medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2025-302medsovet-9320Research ArticleРЕВМАТОЛОГИЯRHEUMATOLOGYУправление остеоартритом на ранней стадии развития заболеванияManaging osteoarthritis in the early stages of the diseasehttps://orcid.org/0000-0003-3509-1072БашковаИ. Б.BashkovaI. B.

Башкова Инна Борисовна - к.м.н., доцент, доцент кафедры госпитальной терапии, Чувашский государственный университет имени И.Н. Ульянова; врач-ревматолог, Федеральный центр травматологии, ортопедии и эндопротезирования (г. Чебоксары).

428015, Чувашская Республика, Чебоксары, Московский проспект, д. 15; 428020, Чувашская Республика, Чебоксары, ул. Федора Гладкова, д. 33

Inna B. Bashkova - Cand. Sci (Med.), Associate Professor, Associate Professor of the Department of Hospital Therapy, Chuvash State University named after I.N. Ulyanov; Rheumatologist, Federal Center for Traumatology, Orthopedics and Arthroplasty (Cheboksary).

15, Moskovsky Ave., Cheboksary, Chuvash Republic, 428015; 33, Fedor Gladkov St., Cheboksary, Chuvash Republic, 428020

innabashkova@yandex.ruhttps://orcid.org/0000-0001-7313-0365БусалаеваЕ. И.BusalaevaE. I.

Бусалаева Елена Исааковна - к.м.н., доцент, доцент кафедры госпитальной терапии, Чувашский государственный университет имени И.Н. Ульянова; доцент кафедры терапии и общеврачебной практики, Институт усовершенствования врачей;

428015, Чувашская Республика, Чебоксары, Московский проспект, д. 15; 428018, Чувашская Республика, Чебоксары, ул. Михаила Сеспеля, д. 27

Elena I. Busalaeva - Cand. Sci. (Med.), Associate Professor, Associate Professor of the Department of Hospital Therapy, Chuvash State University named after I.N. Ulyanov; Associate Professor of the Department of Therapy and General Medical Practice, Institute for Advanced Training of Doctors.

15, Moskovsky Ave., Cheboksary, Chuvash Republic, 428015; 27, Mikhail Sespel St., Cheboksary, Chuvash Republic, 428018

busa-elena@yandex.ruhttps://orcid.org/0009-0003-5517-5537ТимофееваА. Г.TimofeevaA. G.

Тимофеева Алина Геннадьевна - врач-диетолог.

428020, Россия, Чувашская Республика, Чебоксары, ул. Федора Гладкова, д. 33

Alina G. Timofeeva – Dietologist.

33, Fedor Gladkov St., Cheboksary, Chuvash Republic, 428020

timalilya@mail.ruЧувашский государственный университет имени И.Н. Ульянова; Федеральный центр травматологии, ортопедии и эндопротезирования (г. Чебоксары)РоссияChuvash State University named after I.N. Ulyanov; Federal Center for Traumatology, Orthopedics and Arthroplasty (Cheboksary)Russian FederationЧувашский государственный университет имени И.Н. Ульянова; Институт усовершенствования врачейРоссияChuvash State University named after I.N. Ulyanov; Institute for Advanced Training of DoctorsRussian FederationФедеральный центр травматологии, ортопедии и эндопротезирования (г. Чебоксары)РоссияFederal Center for Traumatology, Orthopedics and Arthroplasty (Cheboksary)Russian Federation202508082025012182191Copyright © Башкова И.Б., Бусалаева Е.И., Тимофеева А.Г., 20252025Башкова И.Б., Бусалаева Е.И., Тимофеева А.Г.Bashkova I.B., Busalaeva E.I., Timofeeva A.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/9320

Остеоартрит (ОА) – одно из наиболее распространенных ревматических заболеваний, приводящее к дегенерации гиалинового хряща, воспалению синовиальной ткани и структурным изменениям в суставах. Основными факторами риска развития ОА являются ожирение, возраст, генетическая предрасположенность, травмы и механические перегрузки. Диагностика ОА основывается на клинических симптомах, данных осмотра и рентгенологических признаках, однако ранние стадии заболевания часто остаются нераспознанными. Представлен клинический случай пациентки 52 лет с первичным ОА коленных суставов и межфаланговых суставов кистей и стоп. В совокупности отягощенная наследственность, морбидное ожирение, менопауза, длительное ношение обуви на высоком каблуке, изменение сводов стопы (плоскостопие), нерациональные интенсивные спортивные нагрузки привели к манифестации ОА. Комплексное лечение включало длительный курсовой прием хондроитина сульфата в дозе 1 000 мг/сут, индивидуально подобранные лечебные упражнения, ортезирование стоп, формирование стиля правильного питания, что способствовало уменьшению объема жировой массы и приросту мышечной массы. Через 1,5 года терапии достигнуто улучшение состояния: снижение массы тела на 23 кг, полное купирование суставного болевого синдрома, нормализация исходно повышенного уровня олигомерного матриксного белка хряща и отсутствие рентгенологического прогрессирования ОА. Именно такая комплексная персонализированная терапия на стадии манифестации ОА позволила достичь хороших результатов в управлении заболеванием на ранней стадии и предотвратить его дальнейшее прогрессирование.

Osteoarthritis (OA) is one of the most common rheumatic diseases that leads to degeneration of hyaline cartilage, synovial inflammation, and structural changes in joints. The main risk factors for developing OA are obesity, age, genetic predisposition, injury, and mechanical overload. Diagnosis of OA is based on clinical symptoms, examination data, and X-ray signs, but the early stages of the disease often remain unrecognized. A clinical case of a 52-year-old patient with primary OA of the knee joints, interphalangeal joints of the hands and feet is presented. A combination of burdened heredity, morbid obesity, menopause, prolonged wearing of high-heeled shoes, changes in the arches of the foot (flat feet), irrational intense sports activity led to the manifestation of OA. Comprehensive treatment included long-term administration of chondroitin sulphate at a dose of 1 000 mg/day, individually tailored therapeutic exercises, foot orthotics, and the development of a healthy diet, which led to a reduction in fat mass and an increase in muscle mass. After 1.5 years of therapy, improvement was achieved: a 23 kg reduction in body weight, complete relief of joint pain syndrome, normalisation of the initially elevated level of oligomeric matrix protein in the cartilage, and no radiographic progression of OA. It was this comprehensive personalised therapy at the stage of OA manifestation that made it possible to achieve good results in managing the disease at an early stage and prevent its further progression.

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