N.N. Priorov Journal of Traumatology and OrthopedicsN.N. Priorov Journal of Traumatology and OrthopedicsВестник травматологии и ортопедии им. Н.Н. Приорова0869-86782658-6738Eco-Vector70193610.17816/vto701936YJOBXBSCIENTIFIC REVIEWSНаучные обзорыReview ArticleProspects for the use of structure-modifying drugs and adjuvant therapies for osteoarthritis before and after joint arthroplasty: a reviewВозможности и перспективы применения структурно-модифицирующих препаратов и средств вспомогательной терапии остеоартрита до и после эндопротезирования: обзорhttps://orcid.org/0000-0003-1916-38307865-6011MinasovTimur B.МинасовТимур Булатович
Russian Federation

MD, Dr. Sci. (Medicine), Professor, corresponding member of the Academy of Sciences of the Republic of Bashkortostan

д-р мед. наук, профессор, член-корр. Академии наук республики Башкортастан

M004@ya.ruhttps://orcid.org/0000-0002-5933-57327308-6756SarvilinaIrina V.СарвилинаИрина Владиславовна
Russian Federation

MD, Dr. Sci. (Medicine), Professor

д-р мед. наук, профессор

isarvilina@mail.ruhttps://orcid.org/0000-0002-7663-710X6317-9833GromovaOlga A.ГромоваОльга Алексеевна
Russian Federation

MD, Dr. Sci. (Medicine), Professor

д-р мед. наук, профессор

unesco.gromova@gmail.comhttps://orcid.org/0000-0003-1314-28871402-5186NazarenkoAnton G.НазаренкоАнтон Герасимович
Russian Federation

MD, Dr. Sci. (Medicine), Professor, Corresponding Member of the Russian Academy of Sciences

д-р мед. наук, профессор, член-корреспондент РАН

NazarenkoAG@cito.priorov.ruhttps://orcid.org/0000-0002-6736-97726889-8166ZagorodniyNikolay V.ЗагороднийНиколай Васильевич
Russian Federation

MD, Dr. Sci. (Medicine), Professor, Academician of the Russian Academy of Sciences

д-р мед. наук, профессор, академик РАН

zagorodniy51@mail.ruhttps://orcid.org/0000-0002-5496-07661617-3278YakupovaEkaterina R.ЯкуповаЕкатерина Ришатовна
Russian Federation
katya.yakupova1@yandex.ruhttps://orcid.org/0000-0003-1583-473X9304-4799GlazunovStanislav Yu.ГлазуновСтанислав Юрьевич
Russian Federation
Sglazunov87@mail.ruhttps://orcid.org/0000-0002-8886-33907643-2289KabirovRakhimbay Dzh.КабировРахимбай Джалолович
Russian Federation
rakhimbai.kabirov.96@inbox.ruhttps://orcid.org/0009-0006-6350-3555NezhemedinovaElmira I.НежемединоваЭльмира Ильдяревна
Russian Federation
elmira5597gmail.com@mail.ruBashkir State Medical UniversityБашкирский государственный медицинский университетMedical Center “Novomeditsina”Медицинский центр «Новомедицина»Federal Research Center “Informatics and Management”Федеральный исследовательский центр «Информатика и управление»Priorov National Medical Research Center of Traumatology and OrthopedicsНациональный медицинский исследовательский центр травматологии и ортопедии им. Н.Н. ПриороваPeoples’ Friendship University of RussiaРоссийский университет дружбы народов им. Патриса ЛумумбыRostov State Medical UniversityРостовский государственный медицинский университет11022026020420263312022192701202610022026Copyright ©; 2026, Eco-VectorCopyright ©; 2026, Эко-Вектор2026Eco-VectorЭко-Векторhttps://creativecommons.org/licenses/by-nc-nd/4.0https://journals.eco-vector.com/0869-8678/article/view/701936

This review addresses practical issues of rational pharmacotherapy and adjuvant treatment of osteoarthritis before and after total knee arthroplasty (TKA). The review analyzes the mechanisms underlying complications associated with total knee arthroplasty, the role of comorbid conditions in the development of osteoarthritis and TKA-related complications, and current approaches to phenotyping and endotyping of osteoarthritis for predicting postoperative complications and selecting optimal strategies for preoperative management and postoperative rehabilitation. Particular attention is paid to the mechanisms of action of components and to the personalized selection of disease-modifying and adjuvant therapies at different stages of patient management before and after total knee arthroplasty. The review describes recommended dosing regimens, maximum daily doses, and maximum durations of use for selected structure-modifying drugs and adjuvant therapies for osteoarthritis before and after total knee arthroplasty, based on data from clinical studies and in accordance with instructions for medical use. One of the key aspects of a multimodal, staged approach to managing patients with knee osteoarthritis before and after total knee arthroplasty is the personalized selection of structure-modifying drugs and adjuvant therapies, taking into account individual patient characteristics, including age, comorbidities, and drug tolerability. Standardization of pain assessment, evaluation of biomarkers of structural modification of articular cartilage, and a personalized approach to drug selection are essential for achieving effective and safe management of patients with knee osteoarthritis undergoing total knee arthroplasty, reducing the risk of adverse drug reactions, and improving treatment satisfaction and quality of life after surgical intervention.

Данный литературный обзор посвящён практическим вопросам рациональной фармакотерапии и вспомогательного лечения остеоартрита (ОА) до и после выполнения тотального эндопротезирования (ТЭ) коленных суставов (КС). В обзоре анализируются механизмы возникновения осложнений при ТЭ КС, роль сопутствующих заболеваний в развитии остеоартрита и осложнений ТЭ КС, актуальные вопросы фенотипирования и эндотипирования остеоартрита для прогноза возникновения осложнений ТЭ КС и выбора стратегии дооперационного ведения пациента и его реабилитации, механизм действия компонентов и персонализированный выбор компонентов этапной болезнь-модифицирующей и вспомогательной терапии до и после ТЭ КС. В обзоре приведены рекомендуемый режим дозирования, максимальные суточные дозы и максимальная длительность использования некоторых структурно-модифицирующих лекарственных средств и средств вспомогательной терапии ОА до и после выполнения ТЭ КС в клинических исследованиях в соответствии с инструкциями по медицинскому применению. Одним из ключевых аспектов мультимодального подхода в этапном ведении пациентов с ОА КС до и после ТЭ КС является персонализированный выбор структурно-модифицирующих лекарственных средств и средств вспомогательной терапии ОА, учитывающий индивидуальные особенности пациента, такие как возраст, сопутствующие заболевания, индивидуальная переносимость. Стандартизация оценки болевого синдрома, биомаркёров структурной модификации суставного хряща и персонализированный подход к выбору препаратов необходимы для достижения эффективного и безопасного ведения пациентов с ОА КС, имеющих показания к выполнению ТЭ КС, снижения риска нежелательных реакций при применении лекарственных средств и повышения удовлетворённости лечением и качества жизни пациентов после оперативных вмешательств.

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