This paper deeply discusses the vision of“Aging without Knee Aging”and emphasizes the importance of knee health management for maintaining the quality of life of the elderly. From prevention， scientific knee support， accurate knee protection to deep exploration of knee osteoarthritis pendulum therapy treatment strategy， the practice path of knee health management is analyzed in an all-round way. In the prevention stage， the emphasis is on weight control， avoiding inappropriate exercise， wearing protective devices and paying attention to heat preservation. In the stage of scientific knee protection stage， it is proposed to wear suitable knee pads to provide support and protection；the precision knee preservation stage explores non-replacement therapies，including arthroscopic release，high tibial osteotomy，and tibial tubercle elevation，aiming to alleviate pain while preserving the joint's original structure.In the stage of in-depth exploration， the treatment strategies of knee osteoarthritis pendulum therapy were introduced， including in situ knee osteoarthritis pendulum therapy，load knee osteoarthritis pendulum therapy and resistance knee osteoarthritis pendulum therapy to relieve joint contracture and dysfunction. Effective knee health management requires joint efforts from patients， physicians， and society. By enhancing public education and raising awareness about knee health，we can collectively work toward realizing the vision of“Aging without Knee Aging.”
To evaluate the therapeutic value of the"Knee osteoarthritis pendulum therapy"technique in the prevention and treatment of knee joint disorders，aiming to provide theoretical and practical guidance for the prevention and rehabilitation of knee joint diseases.
Methods
8 patients diagnosed with Kellgren-Lawrence grade II osteoarthritis and Visual Analog Scale （VAS） of 6 were instructed to perform the "knee osteoarthritis pendulum therapy" exercises for six weeks under guidance. Follow-up evaluations were conducted in outpatient settings after the intervention. The primary outcome was the change in pain scores， used to assess the effectiveness of the "knee osteoarthritis pendulum therapy" therapy.
Results
After six weeks of intervention， all patients reported pain relief. VAS scores were reduced to less than 3（mild pain） in six patients， while two patients had VAS scores of 5 （moderate pain）， showing improvement compared to baseline. The overall response rate was 100%， with a marked improvement rate of 75%.
Con-clusion
Preliminary application of the "knee osteoarthritis pendulum therapy" therapy demonstrated favorable outcomes，suggesting its potential clinical value in the management of early-stage osteoarthritis.
Laminectomy decompressionandpediclescrewinternal fixation is a commonly used technique for the treatment of spinal cord injuries caused by thoracolumbar burst fractures， but it has the disadvantage of high surgical trauma.Therefore，we evaluated the efficacy of postural reduction and internal fixation in the treatment of thoracolumbar burst fractures and compared the clinical efficacy of postural reduction internal fixation with laminectomy reduction internal fixation.
Methods
We retrospectively analysed 134 patients with thoracolumbar burst fractures who were surgically treated at the Orthopaedic Medical Centre of the Second Hospital of Jilin University between June 2016 to December 2020.All patients had an ASIA score of C or D.According to the operationmethods， patients were divided into two groups，A and B.Group A（n=66 patients）:treated with postural repositioning decompression and internal fixation；Group B（n=68 patients）: treated with laminectomy decompression and internal fixation. General condition， operative time，in traoperative blood loss，anterior height of injured vertebrae，sagittal Cobb angle，ASIA score，VAS score， ODI score and surgical complications were compared between the two groups.
Results
The average follow-up time of the 134 patients was 29.5±5.3 months， of which 24.4-34.5 months in group A and 24.2-34.8 months in group B.There were 37 males and 29 females in group A with an average age of 42.21±23.93 years and 38 males and 30 females in group B with an average age of 46.80±27.47 years.There was no statistical difference in the general condition of the patients in the two groups（P＞0.05）.At the preoperative and 2-year postoperative follow-up， the percentage height loss of the anterior margin of the injured vertebrae in group A and group B was ［（50.00±11.26）% vs. （46.26±14.50）%， P＞0.05］， ［（13.74±3.33）% vs. （18.19±1.78）%，P＜0.05］，the Cobb angle was［（37.65±2.26）°vs.（37.13±1.59）°，P＞0.05］，［（12.38±1.25）°vs.（15.76±1.45）°，P＜0.05］，and the operation time was［（51.36±5.65）min vs.（74.81±9.29）min，P＜0.001］，intraoperative blood loss was ［（56.80±13.97） mL vs. （188.38±61.15） mL， P＜0.001］， and the results of the VAS score for back pain at 3 days postoperatively were ［（5.44±0.50） vs. （6.49±0.50）， P＜0.05］. When comparing the two groups， there was no statistically significant difference in ASIA score， VAS score for lower limb pain and ODI score at preoperative，3 days postoperative，1 year postoperative and 2 years postoperative follow-up（P＞0.05）. However， all these scores were significantly improved after surgery compared to the preoperative when compared within the two groups（P＜0.05）.
Conclusions
Both postural reduction internal fixation and laminectomy reduction internal fixation are safe and effective procedures for the treatment of thoracolumbar burst fractures. However， for patients with thoracolumbar burst fractures with ASIA scores of C and D， postural reduction internal fixation has the advantages of less surgical trauma， shorter operative time， and less back painin the early postoperative period.
To explore the effects of modified"eggshell"technique on spinal sagittal balance parameters and prognosis in senile patients with osteoporotic vertebral compression fracture （OVCF）.
Methods
A total of 101 elderly patients with OVCF admitted to our hospital from May 2021 to May 2022 were selected as research objects， and randomly divided into control group （50 cases） and study group （51 cases）. The control group was treated with conventional percutaneous kyphoplasty （PKP）， and the study group was treated with modified"eggshell"technique PKP.Operation，postoperative rehabilitation，incidence of adverse events and distribution of bone cement were compared between the two groups. Preoperative and postoperative spinal sagittal balance parameters ［lumbar lordosis Angle （LL）， sacral inclination Angle （SS），thoracic kyphosis Angle （TK）］， fracture healing related indexes ［osteocalcin n-terminal molecular fragments（N-MID），bone morphogenetic protein 7（BMP-7）］，lumbar function（ODI score），and lumbar stability indexes （injured vertebra） were compared between the two groups Percentage of leading edge， Cobb Angle of injured vertebra）.
Results
All patients were followed up for 6 months.There were 33 males and 68 females in each group，with an average age of 72.71±3.74 years.The study group had a higher cement injection volume of （8.21±0.83） ml than the control group's （6.35±0.64） ml， and the incidence of adverse events was 3.92%，which was lower than the control group's 18.00%， the time to get out of bed and hospitalization time were（2.39±0.75）hours and（6.74±1.14）days，respectively，which were shorter than the control group's（3.16±0.98）hours and（7.38±1.26）days，and the difference were statistically significant（P＜0.05）；the excellent and good rate of bone cement distribution in the study group was 88.24%， which was higher than the control group's 72.00%，and the difference was statistically significant（P＜0.05）；one month after surgery，the LL，SS，and the percentage of the anterior edge of the injured vertebra in the study group were（50.43±2.26）°，（28.16±3.14）°，and （94.18±3.05）%， respectively， which were higher than the control group's （48.67±2.50）°， （26.73±2.81）°，and （90.26±4.47）%， and the difference were statistically significant （P＜0.05）； three months after surgery， the LL，SS，and the percentage of the anterior edge of the injured vertebra in the study group were（50.14±2.39）°，（27.88±2.95）°， and （93.56±3.41）%， respectively， which were higher than the control group's （48.26±2.44）°，（26.45±2.67）°，and（89.75±4.29）%，and the difference were statistically significant（P＜0.05）；six months after surgery， the LL， SS， and the percentage of the anterior edge of the injured vertebra in the study group were（49.98±2.51）°， （27.71±2.86）°， and （93.18±3.77）%， respectively， which were higher than the control group's（47.81±2.39）°， （25.92±2.72）°， and （89.34±4.18）%， and the difference were statistically significant （P＜0.05）；one month after surgery， the TK， ODI score， and Cobb angle of the injured vertebra in the study group were（33.21±2.62）°， （17.29±2.23） scores， and （7.26±0.72）°， respectively， which were lower than those in the control group（35.58±2.73）°，（19.85±2.41）scores，and（9.18±0.85）°，respectively，and the difference were statistically significant （P＜0.05）； three months after surgery， the TK， ODI score， and Cobb angle of the injured vertebra in the study group were （33.85±2.77）°， （17.71±2.46） scores， and （7.43±0.75）°， respectively， which were lower than those in the control group（36.01±2.84）°，（20.15±2.59）scores，and（9.30±0.86）°，respectively，and the difference were statistically significant（P＜0.05）；at 6 months after surgery，the TK，ODI score，and Cobb angle of the injured vertebra in the study group were （34.16±2.89）°， （17.93±2.55） scores， and（7.51±0.80）°， respectively， which were lower than those in the control group （36.49±2.90）°， （20.46±2.48）scores， and （9.43 ± 0.84）°， respectively， and the difference were statistically significant （P＜0.05）； at one month after surgery， the serum N-MID and BMP-7 levels in the study group were （48.21±6.95） ng/ml and（2.44±0.35） ng/ml， respectively， which were higher than those in the control group （43.82±6.48） ng/ml and（2.18±0.33）ng/ml，respectively，and the difference was statistically significant（P＜0.05）；at three months after surgery，the serum N-MID and BMP-7 levels in the study group were（44.57±6.17）ng/ml and（2.32±0.32）ng/ml， respectively， which were higher than those in the control group （40.26±6.02） ng/ml and （1.97±0.30） ng/ml， respectively， and the difference were statistically significant （P＜0.05）.
Conclusion
The modified "eggshell" technique in the treatment of elderly patients with OVCF is beneficial to postoperative rehabilitation，can improve the distribution of bone cement， correct the spinal sagittal imbalance， improve lumbar function and stability，and reduce the occurrence of adverse events.
To investigate the effects of percutaneous minimally invasive pedicle screw fixation on vertebral function，tissue trauma and serum levels of bone morphogenetic protein-7（BMP-7）and N-terminal middle molecular fragment of osteocalcin（N-MID）in patients with OVCF.
Methods
The 83 patients with OVCF admitted to our hospital from September 2021 to September 2022 divided into minimally invasive group （42 cases） and open group （41 cases） according to surgical methods. The minimally invasive group was treated with percutaneous minimally invasive pedicle screw internal fixation，while the open group was treated with open pedicle screw internal fixation. The VAS， ODI score， percentage of injured vertebral height and Cobb angle compared two groups before operation，1 month after operation and 3 months after operation； changes of BMP-7 and N-MID levels in patients before and 48 hours after operation. Results The minimally invasive group and open group VAS scores no difference（P＞0.05）；minimally invasive group VAS scores of OVCF patients lower than open group（P＜0.05）.The minimally invasive group ODI score of OVCF patients lower than open group at 1 month and 3 months after operation （P＜0.05）. Two groups height of the anterior edge of the injured vertebra in OVCF patients higher than before operation，and the Cobb angle lower than before operation （P＜0.05）； minimally invasive group and the open group anterior edge height and Cobb angle no difference （P＞0.05）. The two groups after operation 48 hours serum BMP-7 and NMID in OVCF patients higher than before operation（P＜0.05）；minimally invasive group serum BMP-7 and N-MID in OVCF patients higher than open group （P＜0.05）.
Conclusion
Percutaneous minimally invasive pedicle screw fixation can improve the vertebral function of OVCF patients， and improve the serum BMP-7 and N-MID levels of patients，which is worthy of clinical reference.
To analyze the influencing factors of postoperative anemia in elderly patient with intertrochanteric fracture and establish a predictive model to explore the predictive value of this model.
Methods
A retrospective study was conducted to collect the clinical data，laboratory indicators and examination results of 451 elderly patients with intertrochanteric fractures who were treated in the orthopedics department of a hospital from January 2020 to December 2021，and were randomly assigned to the modeling set（319 cases）and validation set （132 cases）according to a ratio of 7:3. Univariate and multivariate logistic regression analysis was performed to screen out the influencing factors of postoperative anemia in elderly patients with intertrochanteric fracture， and a nomogram prediction model was constructed. The performance and clinical practicability of the model were evaluated by Receiver Operating Characteristic （ROC） curve，calibration curve and decision curve respectively，and validation set data were introduced for internal validation of the model.
Results
Among 319 elderly patients with intertrochanteric fracture in the modelingset，105 （32.90%） had anemia. Univariate results showed gender （OR=0.555， 95% CI： 0.318-0.970）， length of hospital stay（OR=1.104， 95% CI： 1.040， 1.173），American Society of Anesthesiologists （ASA） grade （OR=0.649，95%CI：0.478，0.883），Hemoglobin（Hb）at admission（OR=1.021，95%CI：1.005-1.036），B-type natriuretic peptide （BNP） at admission （OR=0.996， 95% CI： 0.993， 0.999）， left ventricular ejection fraction（LVEF）（OR=1.067，95%CI：1.021，1.116）there was a statistical difference（P＜0.05）.Multivariate logistic regression analysis showed that gender（OR=0.498，95%CI：0.272，0.912），length of stay（OR=1.137，95%CI：1.063， 1.216）， Hb at Admission （OR=1.024， 95% CI： 1.007， 1.041）， BNP at Admission （OR=0.997， 95% CI：0.993，0.999），LVEF（OR=1.050，95%CI：1.001，1.102）were the influential factors for postoperative anemia in elderly intertrochanteric patients（P＜0.05）.Based on these factors，anemia column diagram model in elderly patients with intertrochanteric fractures was constructed.The area under ROC curve of the model for predicting postoperative anemia in elderly patients with intertrochanteric fractures was 0.717（95%CI：0.657，0.776），the cut off value of the modeling set model was 0.341，the sensitivity was 0.634，the specificity was 0.711，and the Youden index was 0.345.When the threshold probabilities of modeling set and validation set in the decision curve were 9%-59%and 20%-69%respectively in the decision curve，the net benefit was higher than the extreme curve of no intervention and all intervention，indicating the clinical validity of the prediction model.
Conclusions
The prediction model based on gender，length of stay，Hb at admission，BNP at admission，and LVEF has a certain value in predicting the risk of anemia in elderly patients with intertrochanteric fracture.
To compare the diagnostic value of quantitative CT and dual-energy X-ray absorptiometry for osteoporosis.
Methods
PubMed， FEBM， The Cochrane Library， CBM， CNKI， Wanfang Database，VIP and other databases were searched from the establishment of the database to February 2022 to include relatedstudieson the diagnosis of osteoporosis by quantitative CT and（or）dual-energy X-ray absorptiometry， collect literature that can construct a 2x2 contingency table.The literatures were screened according to the inclusion and exclusion criteria of diagnostic tests，and the quality and risk of bias of the included literature were evaluated by QUADAS-2 literature quality assessment tool and ReviewManager 5.4 software，and Meta-analysis was performed by Stata 14.0 software.
Results
Twenty-one articles were finally included.The meta-analysis showed that the combined sensitivity （Sen combined） of quantitative CT in the diagnosis of osteoporosis was0.94 ［95% CI: 0.84， 0.98］， and the specificity （Spe combined） was 0.55 ［95% CI: 0.31，0.77］，the positive likelihood ratio（+LR combined）was 2.1［95%CI:1.2，3.8］，and the negative likelihood ratio （-LR combined） was 0.11 （95% CI: 0.03， 0.41）； dual energy The combined sensitivity （Sen combined） of X-rays for the diagnosis of osteoporosis was 0.70 ［95% CI: 0.36， 0.91］， the specificity （Spe combined） was 0.86［95%CI:0.55，0.97］，and the positive likelihood ratio（+LR pooled）was 5.1［95%CI:1.2，20.9］，negative likelihood ratio （-LR pooled） was 0.34 （95% CI: 0.12， 0.95）， and the respective diagnostic odds ratios（DOR pooled）were 18（95%CI:3，110）and 15（95%CI:2，115）；the areas under the SROC curve were 0.89［95%CI:0.85，0.91］and 0.86［95%CI:0.83，0.89］，respectively.
Conclusion
Both quantitative CT and dual-energy X-ray have high application value in the diagnosis of osteoporosis，and quantitative CT with higher diagnostic efficiency can be preferred in routine examination.
Muscle and skeletal tissues are integrated organs.They are complementary and anatomically adjacent.The muscle-bone unit are important for the voluntary movement of the individual.Mechanical loading is the key mechanism that connects the two tissues. Recent studies have shown that except for the mechanical coupling between muscles and skeletons，there are cytokines in the circulatory and local microenvironment that couple and mediate the interaction between the two tissues.The cytokines secreted by skeletal muscle are called myokines，which including myostatin（MSTN），Irisin，Insulin-like growth factor-1（IGF-1），fibroblast growth factor-2 （FGF-2）， Interleukin-6 （IL-6）， Interleukin-15 （IL-15）， Osteoglycin （OGN）， Osteoactivin（OA）.In order to further understand the regulatory network and internal mechanism of muscle factors on bone，we will review the molecular regulation of muscle on bone homeostasis，hoping to provide new perspectives for understanding the biological basis of muscle factors on bone regulation and searching for potential therapeutic targets for musculoskeletal diseases in clinic.
Lumbar disc herniation（LDH）is a common disease in spinal surgery，with the main clinical manifestations including lower back and leg pain， and numbness in the lower limbs， which severely impact patients'quality of life.The treatment of LDH is primarily divided into conservative treatment and surgical treatment. Most patients do not require surgical treatment. There are various methods of conservative treatment， each with different mechanisms of action. These methods have both advantages and limitations.The combined use of multiple therapies is worth attention.Due to the significant differences in the condition and disease progression among patients，exploring how to formulate personalized treatment plans for them is a topic deserving in-depth discussion. This article reviews the latest advances in the conservative treatment of LDH， including non-pharmacological treatments such as traction， exercise therapy， physical factor therapy， massage， and acupuncture， as well as the current status of pharmacological treatment. By analyzing the mechanisms， efficacy， and indications of each treatment， the aim is to offer a reference for clinical practice and to promote the standardization and individualization of conservative treatment for LDH.
