smjournalСпортивная медицина: наука и практикаSports medicine: research and practice2223-25242587-9014NEICON10.17238/ISSN2223-2524.2019.4.67smjournal-183Research ArticleРЕАБИЛИТАЦИЯREHABILITATIONВзгляд на остеоартрит коленных суставов и бег через призму МРТ-исследованийThe problem of osteoarthritis of the knee joint and running through the prism of magnetic resonance tomographyhttps://orcid.org/0000-0002-3163-102XСнигиреваА. В.SnigirevaA. V.

Снигирева Анна Владимировна, доцент кафедры госпитальной терапии с профпатологией, доцент, к.м.н.   

Ярославль

+7 (964) 167-39-06

Anna V. Snigireva, M.D., Ph.D. (Medicine), Associate Professor of the Department of Hospital therapy with profpatology

Yaroslavl

+7 (964) 167-39-06

n0613@yandex.ruhttps://orcid.org/0000-0003-3456-9409НосковС. М.NoskovS. M.

Носков Сергей Михайлович, заведующий кафедрой госпитальной терапии с профпатологией, проф., д.м.н.  

Ярославль

Sergey M. Noskov, M.D., D.Sc. (Medicine), Prof., Head of the Department of Hospital therapy with profpatology

Yaroslavl

https://orcid.org/0000-0002-1184-5426ЛаврухинаА. А.LavruchinaA. A.

Лаврухина Алина Александровна, доцент кафедры госпитальной терапии с профпатологией, доцент, к.м.н.  

Ярославль

Alina A. Lavruchina, M.D., Ph.D. (Medicine), Associate Professor of the Department of of Hospital therapy with profpatology

Yaroslavl

ФГБОУ ВО Ярославский государственный медицинский университет, Министерство здравоохранения РФРоссияYaroslavl State Medical UniversityRussian Federation201928082020946773Copyright © Снигирева А.В., Носков С.М., Лаврухина А.А., 20202020Снигирева А.В., Носков С.М., Лаврухина А.А.Snigireva A.V., Noskov S.M., Lavruchina A.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.smjournal.ru/jour/article/view/183

В настоящее время среди марафонцев увеличилось число женщин и лиц пожилого возраста. У этой когорты населения высок риск развития остеоартрита. В общественном мнении распространена малообоснованная научными данными гипотеза, что дополнительная нагрузка на коленные суставы, возникающая при длительном беге, потенциально может приводить к повреждению суставных структур и развитию остеоартрита. В обзоре представлены современные обобщенные данные магнитно-резонасной томографии (МРТ) коленных суставов у лиц, практикующих бег на длинные дистанции. Особое внимание уделено синдрому увеличения содержания жидкости в субхондральной кости, определяемой по повышению интенсивности сигнала на Т2-взвешенных изображениях (снижению на Т1-взвешанных изображениях), получившему название отек костного мозга (ОКМ). Представлена классификация и патогенетические варианты развития ОКМ (теория интрузии и контузии). Рассмотрены частные случаи возникновения ОКМ у марафонцев. Описана динамика ОКМ в разные временные промежутки после забегов у начинающих и профессиональных марафонцев. Продемонстрированы изменения МРТ-изображений хряща коленного сустава после бега по тредмилу у здоровых женщин и у женщин, страдающих остеоартритом. Проведено сравнение частоты развития остеоартрита коленных суставов у бегунов по сравнению с футболистами и тяжелоатлетами. Сделано заключение о профилактическом действии длительной ходьбы и бега (не менее 12,5 км/неделю), включая марафонские дистанции, в отношении развития и прогрессирования остеоартрита коленных суставов.

The number of women and the elderly has now increased among marathon runners. This cohort has a high risk of osteoarthritis development. The hypothesis, based on little scientific evidence, is that the additional stress on knee joints that occurs during long running can potentially lead to damage to joint structures and osteoarthritis development. The review presents modern generalized data on magnetic resonance imaging (MRI) of knee joints in long-distance runners. Special attention is paid to the syndrome of fluid increase in subchondral bone, which is determined by increasing the signal intensity in T2-weighted images (decrease in T1-weighted images), called bone marrow oedema (BMO). Classification and pathogenetic variants of BMO development (theory of intrusion and contusion) are presented. Particular cases of BMO development in marathon runners are considered. The dynamics of BMO in different time intervals after the races in beginners and professional marathon runners is described. Changes in MRI images of knee cartilage after running on the treadmill in healthy women and in women suffering from osteoarthritis are shown. A comparison of the frequency of osteoarthritis of knee joints in runners compared to footballers and weightlifters was made. The conclusion was made on the preventive effect of long walking and running (at least 12.5 km/week), including marathon distances, on the development and progression of osteoarthritis of knee joints.

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