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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="other" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">The Clinician</journal-id><journal-title-group><journal-title xml:lang="en">The Clinician</journal-title><trans-title-group xml:lang="ru"><trans-title>Клиницист</trans-title></trans-title-group></journal-title-group><issn publication-format="print">1818-8338</issn><issn publication-format="electronic">2412-8775</issn><publisher><publisher-name xml:lang="en">Publishing House ABV Press</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">484</article-id><article-id pub-id-type="doi">10.17650/1818-8338-2022-16-1-K657</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>LECTION</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>ЛЕКЦИЯ</subject></subj-group><subj-group subj-group-type="article-type"><subject></subject></subj-group></article-categories><title-group><article-title xml:lang="en">Osteoarthritis: management strategies depending on the location of lesions</article-title><trans-title-group xml:lang="ru"><trans-title>Остеоартрит: особенности ведения больных при различных локализациях</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4669-1006</contrib-id><name-alternatives><name xml:lang="en"><surname>Shostak</surname><given-names>N. A.</given-names></name><name xml:lang="ru"><surname>Шостак</surname><given-names>Н. А.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p> 1 Ostrovityanova St., Moscow 117997 </p></bio><bio xml:lang="ru"><p> 117997 Москва, ул. Островитянова 1 </p></bio><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9710-699X</contrib-id><name-alternatives><name xml:lang="en"><surname>Pravduk</surname><given-names>N. G.</given-names></name><name xml:lang="ru"><surname>Правдюк</surname><given-names>Н. Г.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Natalia Grigorievna Pravdyuk </p><p>1 Ostrovityanova St., Moscow 117997 </p></bio><bio xml:lang="ru"><p>Наталья Григорьевна Правдюк </p><p>117997 Москва, ул. Островитянова 1 </p></bio><email>pravda547@yandex.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6462-0899</contrib-id><name-alternatives><name xml:lang="en"><surname>Anischenko</surname><given-names>M. O.</given-names></name><name xml:lang="ru"><surname>Анищенко</surname><given-names>М. О.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p> 1 Ostrovityanova St., Moscow 117997 </p></bio><bio xml:lang="ru"><p> 117997 Москва, ул. Островитянова 1 </p></bio><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6329-5200</contrib-id><name-alternatives><name xml:lang="en"><surname>Dzhauari</surname><given-names>M. S.</given-names></name><name xml:lang="ru"><surname>Джауари</surname><given-names>М. С.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p> 1 Ostrovityanova St., Moscow 117997 </p></bio><bio xml:lang="ru"><p> 117997 Москва, ул. Островитянова 1 </p></bio><xref ref-type="aff" rid="aff1"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">Pirogov Russian National Research Medical University, Ministry of Health of Russia</institution></aff><aff><institution xml:lang="ru">ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России</institution></aff></aff-alternatives><pub-date date-type="pub" iso-8601-date="2022-01-15" publication-format="electronic"><day>15</day><month>01</month><year>2022</year></pub-date><volume>16</volume><issue>1</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><fpage>40</fpage><lpage>51</lpage><history><date date-type="received" iso-8601-date="2022-07-19"><day>19</day><month>07</month><year>2022</year></date><date date-type="accepted" iso-8601-date="2022-07-19"><day>19</day><month>07</month><year>2022</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2022, Shostak N.A., Pravduk N.G., Anischenko M.O., Dzhauari M.S.</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2022, Шостак Н.А., Правдюк Н.Г., Анищенко М.О., Джауари М.С.</copyright-statement><copyright-year>2022</copyright-year><copyright-holder xml:lang="en">Shostak N.A., Pravduk N.G., Anischenko M.O., Dzhauari M.S.</copyright-holder><copyright-holder xml:lang="ru">Шостак Н.А., Правдюк Н.Г., Анищенко М.О., Джауари М.С.</copyright-holder><ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/"/><license><ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/">https://creativecommons.org/licenses/by/4.0</ali:license_ref></license></permissions><self-uri xlink:href="https://klinitsist.abvpress.ru/Klin/article/view/484">https://klinitsist.abvpress.ru/Klin/article/view/484</self-uri><abstract xml:lang="en"><p>Osteoarthritis (OA) is a multifactorial disease that can be caused by genetic factors, obesity, joint microtrauma, and excessive physical exercises. The key features of OA include gradual loss of articular cartilage, bone tissue remodeling, development of osteophytes, and subchondral sclerosis. The pathogenesis of OA is based on the loss of glycosaminoglycans, collagen disorganization, and inflammation mediated by a cytokine cascade. OA is a complex disease affecting not only cartilage, but also intraarticular and periarticular tissues. Together, these changes compromise joint function and cause chronic pain. Considerable attention has beer recently paid to OA phenotyping in order to introduce a tailored approach into patient management. Phenotypes are applicable to the three most common peripheral OA locations: gonarthrosis, coxarthrosis, and hand OA. An international group of experts of primary care has developed algorithms for OA patient management, including diagnostic criteria, treatment options, and criteria for referring the patient to a specialist (rheumatologist). Current guidelines recommend non-drug therapy, pharmacotherapy, and surgery. There is a growing interest in phytopharmaceuticals, a heterogeneous group of molecules with a high capacity of suppressing inflammation, oxidative stress, and pain, as well as improving joint function. Mucosate® in capsules (DIAMED-pharma, Russia) is one of currently available complex products with phytocompounds. It contains the NEM® complex (natural eggshell membrane), Harpagophytum root extract, glucosamine sulfate, chondroitin sulfate, and manganese sulfate monohydrate.</p><p> </p></abstract><trans-abstract xml:lang="ru"><p>Остеоартрит (ОА) – мультифакториальное заболевание, развитию которого способствуют генетические факторы, ожирение, микротравматизация суставов, избыточные физические усилия. Ключевой особенностью ОА является постепенная потеря суставного хряща и ремоделирование костной ткани с образованием остеофитов и развитием субхондрального склероза. потеря гликозаминогликанов, дезорганизация коллагена, развитие воспалительной реакции, опосредованной цитокиновым каскадом, – основа патогенеза этого заболевания. ОА можно рассматривать как комплексное заболевание, поражающее не только хрящевую ткань, но и внутрисуставные и периартикулярные ткани. В совокупности указанные изменения приводят к нарушению функции суставов и развитию хронической боли. В последнее время большое внимание уделяется фенотипированию ОА для формирования персонифицированного подхода к ведению пациентов. фенотипы применимы к трем наиболее распространенным периферическим локализациям ОА: гонартрозу, коксартрозу и ОА суставов кистей. Международная группа экспертов для врачей первичного звена создала алгоритмы ведения пациентов с ОА, включающие критерии диагностики, варианты оказания медицинской помощи, а также условия направления больного к специалисту (ревматологу). Современные рекомендации по лечению ОА предлагают использовать немедикаментозную терапию, фармакологические методы и хирургическое лечение. В настоящее время большой интерес вызывают фитофармацевтические препараты, которые включают гетерогенный класс молекул с большим потенциалом подавления воспаления, окислительного стресса, боли и улучшения функции суставов. Одним из современных комплексных средств с фитонутрицивными компонентами являются капсулы Мукосат® («ДИАМЕД-фарма», Россия). В его состав входят комплекс NEM® (natural eggshell membrane), экстракт корня гарпагофитума, глюкозамина сульфат, хондроитина сульфат, марганца сульфата моногидрат. Учитывая высокую распространенность и социальную значимость ОА, значимым преимуществом обладают препараты многокомпонентного действия, способные эффективно контролировать симптомы боли и воспаления, а также замедлять прогрессирование болезни (основные точки приложения лекарственных методов лечения ОА).</p></trans-abstract><kwd-group xml:lang="en"><kwd>osteoarthritis</kwd><kwd>gonarthrosis</kwd><kwd>coxarthrosis</kwd><kwd>hand osteoarthritis</kwd><kwd>phytopharmaceuticals</kwd><kwd>Mucosate capsules</kwd><kwd>harpagophytum</kwd><kwd>glucosamine sulfate</kwd><kwd>chondroitin sulfate</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>остеоартрит</kwd><kwd>гонартроз</kwd><kwd>коксартроз</kwd><kwd>остеоартрит суставов кистей</kwd><kwd>фитофармацевтические препараты</kwd><kwd>Мукосат-капсулы</kwd><kwd>гарпагофитум</kwd><kwd>глюкозамина сульфат</kwd><kwd>хондроитина сульфат</kwd></kwd-group><funding-group/></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>Hootman J.M., Helmick C.G., Barbour K.E. et al. 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