目的 探究单髁膝关节置换（UKA）联合注射布比卡因脂质体治疗老年孤立性内侧间室骨关节炎（OA）的效果，并分析其对患者术后长效镇痛的作用。方法 前瞻性选取2023年11月—2025年11月期间收治的80例老年孤立性内侧间室OA患者，分为对照组与研究组，各40例。两组患者均接受UKA手术治疗，研究组在术中于相同部位注射布比卡因脂质体，对照组于术中关节周围注射等体积的生理盐水混合物。比较两组术后疼痛强度，镇痛药物消耗与需求，早期膝关节功能恢复情况、早期膝关节功能，以及两组不良反应发生率。结果 研究组术后6 h、12 h、24 h及48 h VAS评分均低于对照组，术后48 h内，研究组中重度疼痛发生率较对照组低（P＜0.05）；研究组术后首次请求镇痛的时间晚于对照组，48 h内曲马多总消耗量及补救镇痛需求率均较对照组低（P＜0.05）；研究组在术后24 h、48 h、72 h的膝关节主动活动度较对照组大，研究组首次直腿抬高时间、术后下地行走时间及住院时间均较对照组短（P＜0.05）；术前两组膝关节协会评分（KSS）和牛津膝关节评分（OKS）评分无差异（P＞0.05）。术后1周，两组评分均改善，且研究组优于对照组（P＜0.05）；两组不良反应发生率无差异（P＞0.05）。结论 UKA术中联合应用布比卡因脂质体，能安全、有效地为老年孤立性内侧间室OA患者提供长效术后镇痛。且该方案不仅能显著减轻患者早期疼痛、减少阿片类药物依赖，更能有效促进膝关节早期功能恢复、缩短住院时间，并为患者获得更优的早膝关节功能奠定基础。

    Objective To investigate the efficacy of unicompartmental knee arthroplasty（UKA） combined with injection of bupivacaine liposomes in the treatment of elderly isolated medial compartment osteoarthritis（OA），and analyze its long-term analgesic effect on patients after surgery．Methods A prospective study was conducted on 80 elderly patients with isolated medial compartment OA admitted between November 2023 and November 2025．They were divided into a control group and a study group，with 40 patients in each group．Both groups of patients received UKA treatment．The study group received injection of bupivacaine liposomes at the same site during surgery，while the control group received injection of an equal volume of physiological saline mixture around the joints during surgery．Postoperative pain intensity，analgesic drug consumption and demand，early knee joint function recovery，early knee joint function were compared between two groups，and the incidence of adverse reactions was compared between the two groups．Results The study group had lower VAS scores at 6 h，12 h，24 h，and 48 h postoperatively compared to the control group．Within 48 hours after surgery，the incidence of moderate to severe pain in the study group was lower than that in the control group（P＜0.05）．The time to first postoperative analgesic request in the study group was later than that in the control group，and the total tramadol consumption and the need for analgesia within 48 hours were lower（P＜0.05）．The active range of motion of the knee at 24 h，48 h，and 72 h postoperatively was greater in the study group compared to the control group．Additionally，the time to first straight leg raise，time to ambulation，and length of hospital stay were all shorter in the study group（P＜0.05）．Preoperatively，there were no differences between the two groups in the Knee Society Score（KSS） and the Oxford Knee Score（OKS）（P＞0.05）．One week postoperatively，both groups showed improved scores，with the study group showing greater improvement than the control group（P＜0.05）．There was no significant difference in the incidence of adverse reactions between the two groups（P＞0.05）．Conclusions The combined use of bupivacaine liposomes during UKA can provide safe and effective long-term postoperative analgesia for elderly patients with isolated medial compartment OA．And this plan not only reduces early pain and opioid dependence in patients，but also effectively promotes early knee joint function recovery，shortens hospitalization time，and lays a solid foundation for patients to achieve better early knee joint function．

        目的 评估年龄调整内脏脂肪指数（AVAI）与骨关节炎患病率之间的关联。方法 采用加权多元Logistic回归模型和平滑曲线拟合分析AVAI和骨关节炎患病率之间的关系，通过亚组分析和交互作用检验探讨这一关系在不同亚组人群之间的效应差异。此外，通过受试者工作特征曲线（ROC）分析评估AVAI对骨关节炎的预测效能。结果 本研究基于美国国家健康与营养调查（NHANES）2011—2018年数据，共纳入5 929例参与者。较高的AVAI指数与骨关节炎患病率呈正相关（OR=1.22，95%CI：1.07~1.40）。随着AVAI指数的增加，骨关节炎患病风险呈现先上升后缓慢下降的趋势，AVAI的拐点为-4.48。在性别、年龄、教育程度和婚姻状况亚组中观察到交互作用。结论 AVAI与骨关节炎患病率之间存在非线性关系，当AVAI低于-4.48时，骨关节炎的患病风险增加。AVAI可作为一种有效、便捷的筛查工具，用于早期识别骨关节炎高风险人群。

    Objective This study aimed to evaluate the association between the age-adjusted visceral adiposity index（AVAI）and the prevalence of osteoarthritis（OA）．Methods Survey-weighted multivariable logistic regression models and smooth curve fitting were used to examine the relationship between AVAI and OA prevalence．Subgroup analyses and interaction tests were conducted to explore potential effect modifications across different population subgroups．Additionally，the predictive capability of AVAI for osteoarthritis was assessed using receiver operating characteristic（ROC）curve analysis． Results A total of 5 929 participants from the National Health and Nutrition Examination Survey（NHANES）2011–2018 were included．Higher AVAI levels were significantly associated with an increased prevalence of OA（OR=1.22；95%CI：1.07–1.40）．As AVAI increased，the risk of OA initially rose and then gradually declined，with an inflection point observed at ?4.48．Significant interactions were found across subgroups stratified by sex，age，education level，and marital status．Conclusions There exists a nonlinear relationship between AVAI and OA prevalence，with a significant increase in osteoarthritis risk observed when AVAI falls below -4.48．AVAI serves as an effective and convenient screening tool for identifying individuals at high risk of OA at an early stage．

目的 探讨本体感觉训练联合等速肌力训练对早期膝骨关节炎（KOA）患者的应用效果。方法 选择郑州市骨科医院2022年5月—2023年5月收治的120例早期膝骨关节炎患者为研究对象,将所有对象进行编号,采用简单随机方法分成研究组和对照组,每组各60例,两组均接受常规治疗,对照组在此基础上接受等速肌力训练,研究组在对照组基础上联合应用本体感觉训练,比较两组治疗前和治疗6周后疼痛视觉模拟量表（VAS）评分、膝关节伸屈肌群峰力矩（PT）、关节功能以及本体感觉。结果 治疗后研究组VAS评分为（1.33±0.31）分,对照组为（2.05±0.34）分,研究组低于对照组（t=12.121,P<0.05）;治疗后两组膝关节伸、屈肌群PT均较治疗前明显增加（P<0.05）,研究组大于对照组（t₁=2.696,t₂=3.360,P<0.05）;治疗后研究组WOMAC评分为（24.58±5.14）分,对照组为（26.85±5.11）分,研究组低于对照组（t=2.426,P<0.001）,研究组Lequesne指数为（6.55±1.21）分,对照组为（7.02±1.25）分,研究组低于对照组（t=2.093,P<0.001）;治疗后研究组平均轨迹误差为（21.35±5.96）%,对照组为（24.06±5.88）%,研究组改善程度优于对照组（t=2.507,P<0.001）,研究组平均负重力量差为（0.77±0.22）kg,对照组为（1.01±0.24）kg,研究组改善程度明显优于对照组（t=5.710,P<0.001）。结论 本体感觉训练联合等速肌力训练可以显著提升早期膝骨关节炎患者肌力,改善关节功能和本体感觉作用明显,适合推广。

Objective To explore the application effect of proprioceptive training combined with isokinetic muscle strength training on early knee osteoarthritis（KOA）patients．Methods A total of 120 patients with early knee osteoarthritis admitted to a hospital from May 2022 to May 2023 were selected as the study subjects．All subjects were numbered and randomly divided into an experimental group and a control group,with 60 cases in each group．Both groups received routine treatment,while the control group received isokinetic muscle strength training additionally．The experimental group received proprioceptive training in addition to the control group treatment．After 6 weeks of treatment,compare the pain situation,peak torque（PT）of knee extensor and flexor muscles,joint function,and proprioception before and after treatment between two groups were compared．Results After treatment,the VAS scores of both groups were lower than those before treatment（P<0.05）,and the experimental group was lower than the control group（t=12.121,P<0.05）．After treatment,the PT of the knee joint extensor and flexor muscle groups in both groups significantly increased compared to before treatment（P<0.05）,and the experimental group was significantly larger than the control group（P<0.05）．After treatment,the WOMAC score and Lequesne index of the two groups significantly decreased compared to those before treatment（P<0.05）,and the experimental group was smaller than the control group（P<0.05）．After treatment,the average trajectory error and average weight difference between the two groups were significantly smaller than those before treatment（P<0.05）,while the experimental group was smaller than the control group（P<0.05）．Conclusion sThe combination of proprioceptive training and isokinetic muscle strength training can significantly improve muscle strength,joint function,and proprioceptive sensation in patients with early knee osteoarthritis,making it suitable for promotion．

目的 探讨透明质酸钠注射联合富含血小板的血浆治疗膝骨关节炎患者的效果。方法 收集2019年7月—2021年7月在本院就诊的膝骨关节炎患者120例,采用随机数字表法分组,即对照组、观察组,均60例。对照组患者注入富含血小板的血浆(4 mL),观察组患者注射透明质酸钠(2 mL)联合富含血小板的血浆(3.5 mL),1次/周,3次为1个疗程,共2～3疗程。统计2组患者膝关节功能、临床疗效及并发症发生率。结果 ①组内比较:治疗后2月、3月及6月平均Lysholm膝关节评分均升高,P<0.05;②组间比较:治疗前及治疗后2月,2组患者平均Lysholm膝关节评分比较,P>0.05,治疗后3月、6月,2组平均Lysholm膝关节评分比较,P<0.05。2组患者Lysholm膝关节评分均较治疗前有所改善,P<0.05;观察组疼痛评分(18.92±4.11、17.61±3.83)分、肿胀度评分(10.64±2.82、9.66±1.21)分均高于对照组疼痛评分(14.02±3.52、13.54±3.21)分、肿胀度评分(9.62±2.63、8.71±1.93)分(P<0.05)。观察组临床总有效率98.33%高于对照组临床总有效率88.33%(χ²=4.821,P=0.028)。经过6个月的随访后,2组均1例出现局部肿胀,未发生其他并发症。结论 透明质酸钠注射联合富含血小板的血浆治疗膝骨关节炎患者,可以有效改善患者膝关节功能,减轻患者疼痛及肿胀程度等,安全性高,值得推广应用。

Objective To investigate the effect of sodium hyaluronate injection combined with platelet-rich plasma in the treatment of patients with knee osteoarthritis. Methods A total of 120 patients with knee osteoarthritis who were treated in our hospital from July 2019 to July 2021 were collected and randomly divided into control group and observation group,60 cases each.The patients in the control group were injected with platelet-rich plasma(4 mL),and the patients in the observation group were injected with sodium hyaluronate(2 mL)combined with platelet-rich plasma(3.5 mL),once a week,3 times as a course of treatment,total 2-3 courses of treatment.The knee joint function,clinical efficacy and complication rates of the two groups were compared. Results ①Intra-group comparison:the average Lysholm knee joint scores were significantly increased in 2 months,3 months and 6 months after treatment,P<0.05. ②Comparison between groups:before and 2 months after treatment,the average Lysholm knee joint scores of the two groups were significantly increased (P<0.05). After 3 months and 6 months treatment,the comparison of the average Lysholm knee score between the two groups were statistic significant (P<0.05).The Lysholm knee joint scores in both groups were improved compared with those before treatment (P<0.05). Three months after treatment,the pain score(18.92±4.11, 17.61±3.83)and swelling score(10.64±2.82, 9.66±1.21)in the observation group were significantly higher than those in the control group(14.02±3.52, 13.54±3.21, 9.62±2.63, 8.71±1.93, P<0.05).The total clinical effective rate of the observation group was 98.33%,which was significantly higher than that of the control group (88.33%, χ²=4.821,P=0.028).After 6-month follow-up,local swelling occurred in 1 case in both groups,and no other complications occurred. Conclusions Sodium hyaluronate injection combined with platelet-rich plasma in the treatment of patients with knee osteoarthritis can effectively improve the knee joint function and reduce the pain and swelling of the patients.It is safe and worthy of popularization and application.

目的 探讨消肿化瘀膏治疗骨性关节炎的临床疗效。方法 选择2017年5月—2022年1月在本院诊治的骨性关节炎患者124例作为研究对象,根据简单分配原则把患者分为消肿化瘀膏组与传统药物组各62例。传统药物组给予传统药物治疗,消肿化瘀膏组给予消肿化瘀膏治疗,判定2组患者治疗总显效率、疼痛评分、关节评分、血清中炎症因子水平变化。结果 消肿化瘀膏组治疗后的总显效率为98.4%,高于传统药物组的83.9%（P<0.05）。治疗后,2组的疼痛评分都低于治疗前（P<0.05）,且消肿化瘀膏组低于传统药物组（P<0.05）。2组治疗后的关节评分都高于治疗前（P<0.05）,且消肿化瘀膏组与传统药物组相比升高（P<0.05）。2组治疗后的血清白介素-1β、白介素-6水平都低于治疗前（P<0.05）,且消肿化瘀膏组较传统药物组降低更多（P<0.05）。结论 消肿化瘀膏治疗骨性关节炎能有效抑制血清炎症因子的表达,缓解疼痛,改善关节功能,提高患者的总体治疗效果。

Objective To explore the clinical efficacy of Xiaozhonghuayu ointment in the treatment of osteoarthritis．Methods From May 2017 to January 2022,124 patients with osteoarthritis who diagnosed and treated in our hospital were selected as the research subjects．According to the simple allocation principle,the patients were divided into the Xiaozhonghuayu ointment group and the traditional medicine group with 62 cases each．The traditional medicine group was treated with traditional medicine,and the Xiaozhonghuayu ointment group was treated with Xiaozhonghuayu ointment．The total therapeutic efficiency,pain score,joint score,and the changes of serum inflammatory factors were compared in the two groups．Results The total efficiency of Xiaozhonghuayu ointment group after treatment were 98.4%,which were higher than 83.9% in the traditional medicine group（P<0.05）．The pain scores in both groups after treatment were lower than those before treatment（P<0.05）,and that in the Xiaozhonghuayu ointment group were lower than the traditional medicine group（P<0.05）．The joint scores of the two groups after treatment were higher than those before treatment（P<0.05）,and that in the Xiaozhonghuayu ointment group were higher than the traditional medicine group（P<0.05）．After treatment,the levels of serum interleukin-1β and interleukin-6 in the two groups were significantly lower than those before treatment（P<0.05）,compared with the traditional medicine group,those levels in the Xiaozhonghuayu ointment group also decreased significantly after treatment（P<0.05）．Conclusions Xiaozhonghuayu ointment in the treatment of osteoarthritis can effectively inhibit the expressions of serum inflammatory factors,promote pain relief,improve joint function,and improve the overall therapeutic effect of patients．

目的 研究我院自拟肿痛消方中药离子导入联合关节镜手术治疗膝骨性关节炎的疗效。方法 将76 例膝骨性关节炎患者分为2组,即肿痛消方离子导入联合关节镜组和单纯关节镜组,在治疗前、后分别对两组患者进行Lysholm膝关节功能评分。结果 肿痛消方联合关节镜手术治疗对膝骨性关节炎的治疗效果有明显的提高,总有效率达到92.11%,高于对照组。结论 肿痛消方联合关节镜手术治疗对膝骨性关节炎具有良好的治疗效果。可明显降低患者的疼痛感,改善膝关节功能,促进骨关节的恢复。

Objective To study the effect of Zhongtongxiao formula combined with arthroscopy in the treatment of knee osteoarthritis. Methods 76 patients with knee osteoarthritis were divided into two groups, namely, the group of Zhongtongxiao square ion-implantation combined with arthroscopy and the group of arthroscopy alone. Lysholm knee function scores were performed on the two groups before and after treatment. Results The therapeutic effects of Zhongtongxiao formula combined with arthroscopic surgery on knee osteoarthritis were improved, the total effective rate was 92.11%, higher than the control group. Conclusion Zhongtongxiao formula combined with arthroscopy has good therapeutic effect on knee osteoarthritis.It can obviously reduce the pain of patients, improve the function of knee joint and promote the recovery of bone and joint.

目的 探讨中药熏洗与膝关节自我锻炼管理对改善老年骨性膝关节炎功能康复效果。方法 选择90例在本院就诊的老年骨性关节炎患者,按数字表法分为观察组和对照组各45例,对照组采用膝关节康复护理知识教育、膝部中药熏洗与揉搓按摩等治疗,观察组在此治疗护理上加强对患者进行膝关节功能训炼和自我活动行为管理;随访6周,评价两组患者膝关节肿胀、疼痛、训练依从性、膝关节功能。结果 膝关节疼痛缓解、肿胀消退观察组优于对照组;膝关节功能康复效果观察组优于对照组,活动训练依从性观察组高于对照组。结论 应用中药熏洗与加强患者膝关节自我活动训炼管理,可缓解膝关节疼痛、减轻膝关节肿胀,改善患者膝关节功能,提高患者自我功能训练的依从性和生活质量。

Objective To explore the effect of traditional Chinese medicine fumigation and knee joint exercise management on the rehabilitation of senile osteoarthritis of the knee. Methods 90 cases in our hospital for treatment of senile osteoarthritis were randomly divided into observation group and control group with 45 cases in each group, the control group used the knee joint rehabilitation nursing knowledge education, herbal fumigation and massage knee treatment; the observation group on the treatment and nursingwith strengthening the function of knee joint training and self behavior management for the patients; 6 weeks of follow-up, we have evaluation of two groups of patients with knee joint swelling, pain, and knee joint function training compliance. Results The knee joint pain, swelling, knee joint function rehabilitation effect in the observation group were better than that of control group; training compliance in the observation group was better than that of control group. Conclusion The application of herbal fumigation and strengthen the self training of patients with knee joint activity management, may relieve the pain of knee joint, swelling and improve knee function. Theirtraining compliance and quality of life have been increased.

目的 对比观察海桐皮汤熏洗应用于膝骨性关节炎关节镜清理术后的临床疗效。方法 于2012年1月—2014年1月,从我院骨科住院患者中选取因膝骨性关节炎行关节镜清理术病例60例,随机分为两组,对照组术后给予常规康复治疗措施,治疗组在常规康复治疗的基础上于术后2周拆线后配合海桐皮汤熏洗治疗,治疗周期4周。对比两组患者治疗前后的WOMAC评分,分析其疗效差异。结果 两组患者WOMAC评分术后2周比较无差异P＞0.5;治疗4周后,两组患者较术后2周有所降低(P＜0.5),但治疗组疗效优于对照组(P＜0.5)。结论 海桐皮汤熏洗疗法可改善膝骨性关节炎关节镜清理术后膝关节功能,操作简便,成本低廉,无副作用,值得临床推广应用。

KOA是临床上最常见,发病起源于关节软骨的慢性退行性关节疾病。近年来,应用黄芪治疗KOA的报道不断增多,并且开展了大量的机制研究。本文综述了黄芪在KOA治疗中的应用现状及研究进展,同时指出从PPAR-γ信号通路探索黄芪干预KOA的具体分子机制具有积极的理论和实践意义。

       目的   基于Nomogram初步构建膝骨关节炎（KOA）患者术前衰弱的风险预测模型。方法   便利选取172例于2021年12月—2022年8月在广州市某三甲医院关节外科接受择期膝关节置换术的KOA患者为研究对象，依据衰弱的发生与否分为衰弱组（n=111）和非衰弱组（n=61），通过单因素分析筛选变量，纳入Logistic回归分析，并构建列线图模型。结果   单因素分析结果显示年龄、BMI、膝关节疼痛年限、合并症、抑郁、焦虑、疼痛、睡眠障碍、营养状况等在不同组间比较差异存在统计学的意义（P＜0.05）。多因素Logistic回归分析表明，BMI异常（OR=3.360）、膝关节疼痛年限＞5年（OR=14.188）、抑郁（OR=5.608）、睡眠障碍（OR=25.480）是KOA患者术前衰弱的独立危险因素（P＜0.05）。基于此，建立了预测膝骨关节炎患者术前衰弱风险的列线图预测模型。结果显示C-index为0.915，校正曲线接近理想曲线，ROC曲线下面积（AUC）为0.919（95%CI：0.878~0.961），可见该预测模型具有较好的区分度和准确度。结论   根据BMI、膝关节疼痛年限、抑郁以及睡眠障碍这四个独立危险因素，可以准确地预测膝骨关节炎患者术前衰弱的风险。

    Objective  To develop a nomogram for predicting the risk of preoperative frailty in knee osteoarthritis patients．Methods  A convenience sample of 172 patients who underwent elective knee arthroplasty at a Grade-A hospital in Guangzhou from December 2021 to August 2022 was selected．The patients were divided into two groups based on the presence of preoperative frailty：frailty group（n=111）and non-frailty group（n=61）．The variables with statistical differences were screened by univariate analysis for multivariate logistic regression analysis，and the nomogram prediction model was established．Results  Univariate analysis identified significant differences between the groups in age，BMI，years of knee pain，complications，depression，anxiety，pain，sleep disturbance，and nutrition（P＜0.05）．Multivariate logistic regression showed that abnormal BMI（OR=3.360），years of knee pain ＞ 5（OR=14.188），depression（OR=5.608），and sleep disorders（OR=25.480）were independent  risk factors for preoperative frailty in knee osteoarthritis patients（P＜0.05）．Based on these findings，a nomogram prediction model was established．Model verification results demonstrated that the nomogram had good differentiation and accuracy in predicting the risk of preoperative frailty，with a C-index of 0.915，an area under the ROC curve of 0.919（95% CI：0.878~0.961），and a calibration curve slope close to 1．Conclusions  The nomogram，based on four independent risk factors（BMI，years of knee pain，depression，and sleep disturbance），effectively predicts the risk of preoperative frailty in knee osteoarthritis patients．