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<article article-type="research-article" dtd-version="1.3" 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" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">mes</journal-id><journal-title-group><journal-title xml:lang="ru">Экстремальная биомедицина</journal-title><trans-title-group xml:lang="en"><trans-title>Extreme Medicine</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">3033-8964</issn><issn pub-type="epub">3033-8972</issn><publisher><publisher-name>Centre for Strategic Planning of the Federal Medical and Biological Agency</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.47183/mes.2025-323</article-id><article-id custom-type="elpub" pub-id-type="custom">mes-323</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>СПОРТИВНАЯ МЕДИЦИНА</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>SPORTS MEDICINE</subject></subj-group></article-categories><title-group><article-title>Травмы и повреждения крупных суставов у несовершеннолетних спортсменов. Терапия плазмой, обогащенной тромбоцитами. Клинический случай</article-title><trans-title-group xml:lang="en"><trans-title>Injuries and damage to large joints in underage athletes. Therapy with platelet-rich plasma. A clinical case</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9717-5872</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Зябкин</surname><given-names>И. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Zyabkin</surname><given-names>I. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Зябкин Илья Владимирович - д-р мед. наук</p><p>Москва</p></bio><bio xml:lang="en"><p>Ilya V. Zyabkin - Dr. Sci. (Med.)</p><p>Moscow</p></bio><email xlink:type="simple">zyabkin@kidsfmba.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0007-6665-6394</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Панкратов</surname><given-names>И. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Pankratov</surname><given-names>I. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Панкратов Иван Владимирович</p><p>Москва</p></bio><bio xml:lang="en"><p>Ivan V. Pankratov</p><p>Moscow</p></bio><email xlink:type="simple">pankratoviv@kidsfmba.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0000-6070-0947</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ковалькова</surname><given-names>А. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Kovalkova</surname><given-names>A. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Ковалькова Александра Маратовна</p><p>Москва</p></bio><bio xml:lang="en"><p>Aleksandra M. Kovalkova</p><p>Moscow</p></bio><email xlink:type="simple">gimadeeva.alexandra@yandex.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0009-6101-7299</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Хижникова</surname><given-names>В. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Khizhnikova</surname><given-names>V. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Хижникова Виктория Валерьевна</p><p>Москва</p></bio><bio xml:lang="en"><p>Victoria V. Khizhnikova</p><p>Moscow</p></bio><email xlink:type="simple">adm@kidsfmba.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5305-9394</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Завалева</surname><given-names>Е. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Zavaleva</surname><given-names>E. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Завалева Елена Валентиновна - канд. мед. наук</p><p>Москва</p></bio><bio xml:lang="en"><p>Elena V. Zavaleva - Cand. Sci. (Med.)</p><p>Moscow</p></bio><email xlink:type="simple">zavalevaev@kidsfmba.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8549-9493</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Мухортых</surname><given-names>В. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Mukhortykh</surname><given-names>V. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Мухортых Валерий Алексеевич - канд. мед. наук</p><p>Москва</p></bio><bio xml:lang="en"><p>Valeriy A. Mukhortykh - Cand. Sci. (Med.)</p><p>Moscow</p></bio><email xlink:type="simple">valera-89@yandex.ru</email><xref ref-type="aff" rid="aff-2"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Федеральный научно-клинический центр детей и подростков Федерального медико-биологического агентства; Российская медицинская академия непрерывного профессионального образования Министерства здравоохранения Российской Федерации</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Federal Scientific and Clinical Center for Children and Adolescents of the Federal Medical and Biological Agency; Russian Medical Academy of Continuous Professional Education</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Федеральный научно-клинический центр детей и подростков Федерального медико-биологического агентства</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Federal Scientific and Clinical Center for Children and Adolescents of the Federal Medical and Biological Agency</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>17</day><month>11</month><year>2025</year></pub-date><volume>27</volume><issue>4</issue><fpage>542</fpage><lpage>549</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Зябкин И.В., Панкратов И.В., Ковалькова А.М., Хижникова В.В., Завалева Е.В., Мухортых В.А., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Зябкин И.В., Панкратов И.В., Ковалькова А.М., Хижникова В.В., Завалева Е.В., Мухортых В.А.</copyright-holder><copyright-holder xml:lang="en">Zyabkin I.V., Pankratov I.V., Kovalkova A.M., Khizhnikova V.V., Zavaleva E.V., Mukhortykh V.A.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.extrememedicine.ru/jour/article/view/323">https://www.extrememedicine.ru/jour/article/view/323</self-uri><abstract><sec><title>Введение</title><p>Введение. Около 46% травм крупных суставов занимают повреждения коленного сустава, в структуре которых у детей и подростков порядка 15–24% приходится на переднюю крестообразную связку (ПКС). Для сокращения вероятности отдаленных осложнений после травм у несовершеннолетних профессиональных спортсменов, реабилитационного периода и скорейшего возвращения в спорт высших достижений необходимо внедрение в клиническую практику инновационных технологий регенеративной медицины, в том числе с использованием плазмы, обогащенной тромбоцитами (PRP). Применение PRP имеет ряд преимуществ по сравнению с другими консервативными методами терапии, а именно: являясь ортобиологическим препаратом, PRP представляет собой биологическое вещество собственного организма пациента, способствующее ускорению регенерации с минимальным риском возникновения побочных явлений; это малоинвазивная манипуляция, при соблюдении методики не приводящая к осложнениям. Несмотря на то что PRP-терапия широко применяется при лечении заболеваний и повреждений крупных суставов у взрослой категории пациентов, использование данного терапевтического метода у несовершеннолетних спортсменов изучено недостаточно, в связи с чем и явилось целью настоящей работы.</p><p>Описание клинического случая. Представлено клиническое наблюдение профессионального спортсмена с травмой коленного сустава с оценкой функциональных и клинических результатов PRP-терапии. В данной работе продемонстрированы две стандартизированные методики по применению PRP, обозначены преимущества закрытого цикла приготовления PRP: минимизация контакта с внешней средой, снижающего возможные риски инфицирования; сокращение расходных материалов, повышающего экономическую эффективность. Описанный клинический случай травмы ПКС у юниора с полным функциональным и структурным (по данным магнитно-резонансной томографии) восстановлением при проведении PRP-терапии продемонстрировал эффективность, безопасность и хорошую переносимость применения плазмы, обогащенной тромбоцитами. Положительный результат отмечен как клинически (констатация регресса болевого синдрома, оцениваемого по визуально-аналоговой шкале, восстановления функции сустава, положительная динамика провокационных тестов (тест Лахмана и переднего выдвижного ящика)), так и по данным визуализации.</p></sec><sec><title>Выводы</title><p>Выводы. Применение PRP-терапии при травмах ПКС у несовершеннолетних профессиональных спортсменов является перспективным терапевтическим подходом в ортопедии и спортивной медицине с использованием технологий регенеративной медицины. Закрытый цикл приготовления PRP имеет ряд преимуществ перед открытым, включая экономическую эффективность благодаря минимизации расхода медицинских изделий. Показана безопасность метода при соблюдении требований к его проведению (асептика, антисептика, ультразвуковой контроль и др.) и подтверждена высокая чувствительность магнитно-резонансной томографии в рамках оценки динамики повреждений ПКС.</p></sec></abstract><trans-abstract xml:lang="en"><sec><title>Introduction</title><p>Introduction. Approximately 46% of large joint injuries involve damage to the knee joint, among which anterior cruciate ligament (ACL) injuries account for about 15–24% in children and adolescents. In order to reduce the likelihood of long-term complications after injuries in underage professional athletes, shorten the rehabilitation period, and enable a quicker return to elite sports, innovative regenerative medicine technologies should be implemented into clinical practice, including the use of platelet-rich plasma (PRP). In comparison with other conservative treatment methods, PRP offers several advantages. Being an orthobiological agent, PRP is a biological substance derived from the patient’s own body, promoting accelerated regeneration with minimal risk of side effects. When performed correctly, this procedure shows minimal invasiveness and does not lead to complications. Although PRP therapy is widely used in treating diseases and injuries of large joints in adult patients, the application of this therapeutic method in underage athletes has not been sufficiently studied, which is the focus of this study.</p></sec><sec><title>Case report</title><p>Case report. We present a clinical case of a professional athlete with a knee joint injury, assessing the functional and clinical outcomes of PRP therapy. Two standardized methods for PRP application are demonstrated, highlighting the advantages of a closed-loop PRP preparation system. These include minimized exposure to the external environment, mitigating potential risks of infection, and reduced consumption of materials, enhancing cost-effectiveness. The described clinical case of an ACL injury in a junior athlete, with complete functional and structural recovery (as confirmed by magnetic resonance imaging, MRI), demonstrated the efficacy, safety, and good tolerability of PRP therapy. Positive outcomes were observed both clinically (regression of pain assessed via the visual analog scale, restoration of joint function, and positive dynamics in provocative tests such as the Lachman test and anterior drawer test) and through MRI data.</p></sec><sec><title>Conclusions</title><p>Conclusions. The use of PRP therapy for ACL injuries in underage professional athletes represents a promising therapeutic approach in orthopedics and sports medicine, utilizing regenerative medicine technologies. The closed-loop system for PRP preparation offers several advantages over open-loop systems, including cost-effectiveness due to minimized consumption of medical supplies. The safety of the method is ensured provided that the procedural requirements are met (asepsis, antisepsis, ultrasound guidance, etc.); the high sensitivity of MRI in tracking the dynamics of ACL injuries is confirmed.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>спортивная медицина</kwd><kwd>детские спортивные травмы</kwd><kwd>повреждения крупных суставов</kwd><kwd>PRP-терапия</kwd><kwd>несовершеннолетние спортсмены</kwd></kwd-group><kwd-group xml:lang="en"><kwd>sports medicine</kwd><kwd>pediatric sports injuries</kwd><kwd>large joint damage</kwd><kwd>PRP therapy</kwd><kwd>underage athletes</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">работа выполнена в рамках государственного задания № 124022800121-3 НИР «PRP-терапия при травмах и заболеваниях крупных суставов у юниоров спортивных сборных команд Российской Федерации»; шифр темы: «PRP-терапия при травмах»; код 83.002.24.800</funding-statement><funding-statement xml:lang="en">this work was conducted as part of State Task No. 124022800121-3, Research Project “PRP therapy for injuries and diseases of large joints in junior members of Russian Federation sports teams”; Theme Code: “PRP therapy for injuries”; Project Code: 83.002.24.800</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Рябов ВП, Нуруллин ИФ, Курмаев ЗФ, Сунгатуллин РИ, Белов АМ Профессиональные травмы и заболевания у спортсменов. 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