DOI: 10.25881/20728255_2021_16_3_12


Krainyukov P.E.1, 2, Kokorin V.V.1, 3, Chesnakov A.N.1, Evtushenko A.A.4, Epifanov S.A.3

1 Central Military Clinical Hospital. P.V. Mandryka, Moscow

2 RUDN University, Moscow

3 Pirogov National Medical and Surgical Center, Moscow

4 422 Military Hospital, Nizhny Novgorod


At present, the choice of the optimal approach in the treatment of patients suffering from enthesopathies of various localization, as well as the reduction of the terms of their rehabilitation, remains an urgent and significant medical and social problem of modern society. The problem affects most of the population during life and covers all areas of work. Lack of generally accepted standards of treatment, delayed diagnosis, long-term and persistent nature of the disease, cause ambiguous outcomes and a high percentage of relapses, leads to neglect of the process, deterioration of the quality of life of patients and disability of the working population.

The article discusses the methods of regenerative therapy used in the treatment of patients with enthesopathies. The analysis of the characteristics of the use of modern techniques is carried out and the possible terms of rehabilitation of patients are reflected.

Keywords: enthesis, enthesopathy, regeneration, auto tissue, rehabilitation.


1. Balabanova RM. Enthesitis: diagnosis and treatment. Russian Medical Journal. 2012; 11: 538. (In Russ).

2. Dennis MG, Kay-Geert AH, Ai LT. Differentiation between osteoarthritis and psoriatic arthritis: implications for pathogenesis and treatment in the biologic therapy era. Rheumatology. 2015; 54(1): 29-38.

3. Juneja SC, Veillette C. Defects in Tendon, Ligament, and Enthesis in Response to Genetic Alterations in Key Proteoglycans and Glycoproteins: A Review. Arthritis. 2013; 154812. doi. 10.1155/2013/154812.

4. Wang X, Xie L, Crane J, et al. Aberrant TGF-β activation in bone tendon insertion induces enthesopathy — like disease. Journal of Clinical Investigation. 2018; 128(2): 846-860.

5. Khitrov NA. Paraartikulyarnyye tkani: varianty porazheniya i ikh lecheniye. Russian Medical Journal. 2017; 3: 177-187. (In Russ).

6. Zagorodnyj GM, Karpenkov KM, Tihonenkov AA, Yasyukevich AS. Osobennosti primeneniya preparatov gialuronana vnutrisustavno v sportivnoj praktike. Medical news. 2014; 11(242): 69-73. (In Russ).

7. Yasyukevich AS, Gulevich NP, Muha PG. Analiz urovnya i struktury sluchaev sportivnogo travmatizma v otdel’nyh vidah sporta. Applied sports science. 2016; 1(3): 89-99. (In Russ).

8. Kokorin VV, Kuz’min DB, Kraynyukov PYe, Yepifanov SA. Rol’ infektsii v etiopatogenezeentezopatiy. Bulletin of the National Medical and Surgical Center N.I. Pirogov. 2020; 15(3): 141-149. (In Russ).

9. Arend CF. Role of sonography and magnetic resonance imaging in detecting deltoideal acromialenthesopathy: an early finding in the diagnosis of spondyloarthritis and an under-recognized cause of posterior shoulder pain. Journal of ultrasound in medicine. 2014; 33(4): 557-61.

10. Karateev AE, Karateev DE, Orlova ES, et al. «Malaya» revmatologiya: nesistemnaya revmaticheskaya patologiya okolosustavnyh myagkih tkanej verhnej konechnosti. CHast’ 1. Modern rheumatology. 2015; 9(2): 4-15. (In Russ).

11. Godzenko AA. Lechenie periartikulyarnyh bolevyh sindromov. Russian Medical Journal. 2012; 7: 382-384. (In Russ).

12. Malahov NB, Pykov MI, CHochiev GM. Normal’naya ekhoanatomiya paraartikulyarnyh tkanej kolennogo sustava u detej i metodika ih ul’trazvukovogo obsledovaniya. Ultrasonic and functional diagnostics. 2002; 2: 101-111. (In Russ).

13. Ivanova ON, Sobolev YUA, Pyadova EA, et al. Sravnitel’nyj analiz artrosonograficheskih i rentgenograficheskih izmenenij sustavov pri revmaticheskih zabolevaniyah. Scientific practical rheumatology. 2004; 4 (prilozhenie): 11 (In Russ).

14. Adzhigajtkanova SK. Diagnostika i lechenie otdel’nyh form revmaticheskih zabolevanij s pozicii dokazatel’noj mediciny. Teaching manual. 2013. Р.6-23. (In Russ).

15. Ahmerov RR, Zarudij RF, Hajrullin FR. Primenenie tekhnologii Pasmolifting v travmatologii i vosstanovitel’noj medicine. A collection of methodical recommend ations on the use of platelet autologous plasma. Plazmolifting TM technology. Moskva, 2016. Р.24-33. (In Russ).

16. Teplov OV, Teplova YUS, Plaksejchuk YUA, et al. Metodika primeneniya autologichnoj bogatoj trombocitami plazmy v lechenii pacientov c osteoartrozom kolennyh sustavov. Metodicheskie rekomendacii. Kazan’, 2017 (In Russ).

17. Wu PI, Diaz R, Borg-Stein J. Platelet-rich plasma. Physical Medicine and Rehabilitation Clinics of North America. 2016; 27(4): 825-853.

18. Papalia R, Diaz Balzani L, Torre G, Tirindelli MC, et al. Intraoperative application platelet rich fibrin, postoperative injections of PRP or microfracture only for osteochondral lesions of the knee: a five-year retrospective evaluation. Journal of biological regulators & homeostatic agents. 2016; 30(4): 41-49.

19. Cole BJ, Karas V, Hussey K, Pilz K. Hyaluronic acid versus platelet-rich plasma: a prospective, double-blind randomized controlled trial comparing clinical outcomes and effects on intraarticular biology for the treatment of knee osteoarthritis. American Journal of Sports Medicine. 2017; 45(2): 339-346.

20. Laver L, Marom N, Dnyanesh L, Mei-Dan O, et al. PRP for degenerative cartilage disease. Cartilage. 2016; 1.

21. Joshi Jubert N, Rodríguez L, Reverté-Vinaixa MM, Navarro A. Platelet-rich plasma injections for advanced knee osteoarthritis: a prospective, randomized, double-blinded clinical trial. Orthopaedic journal of sports medicine. 2017; 5(2).

22. D’souza N, Rossignoli F, Golinelli G, Grisendi G, Spano C, Candini O, Dominici M. Mesenchymal stem/ stromal cells as a delivery platform in cell and gene therapies. BMC Medicine. 2015; 13(1): 186.

23. Ennis WJ, Sui A, Bartholomew A. Stem cells and healing: impact on inflammation. Advances in Wound Care. 2013; 2(7): 369-378.

24. Fodor PB, Paulseth SG. Adipose derived stromal cell (ADSC) injections for pain management of osteoarthritis in the human knee joint. Aesthetic Surgery Journal. 2015; 36(2): 229-236.

25. Ude CC, Sulaiman SB, Min-Hwei N, Hui-Cheng C, Ahmad J, Yahaya NM, Saim AB, Idrus RBH. Cartilage regeneration by chondrogenic induced adult stem cells in osteoarthritic sheep model. PLoS One. 2014; 9(6): e98770. doi: 10.1371/journal.pone.0098770.

26. Bourin P, Bunnell BA, Casteilla L, Dominici M, Katz AJ, March KL, Redl H, Rubin JP, Yoshimura K, Gimble JM. Stromal cells from the adipose tissue-derived stromal vascular fraction and culture expanded adipose tissue-derived stromal/stem cells: a joint statement of the International Federation for Adipose Therapeutics and Science (IFATS) and the International Society for Cellular Therapy (ISCT). Cytotherapy. 2013; 15(6): 641-648.

For citation

Krainyukov P.E., Kokorin V.V., Chesnakov A.N., Evtushenko A.A., Epifanov S.A. Prospects for cell technologies in the treatment of patients with enthesopathies. Bulletin of Pirogov National Medical & Surgical Center. 2021;3(16):12-17. (In Russ.)