This study focused on analyzing the differential expression profiles of microRNAs in the plasma of a rat model with post-traumatic osteoarthritis (PTOA) and aimed to elucidate the role of microRNAs in the pathogenesis and progression of PTOA through bioinformatics analysis.

Blood samples were collected from nine two-month-old female Sprague-Dawley rats, and microRNAs (miRNAs) were sequenced. The rats were divided into three groups: a normal control group (Group K: no intervention), a mild PTOA group induced by surgery (Group H: modified Hulth model at three weeks post-surgery), and a severe PTOA group induced by surgery (Group J: modified Hulth model at five weeks post-surgery). Differential miRNA expression was identified and validated using quantitative real-time polymerase chain reaction (qPCR). Bioinformatics analysis was performed to predict target genes and analyze associated pathways. A human knee osteoarthritis-like chondrocyte model was established by stimulating chondrocytes with recombinant human interleukin-1β (IL-1β). Reverse transcription PCR (RT-PCR) was used to verify whether the differentially expressed miRNAs were also differentially expressed in human knee chondrocytes and human knee osteoarthritis-like chondrocytes.

Differential expression was observed between Group H and Group K for miR-6315, miR-143-5p, miR-150-5p, and miR-301b-3p. Among these, miR-6315, miR-150-5p, and miR-301b-3p were upregulated, while miR-143-5p was down regulated. Between Group J and Group K, miR-6315 was significantly upregulated. However, between Group H and Group J, miR-511-3p and miR-301a-3p were upregulated and showed differential expression. Furthermore, in the comparison between Group K and Group H (early stage), miR-6315, miR-143-5p, miR-150-5p, and miR-301b-3p exhibited differential expression, suggesting their potential as biomarkers for joint injury in rat PTOA. In Group J, miR-6315 was also upregulated, consistent with the above findings. Thus, miR-511-3p and miR-301a-3p may serve as biomarkers to distinguish between mild and severe PTOA. Notably, miR-143-5p, miR-150-5p, and miR-301b-3p were differentially expressed in human knee osteoarthritis chondrocytes compared to normal human knee chondrocytes, with miR-150-5p and miR-301b-3p showing significant upregulation.

miR-6315, miR-143-5p, miR-150-5p, and miR-301b-3p may serve as biomarkers for joint injury in rat PTOA. Further investigation in human tissues is warranted to evaluate their potential applicability as biomarkers for PTOA in humans.

The relationship between serum total testosterone levels and osteoarthritis (OA) remains controversial. This study aimed to investigate the association between serum total testosterone levels and the risk of OA in middle-aged and older women.

A cross-sectional study design was employed, including data from 1,627 women aged 50 and older from the 2013-2016 cycles of the National Health and Nutrition Examination Survey (NHANES) in the United States. The exposure variable was serum total testosterone levels, and the outcome variable was OA.

The multivariable logistic regression analysis revealed a significant association between higher serum testosterone levels and a reduced risk of OA in women over 50 in the United States. Specifically, for every 20-unit increase in serum testosterone levels, the risk of OA decreased by 27.2% [OR=0.728; 95% CI: 0.566, 0.936; P=0.0169]. The smooth curve fitting demonstrated a linear relationship between the two variables. Interaction tests showed that factors such as age, BMI, hypertension, diabetes, waist circumference, serum total cholesterol levels, estradiol levels, and SHBG levels did not significantly influence the relationship between serum testosterone levels and OA.

In women aged 50 and older in the United States, higher serum testosterone levels are associated with a lower risk of OA. This study provides new insights and evidence into the relationship between serum testosterone levels and OA.

Postoperative knee stiffness following open-wedge high tibial osteotomy (OW-HTO) can significantly compromise surgical outcomes. However, there is a paucity of research investigating the predictive factors for knee stiffness after OW-HTO.

This was a retrospective cohort study involving patients who underwent primary OW-HTO between 2023 and 2024. Demographic data, Kellgren-Lawrence grade, hip-knee-ankle (HKA) angle, medial tibial plateau settlement value, size of internal fixation, type of bone graft, and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were collected. The primary outcome was "postoperative knee stiffness," defined as a worsening of the WOMAC stiffness score at 1 year postoperatively combined with the presence of stiffness symptoms during follow-up evaluations. Univariate analysis and multivariate logistic regression analysis were used to identify independent predictive factors for postoperative stiffness.

A total of 527 patients were included, with 193 males and 334 females, and a mean age of 59.5 years. At 1 year postoperatively, 91 (17.3%) patients developed postoperative knee stiffness. Univariate analysis showed that sex, body mass index (BMI), history of diabetes mellitus, preoperative HKA angle, preoperative medial tibial plateau settlement value, preoperative WOMAC stiffness score, size of internal fixation, and type of bone graft were associated with postoperative stiffness. After including variables in the multivariate logistic regression and applying backward stepwise regression for selection, BMI (OR=1.23, 95% CI: 1.14, 1.32, P<0.001), medial tibial plateau settlement value (OR=1.23, 95% CI: 1.12, 1.35, P<0.001), size of internal fixation (OR=1.02, 95% CI: 1.01, 1.03, P<0.001), and advancement bone flap grafting (OR=0.24, 95% CI: 0.13, 0.41, P<0.001) were identified as independent predictive factors for postoperative stiffness.

In patients undergoing OW-HTO, higher BMI and a larger medial tibial plateau settlement value are risk factors for postoperative knee stiffness, while using smaller-sized internal fixations and advancement bone flap grafting can reduce the risk of postoperative stiffness. Strengthening perioperative management in high-risk populations and optimizing surgical techniques and internal fixation selection may reduce the progression of stiffness and improve functional outcomes.

This study aims to explore the correlation between rheumatoid arthritis (RA) and stroke risk in the adult population of the United States, utilizing data resources from the National Health and Nutrition Examination Survey (NHANES) from 2009 to 2023.

We analyzed 36,360 participants in the NHANES database, including 1, 677 RA patients. Demographic characteristics and baseline characteristics were presented using descriptive statistics, and complex sample weights were used to estimate population characteristics, body mass index (BMI), and the overall incidence of diabetes, hypertension, and arthritis. Subsequently, in the multivariate linear regression model, covariates with statistical significance were included for analysis, with RA as the predictor variable and stroke as the outcome variable, calculating the effect size (β) and its 95% confidence interval (CI).

The study found that compared to non-RA individuals, RA patients had a higher risk of stroke (OR=3.183, 95% CI: (2.493, 4.064), P<0.001). After adjusting for potential confounding factors, the positive correlation between RA and stroke still existed (OR=1.599, 95% CI: (1.209, 2.114), P=0.004). Subgroup analysis showed that the risk of stroke increased in female RA patients (OR=1.605, 95%CI: (1.128, 2.282), P=0.008); RA patients under the age of 60 had a more significant increase in stroke risk (OR=2.686, 95% CI: (1.679, 4.299), P<0.001).

The results of the study reveal a significant association between RA and stroke risk, highlighting the importance of stroke prevention and management in RA patients. These findings provide a new perspective for clinical decision-making and offer a scientific basis for the formulation of future public health policies.

To observe the implementation effect of an intelligent training system in the perioperative rehabilitation of patients undergoing total knee arthroplasty (TKA).

A prospective randomized controlled trial was conducted. A total of 40 patients who underwent TKA in the Department of Orthopedics, Beijing Hospital, from December 2023 to July 2024, The cohort consisted of 13 males and 27 females, with a mean age of 70.40±6.22 years. Using a random number table, patients were allocated to either the control or experimental group, with each group consisting of 20 patients. The control group received standard rehabilitation training, while the experimental group received rehabilitation training based on an intelligent training system in addition to conventional rehabilitation. Outcomes compared between the two groups included knee joint function, range of motion (ROM), adherence to rehabilitation training, first ambulation time, activities of daily living (ADL), nursing satisfaction,and pain levels.

Repeated measures analysis of variance for HSS scores, ROM, Barthel Index, and NRS pain scores at various postoperative time points indicated statistically significant differences between the groups (P<0.001). Compared with the control group, the experimental group showed higher knee function scores at 4 days and 6 weeks postoperatively (P<0.001), greater knee range of motion at postoperative days 1, 4, and 6 weeks (P<0.001), higher activities of daily living scores at postoperative days 4 and 6 weeks (P<0.001), and lower pain scores from postoperative days 1 to 4, as well as at 6 weeks (P<0.05). Significant interactions between group and time point were observed (P<0.001), with statistically significant differences noted across all postoperative time points in the experimental group. Furthermore, the experimental group showed significantly superior exercise compliance, time to first ambulation, and nursing satisfaction compared with the control group (P<0.001).

The intelligent wearable training system demonstrates significant efficacy in perioperative rehabilitation for TKA patients, effectively improving rehabilitation outcomes and warranting widespread clinical application and promotion.

To screen the evaluation tools suitable for perioperative DVT risk prediction in patients with polytrauma, and guide the medical staff to prevent DVT and ensure the safety of high-risk patients.

A case-control study was conducted. 54 patients with polytrauma and perioperative DVT admitted to a trauma center from June 2017 to October 2022 were selected as the treatment group, and 108 patients with polytrauma without DVT admitted during the same period were randomly selected as the control group. The clinical predictive efficacy of perioperative DVT was determined by receiver operating characteristic curve (ROC), including trauma severity score (ISS), Caprini risk assessment model, and RAPT risk assessment scale.

The areas under the ROC curves of ISS, Caprini and RAPT scales were 0.623 (95% CI: 0.544, 0.698, P<0.01), 0.810 (95% CI: 0.741, 0.867, P<0.01) and 0.805 (95% CI: 0.544, 0.698, P<0.01), respectively. 0.736, 0.863, P<0.01). The optimal critical value of Caprini score was 11.5 points, and the sensitivity and specificity were 68.5% and 85.2%, respectively.

The Caprini and RAPT scale can effectively predict the high-risk population of preoperative DVT among polytrauma patients, but the Caprini scale needs to be reclassified as a risk stratification.

To analyze the efficacy and prognosis of incision reduction and fixation combined with Different methods of ligament repair for ankle fracture combined with lower tibiofibular anterior ligament rupture, and to provide relevant references for the rehabilitation of patients with this disease.

The clinical data of 57 patients with ankle fracture combined with lower tibiofibular anterior ligament rupture from October 2021 to October 2022 in our hospital were analyzed. The patients were divided into group A (30 cases) and group B (27 cases) according to their treatment modes.Both groups were treated with incision and repositioning combined with ligament repair, group A used deltoid ligament repair, and group B used lower tibiofibular combined screw fixation repair. Observe the clinical efficacy and prognosis of the two groups.

The hospital stay (15.66±2.12) and fracture healing time (11.44±2.00) in Group A were significantly shorter than those in Group B (18.70±2.45 and 13.56±2.01, respectively), with t-values of 5.022 and 3.986, and both P<0.05. Repeated measures ANOVA for VAS scores at 1 month and 3 months postoperatively between Group A and Group B showed statistically significant differences between the groups, with an interaction between group and time point. Differences between the two groups were statistically significant at all time points except preoperatively; the VAS scores in both Group A and Group B decreased in the order of 3 months postoperatively <1 month postoperatively < preoperatively (P<0.05). Additionally, the VAS scores in Group A were significantly lower than those in Group B at 1 month postoperatively (P<0.05). Repeated measures ANOVA for Baird-Jackson scores at 3 months and 6 months postoperatively between Group A and Group B also revealed statistically significant differences between the groups, with an interaction between group and time point. Differences between the two groups were statistically significant at all time points except preoperatively; the Baird-Jackson scores in both Group A and Group B increased in the order of preoperative <3 months postoperative <6 months postoperative (P<0.05). Furthermore, the Baird-Jackson scores in Group A were significantly higher than those in Group B at both 3 months and 6 months postoperatively (P<0.05). At 6 months postoperatively, the excellent and good rate in Group A (93.33%) was significantly higher than that in Group B (62.96%) (P<0.05). There was no statistically significant difference in the incidence of postoperative complications between the two groups (P>0.05).

Compared with lower tibiosis combined screw fixation repair, trigonal ligament repair showed significant advantages in length of hospitalization, fracture healing time, pain relief, recovery of ankle joint function, and excellent rate.

Osteochondral defect (OCD) represent a prevalent orthopedic condition that significantly impacts patients' quality of life due to the complex anatomical structure and poor intrinsic healing capacity of the affected tissue. While current treatment modalities (including arthroscopic surgery, microfracture, osteochondral autograft/allograft transplantation, and regenerative therapies) demonstrate varying efficacy, all present inherent limitations. To address this challenging clinical problem and achieve complete regeneration of the osteochondral unit, a novel biphasic, porous, biocompatible and biodegradable aragonite-based scaffold—Agili-C^®—has emerged as a promising solution.This review examines the anatomical characteristics of OCD and elucidates the microstructure of Agili-C^® along with its mechanism for OCD repair. We evaluate preclinical and clinical studies, detail its indications and surgical techniques, aiming to provide both theoretical foundation and practical guidance for Agili-C^® application in knee OCD management. Furthermore, this article critically addresses limitations identified in previous clinical trials and emphasizes the need for ongoing assessment of long-term therapeutic outcomes.