infection allows us to consider this type of implant as a promising tool for solving the problems of treatment and prevention of periprosthetic infection and osteomyelitis in clinical practice.

Relevance. Several methods are currently used to maintain the motion of the first metatarsophalangeal joint in osteoarthritis of stage 3-4. However, the pathology of the sesamoid bones and the metatarsophalangeal joint, in particular, is often ignored. The authors proposed a new method for treating osteoarthritis of the first metatarsophalangeal joint of stage 3-4 with pronounced degenerative changes in the metatarsophalangeal joint.

The aim of the work is to demonstrate an original technique and the results of treating osteoarthritis of the first metatarsophalangeal joint of stage 3-4 with concomitant degenerative changes in the metatarsophalangeal joint by hemiendoprosthetics of the first metatarsophalangeal joint with a ceramic implant in the UK with plastic surgery of the metatarsophalangeal joint with a collagen membrane.

Materials and methods. The surgical technique includes resection of the articular surface of the head of the first metatarsal bone, selection of the size of the hemiendoprosthesis, insertion of a guide pin through the guide followed by formation of a channel using two types of compactors. Resection of the altered articular surface of the head of the first metatarsal bone and its osteoperforation according to Beck are performed. If necessary, resection is performed along the plane of hypertrophied sesamoid bones. Adaptation of the collagen membrane and fixation using fibrin glue or suture material are performed.

Results. In the Foot Surgery Center of the S. S. Yudin City Clinical Hospital, 21 patients were operated on using the described technique with an observation period of more than 12 months. There were 17 women (81.0%) and 4 men (19.0%). The average age of the patients was 61 years ± 7.7 (43-72). There were 12 patients over 60 years old (57.4%). The range of motion of the 1 MTP joint without load: before treatment - 15° ± 3.3 (5°-20°), after 12 months 25° ± 3.8 (15°- 30°). The range of motion of the first MTP joint with physiological load simulating the pre-transfer phase: before treatment - 15° ± 3.0 (10°- 25°), 12 months after surgery - 35° ± 5.2 (25°-45°). Results of the patient questionnaire using the visual analogue scale (VAS): before surgery - 7.7 ± 1.9 (4-10) points, 12 months after the treatment - 1.6 ± 0.8 (0-3) points. Questionnaire using the American Orthopaedic Foot and Ankle Society Hallux Score (AOFAS HS) scale before and 12 months after the treatment - 35.5 ± 10.9 (18-52) and 82.7 ± 5.2 (73-90), respectively. The Foot Function Index (FFI) scores at the time of preoperative examination were 63.5% ± 9.9 (48% - 82%), after 12 months - 10.5% ± 2.5 (7% -16%).

Conclusion. Hemiendoprosthetics of the first metatarsophalangeal joint in combination with plastic surgery of the metatarsophalangeal joint with a collagen membrane allows for the restoration of movement in both the metatarsophalangeal and metatarsophalangeal joints, which allows for a comprehensive approach to the issue of restoring movement.

Introduction: Posttraumatic arthritis of the patellofemoral joint is a serious medical problem, especially among young and middle-aged people and active athletes. According to various studies, the incidence of posttraumatic changes in the patellofemoral joint ranges from 10% to 40%, which confirms the relevance of surgical treatment.

Objective: to improve the results of surgical treatment of post-traumatic osteoarthritis of the patellofemoral joint with lateral patellar hyperpression using arthroscopic lateral patellar release.

Materials and Methods: Fifty-four patients aged 20 to 70 years (M±σ 50.7±13.3 years) with lateral patellar hyperpressure syndrome participated in the study. Patients were divided into 2 groups: 39 patients who underwent surgical treatment and 15 patients who were treated conservatively. All patients were questioned using the VAS and KOOS scales.

Results: The VAS scale score in group 1 patients had a faster decrease in pain score in dynamics (from 6,5 to 1,56; 74%) compared to that in group 2 patients. Total KOOS scale score in patients of group 1 in dynamics increased in earlier terms (from 36,12 to 80,09; 121,73%) in comparison with the index of patients of group 2. By the end of follow-up in both groups, statistically reliable improvement of VAS and KOOS scores was noted. Surgical intervention, including dissection of the lateral supporting ligament of the patella, provided faster pain relief (VAS score) and improved functional status with increased activity levels (in daily life and sports) and quality of life (KOOS score) compared with conservative treatment.

Conclusion: The analysis of the results of surgical treatment of post-traumatic patellofemoral joint arthritis showed positive outcomes and a significant improvement in the clinical indicators of the knee joint, as well as a reduction in pain levels at earlier stages compared to conservative treatment.

Background: Knee osteoarthritis (OA) is a prevalent degenerative joint disorder characterized by chronic pain and functional impairment. While minimally invasive treatments like platelet-rich plasma (PRP) injections and genicular nerve denervation are used for advanced stages, their comparative efficacy requires further investigation.

Objective: To compare the effectiveness and safety of intra-articular PRP injections and laser genicular nerve denervation (LGND) in patients with late-stage knee OA.

Methods: In this prospective, randomized, controlled trial, 31 patients with Kellgren-Lawrence grade 3-4 gonarthrosis were allocated to either a single intra-articular injection of autologous PRP (n=16) or a percutaneous LGND procedure (n=15) targeting the superomedial, superolateral, and inferomedial genicular nerves under combined x-ray and ultrasonographic guidance. The primary outcomes were the change from baseline in Visual Analog Scale (VAS) pain scores and the Oswestry Disability Index (ODI) at 2 weeks, 3 months, and 6 months post-procedure.

Results: The LGND group demonstrated a statistically significant and greater reduction in both VAS and ODI scores at all follow-up intervals compared to the PRP group. No serious adverse events were reported in either group throughout the 6-month study period.

Conclusion: For patients with late-stage knee osteoarthritis, laser genicular nerve denervation provides superior and sustained pain relief and functional improvement over a single intra-articular PRP injection, with a comparable safety profile over six months.

Rationale: Total hip joint endoprosthetics is the most common way of surgical treatment of hip joint osteoarthrosis. The long-term existence of this method and the development of operative techniques allow minimizing the risks of complications during primary hip joint arthroplasty. However, in case of concomitant pathology with changes in bone density in patients, the risk of fractures increases both at the stage of endoprosthesis installation and in the postoperative period.

Study objective: To identify treatment characteristics and potential technical difficulties during total hip joint endoprosthetics in patients diagnosed with osteopetrosis.

Materials and Methods: This article presents a clinical case of total endoprosthetics in a patient with osteopetrosis and a review of current medical periodicals on this topic.

Conclusion: The materials of this clinical case and literature review are intended to draw the attention of practicing traumatologists and orthopedists to possible difficulties and complications in treatment of patients with osteopetrosis and to prevent intraoperative complications during hip joint endoprosthetics.

Introduction: osteoarthritis is classified as a disease of the musculoskeletal system characterized by the destruction of articular cartilage affecting the entire joint, subchondral bone, synovial membrane, ligaments, tendons and muscles. However, the molecular and cellular mechanisms contributing to the spread of pathogenic factors through the tissues of the joint are still unknown. Due to the emergence of new highly effective research methods, significant progress has been made in recent years in the study and understanding of the molecular mechanisms leading to the development of joint pathologies.

The aim of the study was to study the molecular mechanisms of initiation and progression of osteoarthritis, as well as to summarize potential therapeutic strategies for the treatment of joint pathologies.

Materials and methods: the analysis of scientific medical literature sources containing data from their own research, as well as reviews on the diagnosis and treatment of osteoarthritis, was carried out. Information was searched by keywords in electronic medical and general scientific databases: PubMed, ScienceDirect, eLibrary.

Results: The above review of scientific data strongly suggests that the identification of informative biomarkers necessary for the prevention and treatment of joint disease has become an urgent need for clinical practice.