rsjРоссийский хирургический журналRussian surgical journal3034-72703033-5604Фонд Алмазова10.18705/3034-7270-2026-2-1-67-78rsj-92Research ArticleТРАВМАТОЛОГИЯTRAUMATOLOGYОстеоартрит коленного сустава: особенности эмбриогенеза, эпидемиология, концепция ранней диагностики (обзор литературы)Osteoarthritis of the knee joint: features of embryogenesis, epidemiology, concept of early diagnosis (literature review)https://orcid.org/0000-0003-4585-5160ТкаченкоА. Н.TkachenkoA. N.

Ткаченко Александр Николаевич  – д-р мед. наук, профессор, профессор кафедры общей хирургии

Санкт-Петербург

Tkachenko Alexander N. – Doctor of Medical Sciences, Professor, Professor  of  the  Department  of  General  Surgery

St. Petersburg

altkachenko@mail.ruhttps://orcid.org/0000-0002-2660-9469ОстапченкоА. А.OstapchenkoA. A.

Остапченко Андрей Александрович – канд. мед. наук, доцент кафедры общей хирургии

Санкт-Петербург

Ostapchenko Andrey A. – Candidate of Medical Sciences, Associate Professor of the Department of General Surgery

St. Petersburg

aostap@gmail.comhttps://orcid.org/0000-0001-8389-3841ДеевР. В.DeevR. V.

Деев Роман Вадимович – канд. мед. наук, доцент, исполняющий обязанности директора

Москва

Deev Roman V. – Candidate of Medical SciencesActing Director

Moscow

romdey@gmail.comhttps://orcid.org/0000-0002-0644-9701ВороковА. А.VorokovA. A.

Вороков Алимбек Альбертович – канд. мед. наук, ординатор клиники травматологии и ортопедии

Санкт-Петербург

Vorokov Alimbek A. – Candidate of Medical Sciences, Resident of the Traumatology and Orthopedics Clinic

St. Petersburg

alimbekvor@icloud.comhttps://orcid.org/0009-0005-6681-2858МироевскийФ. В.MiroyevskiyF. V.

Мироевский Филипп Владиславович – канд. мед. наук,  доцент  кафедры  общей  хирургии

Санкт-Петербург

Miroevskiy Filipp V. – Candidate of Medical Sciences, Associate Professor of the Department of General Surgery

St. Petersburg

traumafil@gmail.comhttps://orcid.org/0000-0002-7367-7528СавицкийВ. Д.SavitskiyV. D.

Савицкий Вячеслав Дмитриевич – ассистент кафедры общей хирургии

Санкт-Петербург

Savitskiy Vyacheslav D. – Assistant Professor, Department of General Surgery

St. Petersburg

slava_savitski@mail.ruФедеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр имени В. А. Алмазова» Министерства здравоохранения Российской Федерации; Федеральное государственное бюджетное образовательное учреждение высшего образования «Северо-Западный государственный медицинский университет им. И.И. Мечникова» Министерства здравоохранения Российской ФедерацииРоссияFederal State Budgetary Institution “V. A. Almazov National Medical Research Centre” of the Ministry of Health of the Russian Federation; North-Western State Medical University named after I.I. Mechnikov of the Ministry of Health of the Russian FederationRussian FederationФедеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр имени В. А. Алмазова» Министерства здравоохранения Российской ФедерацииРоссияFederal State Budgetary Institution “V. A. Almazov National Medical Research Centre” of the Ministry of Health of the Russian FederationRussian FederationНаучно-исследовательский институт морфологии человека имени академика А.П. Авцына Государственного научного центра Российской Федерации Федерального государственного бюджетного научного учреждения «Российский научный центр хирургии имени академика Б.В. ПетровскогоРоссияAvtsyn research institute of human morphology of federal state budgetary scientific institution “Petrovsky national research centre of surgery”Russian FederationФедеральное государственное бюджетное образовательное учреждение высшего образования «Северо-Западный государственный медицинский университет им. И.И. Мечникова» Министерства здравоохранения Российской ФедерацииРоссияNorth-Western State Medical University named after I.I. Mechnikov of the Ministry of Health of the Russian FederationRussian Federation202629032026216778Copyright © Ткаченко А.Н., Остапченко А.А., Деев Р.В., Вороков А.А., Мироевский Ф.В., Савицкий В.Д., 20262026Ткаченко А.Н., Остапченко А.А., Деев Р.В., Вороков А.А., Мироевский Ф.В., Савицкий В.Д.Tkachenko A.N., Ostapchenko A.A., Deev R.V., Vorokov A.A., Miroyevskiy F.V., Savitskiy V.D.This work is licensed under a Creative Commons Attribution 4.0 License.https://rsj.elpub.ru/jour/article/view/92

Несмотря на научные доказательства того, что сустав – это самостоятельный полый орган, состоящий преимущественно из мягких тканей, практическая медицина во многих странах, включая Россию, продолжает использовать устаревшее определение, ориентированное на костные структуры. Признание сустава как органа становится не только научной, но и клинической необходимостью для оптимизации мультидисциплинарного подхода к остеоартриту. В процессе эмбриогенеза коленный сустав формируется как самостоятельный орган, закладка которого происходит до и вне костных зачатков. Частота остеоартрита определяется сочетанием генетических, демографических, социальных и культурных факторов в каждом регионе мира. Учет этих особенностей позволит разработать эффективные стратегии профилактики и лечения на национальном уровне. Диагностика остеоартрита коленного сустава переживает качественный скачок – от пассивного выявления поздних рентгенологических изменений к активному поиску ранних, обратимых признаков заболевания. Современный диагностический арсенал, включающий количественную МРТ, УЗИ и молекулярные биомаркеры, предоставляет уникальную возможность вмешаться в патологический процесс на стадии, когда еще возможно сохранить сустав как орган. Реализация этой парадигмы требует переосмысления роли врача-ортопеда и ревматолога: от «хирурга последней инстанции» к «специалисту по сохранению сустава».

Despite scientific evidence that the joint is an independent, hollow organ composed primarily of soft tissue, clinical practice in many countries, including Russia, continues to use an outdated definition focused on bone structures. Recognizing the joint as an organ is becoming not only scientifically but also clinically necessary to optimize a multidisciplinary approach to osteoarthritis. During embryogenesis, the knee joint develops as an independent organ, forming before and beyond the bone primordia. The incidence of osteoarthritis is determined by a combination of genetic, demographic, social, and cultural factors in each region of the world. Taking these factors into account will enable the development of effective prevention and treatment strategies at the national level. The diagnosis of knee osteoarthritis is undergoing a qualitative leap – from passive detection of late radiographic changes to an active search for early, reversible signs of the disease. Modern diagnostic tools, including quantitative MRI, ultrasound, and molecular biomarkers, offer a unique opportunity to intervene in the pathological process at a stage when joint preservation is still possible. Implementing this paradigm requires rethinking the role of orthopedists and rheumatologists: from “surgeons of last resort” to “joint preservation specialists”.

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