grekovВестник хирургии имени И.И. ГрековаGrekov's Bulletin of Surgery0042-46252686-7370Federal State Budgetary Educational Institution of Higher Education «Academician I.P. Pavlov First St. Petersburg State Medical University» of the Ministry of Healthcare of the Russion Federation, FSBEI HE I.P.Pavlov SPbSMU MOH Russia10.24884/0042-4625-2025-184-5-16-22grekov-2702Research ArticleВОПРОСЫ ОБЩЕЙ И ЧАСТНОЙ ХИРУРГИИPROBLEMS OF GENERAL AND SPECIAL SURGERYСравнение эффективности консервативного и хирургического лечения морбидного ожирения у пациентов с коксартрозомComparison of the efficacy of conservative and surgical treatment of morbid obesity in patients with coxarthrosishttps://orcid.org/0009-0002-4156-0525АховА. О.AkhovА. О.

Ахов Андемиркан Олегович, аспирант кафедры травматологии, ортопедии и хирургии катастроф

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Akhov Andemirkan O., Postgraduate Student of the Department of Traumatology, Orthopedics and Disaster Surgery

Moscow

Andy.akhov@gmail.comhttps://orcid.org/0000-0002-2202-8149ЛычагинА. В.LychaginA. V.

Лычагин Алексей Владимирович, доктор медицинских наук, доцент, зав. кафедрой травматологии, ортопедии и хирургии катастроф

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Lychagin Alexey V., Dr. of Sci.(Med.), Professor, Head of the Department of Traumatology, Orthopedics and Disaster Surgery

Moscow

dr.lychagin@mail.ruhttps://orcid.org/0000-0003-4202-4468ГрицюкА. А.GritsyukA. A.

Грицюк Андрей Анатольевич, доктор медицинских наук, профессор, профессор кафедры травматологии, ортопедии и хирургии катастроф лечебного факультета

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Gritsyuk Andrey A., Dr. of Sci.(Med.), Professor, Professor of the Department of Traumatology, Orthopedics and Disaster Surgery, Faculty of Medicine

Moscow

drgaamma@gmail.comhttps://orcid.org/0000-0001-8517-7216ЯвлиеваР. Х.YavlievaR. K.

Явлиева Роза Хазбулатовна, кандидат медицинских наук, доцент кафедры травматологии, ортопедии и хирургии катастроф

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Yavlieva Roza K., Cand. of Sci.(Med.), Associate Professor of the Department of Traumatology, Orthopedics and Disaster Surgery

Moscow

hazbulatovna@mail.ruПервый Московский государственный медицинский университет имени И. М. Сеченова (Сеченовский университет)РоссияI. M. Sechenov First Moscow State Medical UniversityRussian FederationФГАОУ ВО Первый МГМУ им. И. М. Сеченова Минздрава России (Сеченовский Университет)РоссияI. M. Sechenov First Moscow State Medical UniversityRussian Federation20252412202518451622Copyright © Ахов А.О., Лычагин А.В., Грицюк А.А., Явлиева Р.Х., 20252025Ахов А.О., Лычагин А.В., Грицюк А.А., Явлиева Р.Х.Akhov А.О., Lychagin A.V., Gritsyuk A.A., Yavlieva R.K.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.vestnik-grekova.ru/jour/article/view/2702

ВВЕДЕНИЕ. Количество пациентов с ожирением и коксартрозом ежегодно прогрессивно увеличивается. Однако в настоящее время отсутствует консенсус относительно тактики предоперационного ведения пациентов с ожирением и остеоартритом тазобедренного сустава.ЦЕЛЬЮ нашего исследования явилось изучение эффективности консервативного и хирургического лечения морбидного ожирения у пациентов с коксартрозом.МЕТОДЫ И МАТЕРИАЛЫ. Проведено ретроспективное когортное одноцентровое исследование, обследованы пациенты с коксартрозом, которые были направлены в клинику для тотального эндопротезирования тазобедренного сустава, при этом у пациентов в анамнезе до госпитализации было диагностировано морбидное ожирение (индекс массы тела более 40 кг/м2). Когорта составлена из 115 пациентов, 29 мужчин (25,2 %) и 86 женщин (74,8 %), средний возраст 64,2±6,9 года, средний индекс массы тела составил 44,3±2,7 кг/м2. Отобрано две группы пациентов: 56 пациентов (I группа исследования) с диагностированным коксартрозом и морбидным ожирением, которые добровольно проходили консервативное лечение ожирения в амбулаторных условиях по месту жительства; во вторую группу (II группа) мы отобрали 59 пациентов с коксартрозом, которым была выполнена бариатрическая операция.РЕЗУЛЬТАТЫ. Консервативное лечение морбидного ожирения при наличии первичного эффекта в 5 % ИМт (3 месяца) дает максимальную потерю веса, к 9 месяцам после начала лечения достигая 13 % (38,7±1,1 кг/м2) от первоначального среднего показателя. БО вызывают снижение веса до 28,9 % к 6 месяцам (32,1±1,0 кг/м2) и в дальнейшем стабилизируются на показателях около 20 % от первоначального ИМт.ВЫВОД. Консервативное лечение морбидного ожирения у пациентов с коксартрозом дает максимальную потерю веса, к 9 месяцам после начала лечения достигая 13 %, после бариатрических операций в течение 6 месяцев происходит максимальная потеря веса до 28,9 % от первоначального среднего показателя ИМт пациентов. 

INTRODUCTION. The number of patients with obesity and coxarthrosis increases progressively every year. However, there is currently no consensus on the tactics of preoperative management of patients with obesity and osteoarthritis of the hip joint.The OBJECTIVE of our research was to study the effectiveness of conservative and surgical treatment of morbid obesity in patients with coxarthrosis.METHODS AND MATERIALS. A retrospective single-center cohort study was conducted, patients with coxarthrosis were examined who were referred to the clinic for total hip arthroplasty, while the patients had a history of morbid obesity (body mass index over 40 kg/m2) before hospitalization. The cohort consisted of 115 patients, 29 men (25.2 %) and 86 women (74.8 %), the average age was 64.2±6.9 years, the average body mass index was 44.3±2.7 kg/m2. Two groups of patients were selected: 56 patients (study group I) with diagnosed coxarthrosis and morbid obesity, who voluntarily underwent conservative treatment of obesity in outpatient settings at their place of residence; the second group (group II) included 59 patients with coxarthrosis who underwent bariatric surgery.RESULTS. Conservative treatment of morbid obesity in the presence of a primary effect of 5 % of BMI (3 months) gives a maximum weight loss by 9 months after the start of treatment, reaching 13 % (38.7±1.1 kg/m2) of the initial average. BO cause weight loss of up to 28.9 % by 6 months (32.1±1.0 kg/m2) and subsequently stabilize at about 20 % of the initial BMI.CONCLUSION. Conservative treatment of morbid obesity in patients with coxarthrosis gives maximum weight loss by 9 months after the start of treatment, reaching 13 %, after bariatric surgery for 6 months there is a maximum weight loss of up to 28.9 % of the initial average BMI of patients.

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