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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">pirogovestnik</journal-id><journal-title-group><journal-title xml:lang="ru">Вестник Национального медико-хирургического центра им. Н.И. Пирогова</journal-title><trans-title-group xml:lang="en"><trans-title>Bulletin of Pirogov National Medical &amp; Surgical Center</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2072-8255</issn><issn pub-type="epub">2782-3628</issn><publisher><publisher-name>Национальный медико-хирургический Центр им. Н.И. Пирогова</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.25881/20728255_2026_21_1_73</article-id><article-id custom-type="elpub" pub-id-type="custom">pirogovestnik-537</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>ОРИГИНАЛЬНЫЕ СТАТЬИ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ORIGINAL ARTICLES</subject></subj-group></article-categories><title-group><article-title>ЛЕЧЕНИЕ АСЕПТИЧЕСКОГО НЕКРОЗА ГОЛОВКИ БЕДРЕННОЙ КОСТИ В ЭКСПЕРИМЕНТЕ С ПРИМЕНЕНИЕМ КРИОВОЗДЕЙСТВИЯ АППЛИКАТОРОМ ИЗ ПОРИСТОГО НИКЕЛИДА ТИТАНА</article-title><trans-title-group xml:lang="en"><trans-title>CRYOAPPLICAION IN ASEPTIC NECROSIS OF THE FEMORAL HEAD IN AN EXPERIMENT</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кужеливский</surname><given-names>И. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Kuzhelivsky</surname><given-names>I. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Екатеринбург</p></bio><bio xml:lang="en"><p>Ekaterinburg</p></bio><email xlink:type="simple">kuzhel@rambler.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Гордиенко</surname><given-names>И. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Gordienko</surname><given-names>I. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Екатеринбург</p></bio><bio xml:lang="en"><p>Ekaterinburg</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ялунин</surname><given-names>Н. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Yalunin</surname><given-names>N. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Екатеринбург</p></bio><bio xml:lang="en"><p>Ekaterinburg</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Немыкина</surname><given-names>Е. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Nemykina</surname><given-names>E. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Екатеринбург</p></bio><bio xml:lang="en"><p>Ekaterinburg</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Пономарев</surname><given-names>А. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Ponomarev</surname><given-names>A. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Екатеринбург</p></bio><bio xml:lang="en"><p>Ekaterinburg</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Черный</surname><given-names>С. П.</given-names></name><name name-style="western" xml:lang="en"><surname>Chernyii</surname><given-names>S. P.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Екатеринбург</p></bio><bio xml:lang="en"><p>Ekaterinburg</p></bio><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБОУ ВО «Уральский государственный медицинский университет»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Ural state medical university</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2026</year></pub-date><pub-date pub-type="epub"><day>21</day><month>03</month><year>2026</year></pub-date><volume>21</volume><issue>1</issue><fpage>73</fpage><lpage>77</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Кужеливский И.И., Гордиенко И.И., Ялунин Н.В., Немыкина Е.Н., Пономарев А.С., Черный С.П., 2026</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="ru">Кужеливский И.И., Гордиенко И.И., Ялунин Н.В., Немыкина Е.Н., Пономарев А.С., Черный С.П.</copyright-holder><copyright-holder xml:lang="en">Kuzhelivsky I.I., Gordienko I.I., Yalunin N.V., Nemykina E.N., Ponomarev A.S., Chernyii S.P.</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://submit.pirogov-vestnik.ru/jour/article/view/537">https://submit.pirogov-vestnik.ru/jour/article/view/537</self-uri><abstract><sec><title>Обоснование</title><p>Обоснование: проблема лечения заболеваний опорно-двигательного аппарата является одной из наиболее актуальных в современной науке. Главным фокусом для отечественной регенеративной медицины становятся способы лечения дегенеративно-дистрофических заболеваний костно-суставной системы у детей. К передовому методу регенеративной медицины относят криотехнологии. В настоящем исследовании впервые была реализована и оценена новая методика биостимулирующих операций на предложенной оригинальной модели асептического некроза головки бедренной кости.</p></sec><sec><title>Цель</title><p>Цель: оценка эффективности субдеструктивного криовоздействия на очаг остеонекроза головки бедренной кости экспериментальной модели, максимально приближенной к болезни Легг-Кальве-Пертеса.</p></sec><sec><title>Материалы и методы</title><p>Материалы и методы: исследование проведено на 24 кроликах породы «шиншилла» обоего пола. Животным проведен ряд оперативных вмешательств на фоне асептического некроза головки бедренной кости по туннелизации и криовоздействию аппликатором из пористого никелида титана на очаг остеонекроза для оптимизации остеорепаративных процессов костной ткани. Контрольную группу составили 8 животных, которым оперативные вмешательства не проводились.</p></sec><sec><title>Результаты</title><p>Результаты: согласно данным гистоморфологических исследований выявлен активно протекающий процесс неоостеогенеза, что свидетельствует об эффективности криовоздействия аппликатором из пористого никелида титана для предупреждения эффекта адгезии и оптимизации остеогистогенеза в условиях экспериментальной модели асептического некроза головки бедренной кости.</p></sec><sec><title>Заключение</title><p>Заключение: результаты экспериментальных исследований позволяют применить предложенный разработанный способ криовоздействия на патологически изменённую костную ткань при лечении болезни Легг-Кальве-Пертеса у детей с целью активизации репаративной регенерации в некротически изменённой головке.</p></sec></abstract><trans-abstract xml:lang="en"><sec><title>Background</title><p>Background: the problem of treatment of diseases of the musculoskeletal system is one of the most urgent in modern science. The main focus for our regenerative medicine is the treatment of degenerative-dystrophic diseases of the musculoskeletal system in children. This study examined the effects of liquid nitrogen vapor on osteogenesis in the rabbit femur. Cryotweezers made of porous nickel titanium alloy (nitinol or NiTi) obtained by self-propagating high temperature synthesis were used in this experiment.</p></sec><sec><title>Aims</title><p>Aims: evaluation of the effectiveness of subdestructive cryotherapy on the focus of osteonecrosis of the femoral head in an experimental model as close as possible to LeggCalve-Perthes Disease and enhance osteogenesis in rabbit bones through cryotherapy using porous NiTi cryotweezers.</p></sec><sec><title>Materials and methods</title><p>Materials and methods: the study was conducted on 24 rabbits. The animals underwent of a surgical interventions against the background of aseptic necrosis of the femoral head by tunneling and cryotherapy with an applicator made of porous titanium nickelide on the osteonecrosis site to optimize osteoreparative processes of bone tissue. The control group consisted of 8 animals that did not undergo surgery.</p></sec><sec><title>Results</title><p>Results: It was found that a 3 s exposure time stimulates osteogenesis, which was manifested in a greater number of osteoblasts in the regenerate compared to the control sample without liquid nitrogen. It was observed that increasing the exposure to 6, 9 or 12 s had a destructive effect, to varying degrees. The most severe damage was exerted by a 12 s exposure, which resulted in the formation of osteonecrosis areas. In the samples exposed to 6 and 9 s of cryotherapy, destruction of the cytoplasm of osteocytes and osteoclasts was observed.</p></sec><sec><title>Conclusions</title><p>Conclusions: The NiTi alloy produced through the SHS method offers a novel approach to the manufacture and use of cryoinstruments due to its high heat capacity and ductility, which provide rapid local cooling and its ability to prevent sticking to moist mucous tissues. The experimental results obtained make it possible to apply the proposed developed cryotherapy method to pathologically altered bone tissue.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>субдеструктивное криовоздействие</kwd><kwd>криорегенерация</kwd><kwd>остеохондропатия</kwd><kwd>болезнь Легг-Кальве-Пертеса</kwd><kwd>пористый никелид титана</kwd><kwd>жидкий азот</kwd></kwd-group><kwd-group xml:lang="en"><kwd>сryotherapy</kwd><kwd>bone regeneration</kwd><kwd>Legg-Calve-Perthes Disease</kwd><kwd>titanium nickelide</kwd><kwd>nitrogen</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">Экспериментальные исследования на лабораторных животных было поддержано Российским научным фондом, грант № 19-72-10105</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">Beni R, Hussain SA, Monsell F, Gelfer Y. 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