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Efficacy and safety of extracorporeal shock wave therapy combined with sodium hyaluronate in treatment of Knee osteoarthritis:a systematic review and Meta-analysis

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Journal of Traditional Chinese Medicine 2024年第2期44卷 243-250页

作者： ZHOU Mingwang DONG Zhuanli WEI Changhao FENG Lufang WANG Xiaoping LIU Haiping JI Xing YANG Kehu LI Shenghua Department of Orthopaedics Gansu Provincial Hospital of Traditional Chinese MedicineLanzhou 730050China Department of Quality Management Lanzhou Petrochemical General HospitalLanzhou 730050China Department of Orthopaedics Lanzhou Petrochemical General HospitalLanzhou 730050China Evidence-Based Social Science Research Center School of Public HealthLanzhou UniversityLanzhou730000China Evidence-Based Medicine Center School of Basic Medical SciencesLanzhou UniversityLanzhou 730000China Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province Lanzhou 730000China Center for Translational Medicine Gansu Provincial Hospital of Traditional Chinese MedicineLanzhou 730050China Department of Orthopaedics Gansu Provincial Hospital of Traditional Chinese MedicineLanzhou 730000China

OBJECTIVE:To assess the efficacy and safety of extracorporeal shockwave therapy(ESWT)combined with sodium hyaluronate(HA)for the treatment of Knee osteoarthritis(KOA).METHODS:PubM ed,Embase,the Cochrane Library,Web of Science,China National Knowledge Infrastructure,Wanfang database,China Science and Technology Journal Database,and SinoMed were searched from inception to July 2020.The quality of the randomized controlled trials was evaluated independently by two reviewers according to the criteria in the Cochrane Collaboration for Systematic Reviews.The identified articles were then screened individually using EndnoteX9 for eligibility in this Meta-analysis.The heterogeneity among the articles was evaluated using I2.RESULTS:A total of 17 studies,comprising 2000 individuals,were included in this Meta-analysis.The results showed that a significant improvement was observed in Knee pain and function based on the clinical efficacy of ESWT combined with HA.Statistical analysis of clinical efficacy showed that[relative risk(RR)=1.21,95%confidence interval(CI)(1.12,1.30),P<0.01].Statistical analysis of visual analog scale showed that[standardized mean difference(SMD)=-2.84,95%CI(-4.01,-1.66),P<0.01].Western Ontario and McMaster University osteoarthritis index statistical analysis showed that[SMD=-1.57,95%CI(-2.52,-0.61),P<0.01].Lysholm score statistical analysis showed that[SMD=1.71,95%CI(0.98,2.44),P<0.01].In addition,only minor side effects,such as redness and swelling of the skin,were observed.CONCLUSIONS:Medium to low quality evidence showed that ESWT combined with HA offers an inexpensive,welltolerated,safe,and effective method to improve pain and functionality in patients with KOA.However,tightly controlled,randomized,large multicenter trials are warranted to validate the current findings.

关键词： osteoarthritis Knee randomized controlled trial extracorporeal shockwave therapy hyaluronic acid Meta-analysis

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Commentary on“The deterministic condition for the ground reaction force acting point on the combined Knee valgus and tibial internal rotation moments in the early phase of cutting maneuvers in female athletes”

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Journal of Sport and Health Science 2024年第3期13卷 373-375页

作者： Nathan D.Schilaty Nathaniel A.Bates Department of Neurosurgery&Brain Repair University of South FloridaTampaFL 33620USA Department of Medical Engineering University of South FloridaTampaFL 33620USA Center for Neuromusculoskeletal Research University of South FloridaTampaFL 33620USA Department of Orthopaedics The Ohio State University Wexner Medical CenterColumbusOH 43210USA

1.Introduction For decades,substantial disagreement has persisted as to whether dynamic Knee valgus is the cause of the majority of anterior cruciate ligament(ACL)injuries or rather the result of the ACL rupture.1 Consequently,great effort and expense has gone into capturing 3-dimensional kinetics and kinematics from live athletes to drive in vitro and in silico models of ACL injury in order to elucidate the actual mechanism of injury,as these factors have been demonstrated to be surrogates of intraarticular structural loading on the ACL.2,3 The elucidation of injury mechanisms for non-contact ACL injuries is of great medical value as such knowledge consequently permits quantified examination and validation of interventions and their respective effectiveness in both prevention and rehabilitation of these traumatic Knee injuries.

关键词： injuries Knee prevention

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Clinical characteristics of flares in patients with rheumatoid arthritis after total hip and total Knee arthroplasty

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Chinese Medical Journal 2023年第23期136卷 2877-2879页

作者： Liang Zhang Cong Ma Hongchao Li Tao Bian Siliang Man Yixin Zhou Department of Orthopedics Beijing Jishuitan HospitalBeijing 100035China Department of Rheumatology and Immunology Beijing Hospital of Traditional Chinese MedicineCapital Medical UniversityBeijing 100010China Department of Rheumatology Beijing Jishuitan HospitalBeijing 100035China

To the Editor:Introduction of conventional synthetic disease-modifying antirheumatic drugs(csDMARDs)has been highly efficacious in reducing the signs and symptoms of rheumatoid arthritis(RA)and in delaying or preventing structural joint damage.Furthermore,the development and clinical use of biological DMARDs(bDMARDs)and targeted synthetic DMARDs(tsDMARDs)have dramatically altered the prognosis of patients with RA,particularly when they are combined with a treat-to-target regimen(T2T).[1]Consequently,over the last two decades,the rates of total hip arthroplasty(THA)and total Knee arthroplasty(TKA)remained stable or even decreased in these special patient populations.Nevertheless,compared to patients with osteoarthritis,patients with RA have a higher risk of having worse functional outcomes and higher rates of complications after arthroplasty.This may be attributed to the complexity of the rheumatic disease process,including high disease activity,comorbidities,and immunosuppressive medications.[2]A key to making perioperative medication management decisions is to balance the risk of periprosthetic infection with the risk of a disease flare.

关键词： arthroplasty patients Knee

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Protocol to establish auxiliary diagnostic model for Knee osteoarthritis functional testing equipment

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Journal of Traditional Chinese Medicine 2023年第2期43卷 379-385页

作者： GUO Zhuang WANG Junwen LI Zhonglong CHEN Zhongjie CHEN Li YAN Shiyan LU Hongrong LI Zhigeng LI Guanying Institute of Basic Theory of Chinese Medicine China Academy of Chinese Medical ScienceBeijing 100700China Institute of Acupuncture and Moxibustion China Academy of Chinese Medical SciencesBeijing 100700China Department of Acupuncture Moxibustion and MassageBeijing HospitalBeijing 100000China Department of Acupuncture Moxibustion and MassageWuhan Hongshan Chinese Medicine HospitalHubei 430070China School of Humanities Beijing University of Chinese MedicineBeijing 100029China

In China,50%of Knee Osteoarthritis(KOA)patients will be treated with Traditional Chinese Medicine or a combination of Traditional Chinese and Western Medicine,which call for objective efficacy evaluation methods.The collection,processing and fusion of multisource data were taken as the main methods,with 150 KOA patients and 100 healthy people as an example to design prospective clinical tests.Data were collected with tongue inspection APP,infrared instrument and channel instrument,etc.And the analysis,screening,fusion and modelling of multi-source data were conducted.The traditional clinical tests have been combined with the customized information platform in this study,which is convenient for clinical tests,medical follow-ups and timely feedback to statistical analysis of data.

关键词： osteoarthritis Knee multi-source data efficacy evaluation prospective clinical test diagnostic tests routine protocol

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Effect of manipulation on cartilage in rats with Knee osteoarthritis based on the Rho-associated protein kinase/LIM kinase 1/Cofilin signaling pathways

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Journal of Traditional Chinese Medicine 2022年第2期42卷 194-199页

作者： GUO Xiao YANG Yunhao LIAO Dongmei PANG Fang YANG Zhixue ZHU Zhengwei LUO Ao TANG Chenglin College of Traditional Chinese Medicine Chongqing Medical UniversityChongqing 400010China Beibei Traditional Chinese Medicine Hospital Chongqing 400700China

OBJECTIVE:To investigate the effect of manipulation treatment on Knee osteoarthritis rats and the effect on Rho-associated protein kinase(ROCK)/LIM-kinase1(LIMK1)/Cofilin signaling pathway.METHOD:Fifty Specific pathogen Free Sprague-Dawley rats were randomly divided into five groups(n=8 each):blank group,model group,manipulation group,celecoxib group,and manipulation combined with celecoxib group(MC group).The osteoarthritis model was established by injecting 0.2 m L 4%papain into the articular disc of the rats.After successfully establishing the model,we treated the manipulation group with pushing manipulation using one-finger-meditation to the Neixiyan(EX-LE4),Waixiyan(EX-LE5),Xuehai(SP10),Liangqiu(ST34),and Zusanli(ST36)acupoints for 10 min each time.Also,the celecoxib group was gavaged with 24 mg·kg^(-1)·d^(-1 )celecoxib,while the MC group was treated using both of these two methods.After four weeks,the cartilage of the right femur was removed for hematoxylin-eosin staining of the cartilage tissue.The expressions of interleukin-1β(IL-1β)and tumor necrosis factor-α(TNF-α)in serum were observed using the enzyme-linked immunosorbent assay.Besides,we detected the expressions of ROCK,LIMK1,Phospho-LIM-kinase1(Phospho-LIMK1),Cofilin,and Phospho-Cofilin by Western blot.RESULTS:Compared to the model group,the manipulation group,celecoxib group,and MC group all exhibited superior results concerning pathological morphologic changes of cartilage,as observed by hematoxylin-eosin staining and calculated using the Mankin score.Besides,in contrast to the blank group,the model group exhibited elevated serum levels of IL-1βand TNF-α(P<0.01),while the expression of ROCK,LIMK1,Phospho-LIMK1,Cofilin,and Phospho-Cofilin in cartilage were all higher(P<0.01).Also,the serum levels of IL-1βand TNF-αin each treatment group were lower(P<0.01)than in the model group.Moreover,there were lower expressions of ROCK,LIMK1,Phospho-LIMK1,Cofilin,and Phospho-Cofilin in cartilage in the manipulation group and the MC group(P<0.01).Compared with t

关键词： osteoarthritis Knee manipulation cytoskeletal proteins Rho-associated kinases LIM kinases actin depolymerizing factors signal transduction

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保膝截骨术在中国的发展

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Science Bulletin 2023年第2期68卷 125-128,M0003页

作者：黄野 Phillipp Lobenhoffer 蒋协远 Knee Preservation Clinical and Research Center Beiiing Jishuitan HospitalBeijing 100035China Klinik für Unfall-und Wiederherstellungschirurgie Hannover 30171Germany Traumatology Department Beijing Jishuitan HospitalBeijing 100035China

With the growth of the aging population, the number of patients with osteoarthritis has been increasing each year in China.The estimated overall incidence of osteoarthritis is approximately8% [1], with nearly 100 million people in China having osteoarthritis. Most cases involve osteoarthritis of the Knee. Therefore, how to effectively treat Knee osteoarthritis(KOA) is not only a medical problem but also a social one.

关键词：截骨术 China. Knee

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Trajectory of bearing movement during Oxford mobile-bearing unicompartmental Knee arthroplasty using a kinematic alignment technique

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Chinese Medical Journal 2023年第5期136卷 613-615页

作者： Xiaowei Sun Feifan Lu Wanshou Guo Liming Cheng Weiguo Wang Qidong Zhang Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences Beijing 100730China Department of Orthopaedic Surgery China-Japan Friendship HospitalBeijing 100029China Department of Orthopedic Surgery Nanfang HospitalSouthern Medical UniversityGuangzhouGuangdong 510515China.

To the Editor:Dislocation of the mobile bearing is the most common reason for revisions in Asian patients who undergo Oxford mobile-bearing unicompartmental Knee arthroplasty(Oxford MB UKA),with an incidence rate as high as 7.9%.[1]Multiple studies have shown that the bearing dislocation rate is significantly higher in Asian than in Western patients.[2]A poor bearing movement trajectory was considered one of the risk factors.Malpositioning of the component results in a wider space between the margin of the bearing and the lateral wall of the tibial component,leading to a poor bearing movement trajectory and even bearing rotation.The superior surface is designed with high surrounding rims(higher in the anterior and posterior parts,lower in the medial and lateral parts).When rotation occurs,the lower rim loses its restriction to mutual movement of the bearing and femoral component,which leads to dislocation.

关键词： Knee movement medial

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Do minimally invasive approaches affect long-term clinical outcomes of total Knee arthroplasty?A cohort analysis with a minimum 10-year follow-up

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Chinese Medical Journal 2023年第11期136卷 1376-1378页

作者： Fuzhen Yuan Zewen Sun Jiangnan Fu Meng Yang Jiying Zhang Yourong Chen Jiakuo Yu Department of Sports Medicine Peking University Third HospitalInstitute of Sports Medicine of Peking UniversityBeijing 100191China Qingdao Medical College Qingdao UniversityQingdaoShandong 266000China Department of Sports Medicine The Affiliated Hospital of Qingdao UniversityQingdaoShandong 266003China

To the Editor:Total Knee arthroplasty(TKA)is a safe and effective treatment for patients with end-stage Knee osteoarthritis,with the conventional medial parapatellar(MP)approach for TKA,good visualization of the Knee can be obtained,helping to achieve correct osteotomy,proper ligament balance and good prosthesis position,which are all important for good long-term results.[1]To improve functional recovery and rehabilitation,some studies have adopted a relatively small incision operation to improve operation.

关键词： Knee arthroplasty medial

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Occurrence,risk factors,and microbiology of surgical site infections after total Knee arthroplasty:preliminary results of a retrospective study

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Chinese Medical Journal 2023年第14期136卷 1747-1749页

作者： Yiming Xu Yingjie Wang Wei Zhu Bin Feng Zehui Lyu Yixin Bian Xisheng Weng Department of Orthopedics State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China

To the Editor:Total Knee arthroplasty(TKA)has became an established treatment for end-stage joint disease.In China,there was a 5.9-fold increase in the number of TKA cases between 2011 and 2019.All kinds of infections are catastrophic complications of TKA.Recent reports have highlighted the underestimated prevalence of surgical site infections(SSIs)and projected an increase in complex SSIs following hip and Knee arthroplasties by 14%between 2020 and 2030.^([1])However,there are few reports describing SSIs in Chinese population.This preliminary retrospective study aimed to gain some insights into the occurrence,risk factors,and microbiological patterns of SSIs in China.

关键词： infections Knee arthroplasty

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Multidisciplinary approach toward enhanced recovery after surgery for total Knee arthroplasty improves outcomes

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World Journal of Clinical Cases 2024年第9期12卷 1549-1554页

作者： Deb Sanjay Nag Amlan Swain Seelora Sahu Ayaskant Sahoo Gunjan Wadhwa Department of Anaesthesiology Tata Main HospitalJamshedpur 831001India Department of Anaesthesiology Manipal Tata Medical CollegeJamshedpur 831001India

Knee osteoarthritis is a degenerative disorder of the Knee,which leads to joint pain,stiffness,and inactivity and significantly affects the quality of life.With an increased prevalence of obesity and greater life expectancies,total Knee arthroplasty(TKA)is now one of the major arthroplasty surgeries performed for Knee osteoarthritis.When enhanced recovery after surgery(ERAS)was introduced in TKA,clinical outcomes were enhanced and the economic burden on the healthcare system was reduced.ERAS is an evidence-based scientific protocol aimed at ameliorating the surgical stress response.ERAS aims to enhance the recovery phase,which encompasses multidisciplinary strategies at every step of perioperative care,including the rehabilitation phase.Implementation of ERAS in TKA aids in reducing the length of hospital stay,improving pain management,reducing perioperative complications,and enhancing patient satisfaction.Multidisciplinary collaboration,integrating the expertise of anesthesiologists,orthopedic surgeons,nursing personnel,and other healthcare professionals,is the cornerstone of ERAS in patients undergoing TKA.

关键词： Arthroplasty Replacement Knee Recovery of function Anesthesia Care Nursing

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