Objective To explore the effect of internet of things-based power bicycle training or quadriceps training alone on pain and quality of life in patients with knee osteoarthritis in a community setting. Methods Patients with knee osteoarthritis who were admitted to West China Hospital of Sichuan University between April and July 2022 were selected. They were randomly divided into a power bicycle training group, a quadriceps muscle training group and a control group by random number table method. The primary outcome was improvement in knee pain, assessed by the Numerical Rating Scale (NRS) score. The secondary outcome was health-related quality of life, assessed by the 36-Item Short Form Health Survey (SF-36) score. Outcomes were assessed at baseline and 4, 8, and 12 weeks after the initial intervention. The statistical analysis was conducted using generalized estimating equations. Results A total of 72 patients were included, with 24 in each group. There was no significant difference in age, gender or other demographic characteristics among the three groups (P>0.05). The results of generalized estimating equations showed that there were interaction effects (group × time) on the NRS score, SF-36 physical functioning score, SF-36 bodily pain score, and SF-36 vitality score (P<0.05), while there was no interaction effect (group × time) on the role physical score, general health score, social functioning score, role emotional score or mental health score of SF-36 (P>0.05). At baseline, there was no statistically significant difference in the NRS score or SF-36 scores among the three groups (P>0.05). After 12 weeks of intervention, the two training groups were better than the control group in the NRS score, SF-36 physical functioning score, and SF-36 bodily pain score, the power bicycle training group was better than the quadriceps training group in the NRS score, the power bicycle training group was better than the control group in the SF-36 social functioning score, and the differences were statistically significant (P<0.05). Conclusions In a community setting, 12 weeks of internet of things-based power bicycle training and quadriceps training can significantly improve joint pain, physiological function and physical pain indicators in patients with knee osteoarthritis, and the power bicycle training is better than the quadriceps training in improving the knee pain of patients.
Objective To investigate the effects of ergometer cycling training based on the internet of things and quadriceps strengthening based on internet mobile phones on joint stiffness, function and walking ability in patients with knee osteoarthritis (KOA) in a community setting. Methods KOA patients attending West China Hospital, Sichuan University were selected between April and July 2022. The patients were randomly divided into ergometer cycling group, quadriceps strengthening group and control group (treated with traditional therapy) using a random number table method. The patient underwent a 12 week intervention. The Western Ontario and McMaster Universities Arthritis Index (WOMAC) scale, Timed Up and Go Test (TUG) were used to evaluate the degree of joint stiffness, joint function and walking ability of patients. Data was collected and evaluated before intervention and at 4, 8, and 12 weeks after the initial intervention.Results A total of 72 patients were included, with 24 cases in each group. There were interactive effects between group and time in WOMAC joint stiffness score, joint functional score and TUG test time (P<0.05). At 8 and 12 weeks after intervention, the joint stiffness scores of the ergometer cycling group and the quadriceps strengthening group were better than those of the control group. At 4, 8 and 12 weeks after intervention, the joint function scores of the ergometer cycling group and the quadriceps strengthening group were better than those of the control group (P<0.05). At 8, 12 weeks after intervention, the TUG test scores of the ergometer cycling group were better than those of the control group and the quadriceps strengthening group (P<0.05). Conclusions In a community setting, both 12-week Internet of thing-based ergometer cycling and internet video-based quadriceps strengthening were effective on improving knee stiffness and function in KOA patients and were superior to traditional methods, the two effects were comparable. Ergometer cycling is superior to quadriceps strengthening and traditional methods in improving walking ability.
ObjectiveTo systematically review the risk factors for knee osteoarthritis among Chinese population.MethodsCNKI, WanFang Data, PubMed and EMbase databases were electronically searched to collect studies related to risk factors for knee osteoarthritis in Chinese population from January 2005 to November 2020. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies; meta-analysis was then performed using RevMan 5.4 software.ResultsA total of 18 studies involving 46 375 patients were included. The results of meta-analysis showed that body mass index (BMI)≥28 kg/m2 (OR=1.78, 95%CI 1.47 to 2.14, P<0.000 1), females (OR=2.20, 95%CI 1.98 to 2.45, P<0.000 1), family history of osteoarthritis (OR=3.56, 95%CI 1.88 to 6.73, P<0.000 1), age≥60 years old (OR=1.42, 95%CI 1.26 to 1.59, P<0.000 1), history of joint trauma (OR=4.11, 95%CI 2.85 to 5.93, P<0.000 1), manual labor (OR=1.57, 95%CI 1.32 to 1.86, P<0.000 1), heavy housework (OR=1.63, 95%CI 1.20 to 2.22, P<0.000 1), humid environment (OR=4.33, 95%CI 2.99 to 6.29, P<0.000 1), drinking habit (OR=1.69, 95%CI 1.21 to 2.36, P=0.002), non-elevator building (OR=1.78, 95%CI 1.18 to 2.70, P=0.006), joint load (OR=9.14, 95%CI 3.05 to 27.45, P<0.000 1), cold environment (OR=2.13, 95%CI 1.32 to 3.44, P=0.002), and habit of sitting cross-legged (OR=7.56, 95%CI 1.74 to 32.79, P=0.007) were risk factors for knee osteoarthritis among Chinese population.ConclusionsControlling and reducing weight, preventing knee injuries, keeping joints warm, controlling alcohol consumption, improving humid and cold living environment, appropriately reducing heavy physical labor, reducing joint weight, and changing the habit of sitting cross-legged can prevent the occurrence of knee osteoarthritis.
Objective To study the effect of multi-disciplinary treatment (MDT) on the surgical efficacy and satisfaction of patients undergoing total knee arthroplasty (TKA) for the first time. Methods The clinical data of patients who underwent unilateral TKA for single-compartment osteoarthritis of the knee in the General Hospital of Ningxia Medical University between January and September 2022 were retrospectively collected and analyzed. According to whether MDT was performed on patients during the perioperative period, they were divided into MDT group and traditional group. Perioperative nutrition-related indicators, perioperative complications, total hospitalization time, Visual Analogue Scale (VAS), and Hospital for Special Surgery Knee Score (HSS) before and after surgery were detected and recorded. Results A total of 95 patients were included. Among them, there were 42 cases in the MDT group and 53 cases in the traditional group. The postoperative complications and total hospital stay of patients in the MDT group were lower than those in the traditional group, and their satisfaction scores were higher than those in the traditional group (P<0.05). The perioperative serum total protein (TP), hemoglobin (Hb), serum albumin (ALB) levels, VAS score, and HSS score of both groups of patients changed over time. The intra group comparison results showed that compared with preoperative, the levels of TP, Hb, and ALB in both groups decreased on the 1st and 3rd postoperative days (P<0.05). On the 3rd day after surgery, the levels of TP, Hb, ALB in the MDT group and Hb, ALB in the traditional group were lower than on the 1st day after surgery (P<0.05). There was no statistically significant difference in TP levels between the traditional group on the 3rd day after surgery and the 1st day after surgery (P>0.05). The results of intra group comparison at different time points showed that there were statistically significant differences in VAS score and HSS score between the two groups (P<0.05). Conclusion The application of MDT in elderly patients undergoing unilateral TKA for the first time can shorten the total hospitalization time, reduce the incidence of perioperative complications, and improve the surgical efficacy and patient satisfaction.
ObjectiveTo systematically evaluate the risk prediction model of knee osteoarthritis (KOA). MethodsThe CNKI, WanFang Data, VIP, PubMed, Embase, Web of Science and Cochrane Library databases were electronically searched to collect relevant studies on KOA’s risk prediction model from inception to April, 2024. After study screening and data extraction by two independent researchers, the PROBAST bias risk assessment tool was used to evaluate the bias risk and applicability of the risk prediction model. ResultsA total of 12 studies involving 21 risk prediction models for KOA were included. The number of predictors ranged from 3 to 12, and the most common predictors were age, sex, and BMI. The range of modeling AUC included in the model was 0.554-0.948, and the range of testing AUC was 0.6-0.94. The overall predictive performance of the models was mediocre and the risk of overall bias was high, and more than half of the models were not externally verified. ConclusionAt present, the overall quality and applicability of the KOA morbidity risk prediction model still have great room for improvement. Future modeling should follow the CHARMS and PROBAST to reduce the risk of bias, explore the combination of multiple modeling methods, and strengthen the external verification of the model.
A novel structural dynamics test method and device were designed to test the biomechanical effects of dynamic axial loading on knee cartilage and meniscus. Firstly, the maximum acceleration signal-to-noise ratio of the experimental device was calculated by applying axial dynamic load to the experimental device under unloaded condition with different force hammers. Then the experimental samples were divided into non-specimen group (no specimen loaded), sham specimen group (loaded with polypropylene samples) and bovine knee joint specimen group (loaded with bovine knee joint samples) for testing. The test results show that the experimental device and method can provide stable axial dynamic load, and the experimental results have good repeatability. The final results confirm that the dynamic characteristics of experimental samples can be distinguished effectively by this device. The experimental method proposed in this study provides a new way to further study the biomechanical mechanism of knee joint structural response under axial dynamic load.
目的:比较针刺配合中国灸穴位贴敷与单纯针刺治疗膝骨关节的临床疗效。方法:将60例符合膝骨关节炎诊断的病员随机分为针刺加中国灸治疗组和单纯针刺对照组,两组均取穴血海、梁丘、犊鼻、膝眼、鹤顶、阳陵泉治疗,治疗组每天加用中国灸穴位贴敷治疗。10次一疗程,2个疗程后观察疗效。结果:治疗组30例中显效20例,好转8例,无效2例,总有效率为93.3%。对照组30例中显效9例,好转16例,无效5例,总有效率为83.3%。两组有效率有显著性差异（Plt;0.05）。结论:针刺配合中国灸穴位贴敷治疗膝骨关节疗效优于单纯针刺。
Objective To compare the performance of ChatGPT-4.5 and DeepSeek-V3 across five key domains of physical therapy for knee osteoarthritis (KOA), evaluating the accuracy, completeness, reliability, and readability of their responses and exploring their clinical application potential. Methods Twenty-one core questions were extracted from 10 authoritative KOA rehabilitation guidelines published between September 2011 and January 2024, covering five task categories: rehabilitation assessment, physical agent modalities, exercise therapy, assistive device use, and patient education. Responses were generated using both the ChatGPT-4.5 and DeepSeek-V3 models and evaluated by four physical therapists with over five years of clinical experience using Likert scales (accuracy and completeness: 5 points; reliability: 7 points). The scale scores were compared between the two large language models. Additional assessment included language style clustering. Results Most of the scale scores did not follow a normal distribution, and were presented as median (lower quartile, upper quartile). ChatGPT-4.5 outperformed DeepSeek-V3 with higher scores in accuracy [4.75 (4.75, 4.75) vs. 4.75 (4.50, 5.00), P=0.018], completeness [4.75 (4.50, 5.00) vs. 4.25 (4.00, 4.50), P=0.006], and reliability [5.75 (5.50, 6.00) vs. 5.50 (5.50, 5.50), P=0.015]. Clustering analysis of language styles revealed that ChatGPT-4.5 demonstrated a more diverse linguistic style, whereas DeepSeek-V3 responses were more standardized. ChatGPT-4.5 achieved higher scores than DeepSeek-V3 in lexical richness [4.792 (4.720, 4.912) vs. 4.564 (4.409, 4.653), P<0.001], but lower than DeepSeek-V3 in syntactic richness [2.133 (2.072, 2.154) vs. 2.187 (2.154, 2.206), P=0.003]. Conclusions ChatGPT-4.5 demonstrates superior performance in accuracy, completeness, and reliability, indicating a stronger capacity for task execution. It uses more diverse words and has stronger flexibility in language generation. DeepSeek-V3 exhibited greater syntactic richness and is more normative in language. ChatGPT-4.5 is better suited for content-rich tasks that require detailed explanation, while DeepSeek-V3 is more appropriate for standardized question-answering applications.
ObjectiveTo investigate the accuracy, safety, and short-term effectiveness of a domestic robot-assisted system in total knee arthroplasty (TKA) by a multicenter randomized controlled trial. Methods Between December 2021 and February 2023, 138 patients with knee osteoarthritis who received TKA in 5 clinical centers were prospectively collected, and 134 patients met the inclusion criteria were randomly assigned to either a trial group (n=68) or a control group (n=66). Seven patients had lost follow-up and missing data, so they were excluded and the remaining 127 patients were included for analysis, including 66 patients in the trial group and 61 patients in the control group. There was no significant difference (P>0.05) in gender, age, body mass index, side, duration of osteoarthritis, Kellgren-Lawrence grading, preoperative Knee Society Score (KSS) and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) score between the two groups. The trial group completed the TKA by domestic robot-assisted osteotomy according to the preoperative CT-based surgical planning. The control group was performed by traditional osteotomy plate combined with soft tissue release. Total operation time, osteotomy time of femoral/tibial side, intraoperative blood loss, and postoperative complications were recorded and compared between the two groups. The radiographs were taken at 5 and 90 days after operation, and hip-knee-ankle angle (HKA), lateral distal angle of femur (LDFA), and posterior tibial slope (PTS) were measured. The difference between the measured values of the above indexes at two time points after operation and the preoperative planning target values was calculated, and the absolute value (absolute error) was taken for comparison between the two groups. The postoperative recovery of lower limb alignment was judged and the accuracy was calculated. KSS score and WOMAC score were used to evaluate the knee joint function of patients before operation and at 90 days after operation. The improvement rates of KSS score and WOMAC score were calculated. The function, stability, and convenience of the robot-assisted system were evaluated by the surgeons. ResultsThe total operation time and femoral osteotomy time of the trial group were significantly longer than those of the control group (P<0.05). There was no significant difference in the tibial osteotomy time and the amount of intraoperative blood loss between the two groups (P>0.05). The incisions of both groups healed by first intention after operation, and there was no infection around the prosthesis. Nine patients in the trial group and 8 in the control group developed lower extremity vascular thrombosis, all of which were calf intermuscular venous thrombosis, and there was no significant difference in the incidence of complications (P>0.05). All patients were followed up 90 days. There was no significant difference in KSS score and WOMAC score between the two groups at 90 days after operation (P>0.05). There was significant difference in the improvement rate of KSS score between the two groups (P<0.05), while there was no significant difference in the improvement rate of WOMAC score between the two groups (P>0.05). Radiological results showed that the absolute errors of HKA and LDFA in the trial group were significantly smaller than those in the control group at 5 and 90 days after operation (P<0.05), and the recovery accuracy of lower limb alignment was significantly higher than that in control group (P<0.05). The absolute error of PTS in the trial group was significantly smaller than that in the control group at 5 days after operation (P<0.05), but there was no significant difference at 90 days between the two groups (P>0.05). The functional satisfaction rate of the robot-assisted system was 98.5% (65/66), and the satisfaction rates of stability and convenience were 100% (66/66). ConclusionDomestic robot-assisted TKA is a safe and effective surgical treatment for knee osteoarthritis, which can achieve favorable lower limb alignment reconstruction, precise implant of prosthesis, and satisfactory functional recovery.
ObjectiveTo investigate the correlation of synovial fluid uric acid, the serum and synovial fluid interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF)-α with knee osteoarthritis (KOA). MethodsThe clinical data of 130 patients with KOA treated between January and December 2013 and 30 patients with gouty arthritis (GA) treated at the same period were collected. The clinical symptoms, Western Ontario and McMaster Universities Osteoarthritis Index score, the serum and synovial fluid IL-1β, IL-6, and TNF-α, uric acid levels, radiographic joint stenosis score, and bone hyperplasia score of the patients were compared using t-test analysis and Spearman correlation analysis. ResultsIn the KOA group, the synovial fluid uric acid and joint stenosis score (r=0.31, P=0.037), bone hyperplasia score (r=0.38, P=0.027) were positively correlated; serum and synovial fluid uric acid gradient and hypnalgia were positively correlated (r=0.34, P=0.031); the synovial fluid IL-6 and joint stenosis score (r=0.33, P=0.029), bone hyperplasia score (r=0.37, P=0.032) were positively correlated; the synovial fluid IL-1β and joint stenosis score (r=0.39, P=0.023), bone hyperplasia score (r=0.34, P=0.034) were positively correlated; and the synovial fluid uric acid and IL-1β (r=0.26, P=0.003), IL-6 (r=0.21, P=0.016) were positively correlated. ConclusionSynovial uric acid, IL-1β and IL-6 play a role in the inflammatory progress of knee osteoarthritis.