urmjУральский медицинский журналUral Medical Journal2949-4389Ural State Medical University10.52420/2071-5943-2023-22-5-103-114urmj-1335Research ArticleЛитературные обзоры | Literature reviewsLiterature reviewsПерспективные направления применения гидрогелей для внутрисуставного лечения остеоартритаProspective applications of hydrogels for the intra-articular treatment of osteoarthritishttps://orcid.org/0000-0003-4207-1862ЧернядьевС. А.Chernjad'evS. A.

Сергей Александрович Чернядьев, доктор медицинских наук, профессор, заведующий кафедрой хирургических болезней, сердечно- сосудистой хирургии, реконструктивной и пластической хирургии

Екатеринбург

Sergej A. Chernjad'ev, Doctor of Science (Medicine), Professor, Head of the Department of Surgical Diseases, Cardiovascular Surgery, Reconstructive and Plastic Surgery

Ekaterinburg

chsa-surg@mail.ruhttps://orcid.org/0000-0003-1261-3712ЖиляковА. В.ZhilyakovA. V.

Андрей Викторович Жиляков, доктор медицинских наук; доцент кафедры хирургических болезней, сердечно-сосудистой хирургии, реконструктивной и пластической хирургии

Екатеринбург

Andrey V. Zhilyakov, Doctor of Science (Medicine), Associate Professor of the Department of Surgical Diseases, Cardiovascular Surgery, Reconstructive and Plastic Surgery

Ekaterinburg

doctor-zhilyakov@rambler.ruhttps://orcid.org/0000-0002-4270-3041ПестовА. В.PestovA. V.

Александр Викторович Пестов, кандидат химических наук, доцент, старший научный сотрудник

Екатеринбург

Aleksandr V. Pestov, PhD (Chemistry), Associate Professor, Senior Researcher

Ekaterinburg

pestov@ios.uran.ruhttps://orcid.org/0009-0003-8588-5724ВеретенниковаЕ. А.VeretennikovaE. A.

Елизавета Андреевна Веретенникова, магистр химии, аспирант

Екатеринбург

Elizaveta A. Veretennikova, Master of Chemistry, Postgraduate Student

Ekaterinburg

lizaveret@yandex.ruhttps://orcid.org/0000-0002-5979-7398ДрукаренкоН. А.DrukarenkoN. A.

Никита Александрович Друкаренко, младший научный сотрудник

Екатеринбург

Nikita A. Drukarenko, младший научный сотрудник

Ekaterinburg

targosk@yandex.ruhttps://orcid.org/0000-0003-0775-4043КаманцевИ. С.KamancevI. S.

Иван Сергеевич Каманцев, кандидат технических наук, заведующий сектором новых материалов и технологий

Екатеринбург

 

Ivan S. Kamancev, PhD (Technical Sciences), Head of the New Materials and Technologies Sector

Ekaterinburg

ks@imach.uran.ruhttps://orcid.org/0000-0003-4123-1940КузнецовА. В.KuznecovA. V.

Алексей Викторович Кузнецов, кандидат технических наук, научный сотрудник

Екатеринбург

Aleksej V. Kuznecov, PhD (Technical Sciences), Researcher

Ekaterinburg

kuz031082@rambler.ruУральский государственный медицинский университетРоссияUral State Medical UniversityRussian FederationИнститут органического синтеза им. И.Я. ПостовскогоРоссияI.Ya. Postovsky Insititute of Organic SynthesisRussian FederationИнститут машиноведения имени Э.С. ГоркуноваРоссияJe.S. Gorkunov Institute of Engineering ScienceRussian Federation202327102023225103114Copyright © Чернядьев С.А., Жиляков А.В., Пестов А.В., Веретенникова Е.А., Друкаренко Н.А., Каманцев И.С., Кузнецов А.В., 20232023Чернядьев С.А., Жиляков А.В., Пестов А.В., Веретенникова Е.А., Друкаренко Н.А., Каманцев И.С., Кузнецов А.В.Chernjad'ev S.A., Zhilyakov A.V., Pestov A.V., Veretennikova E.A., Drukarenko N.A., Kamancev I.S., Kuznecov A.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.umjusmu.ru/jour/article/view/1335Введение

Введение. Остеоартрит (ОА) – это дегенеративное заболевание, которое приводит к постепенной потере хряща и образованию остеофитов, а соответственно – к нестабильности суставов, болям и ограниченной мобильности. Варианты лечения включают лекарственную терапию, физиотерапию, изменение образа жизни и операции по коррекции или замене суставов. Внутрисуставные методы лечения, такие как введение гидрогелей, модифицированных для конкретных клинических задач, становятся все более популярными благодаря своей способности обеспечивать целевое и эффективное облегчение с минимальными побочными эффектами.

Цель работы – оценка использования гидрогелей для внутрисуставного лечения остеоартрита на основании анализа научной литературы.

Материалы и методы

Материалы и методы. Литературные источники отобраны в базах данных PubMed, ScienceDirect и SciSpace с использованием тематических поисковых запросов: “hydrogel” AND “intra?articular” AND “osteoarthritis”. Период поиска был ограничен 2018–2023 гг. публикации. В результате первичного отбора статей по поисковым славам обнаружено 1 576 статей, после анализа и применения критериев исключения в обзор были включены 53 наиболее значимых источника.

Результаты

Результаты. Определены два типа гидрогелей для внутрисуставного применения: инъекционные и имплантируемые. Инъекционные гидрогели применяют для замены синовиальной жидкости, доставки лекарственных средств или заполнения очаговых дефектов хряща. Имплантируемые гидрогели используют для замены или восстановления поврежденного хряща в суставах, пораженных ОА, что обеспечивает восстановление целостности их поверхности, редукцию болевого синдрома и улучшение функции.

Обсуждение

Обсуждение. Гидрогели демонстрируют перспективность в качестве потенциального материала для лечения ОА, поскольку обладают рядом преимуществ, таких как биомимикрия, биосовместимость, малоинвазивность введения и способность доставлять терапевтические агенты непосредственно в пораженный сустав. Однако существует ряд ограничений: неконтролируемая деградация, небольшая долговечность, высокая вероятность негативных местных и системных иммунных реакций.

Заключение

Заключение. Необходимы дальнейшие исследования для оптимизации конструкции и состава гидрогелей для клинического использования, включая разработку новых композиций с программируемыми свойствами, изучение долгосрочных эффектов и сравнение эффективности с другими методами лечения ОА. 

Introduction Osteoarthritis (OA) is a degenerative disease that leads to gradual loss of cartilage and the formation of osteophytes, and consequently to joint instability, pain, and limited mobility. Treatment options include drug therapy, physiotherapy, lifestyle changes and surgery to correct or replace the joint. Intra-articular treatments, such as the injection of hydrogels modified for specific clinical tasks, are becoming increasingly popular due to their ability to provide targeted and effective relief with minimal side effects.

Purpose of this study was to evaluate the use of hydrogels for the intra-articular treatment of osteoarthritis (OA) based on a review of scientific literature.

Materials and methods Literature sources for the evaluation of the use of hydrogels for the intraarticular treatment of OA were selected using the subject search queries “hydrogel” AND “intra? articular” AND “osteoarthritis” in the PubMed, ScienceDirect and SciSpace databases. The search period was limited to 2018–2023 years of publication. An initial selection of articles by search glories resulted in 1,576 articles; after analysis and application of exclusion criteria, 53 of the most relevant sources were included in the review.

Results Two types of hydrogels for intra-articular use have been dentified: injectable and implantable. Injectable hydrogels are used to replace synovial fluid, deliver drugs or fill focal cartilage defects. Implantable hydrogels are used to replace or repair damaged cartilage in joints affected by OA, thereby restoring surface integrity, reducing pain and improving function.

Discussion Hydrogels demonstrate promise as a potential material for the treatment of OA as they offer several advantages, such as biomimicry, biocompatibility, minimally invasive administration and the ability to deliver therapeutic agents directly to the affected joint. However, there are limitations: uncontrolled degradation, low durability and a high likelihood of negative local and systemic immune reactions.

Conclusion Further research is needed to optimize the design and composition of hydrogels for clinical use, including the development of new compositions with programmable properties, studying long-term effects and comparing effectiveness with other OA treatment.

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