The regeneration of cartilage and osteochondral defects remains one of the most challenging clinical problems in orthopedic surgery. Currently, tissue-engineering techniques based on the delivery of appropriate growth factors and mesenchymal stem cells (MSCs) in hydrogel scaffolds are considered as the most promising therapeutic strategy for osteochondral defects regeneration. In this study, we fabricated a heparin-conjugated fibrin (HCF) hydrogel with synovium-derived mesenchymal stem cells (SDMSCs), transforming growth factor-β1 (TGF-β1) and bone morphogenetic protein-4 (BMP-4) to repair osteochondral defects in a rabbit model. An in vitro study showed that HCF hydrogel exhibited good biocompatibility, a slow degradation rate and sustained release of TGF-β1 and BMP-4 over 4 weeks. Macroscopic and histological evaluations revealed that implantation of HCF hydrogel with SDMSCs, TGF-β1 and BMP-4 significantly enhanced the regeneration of hyaline cartilage and the subchondral bone plate in osteochondral defects within 12 weeks compared to hydrogels with SDMSCs or growth factors alone. Thus, these data suggest that combined delivery of SDMSCs with TGF-β1 and BMP-4 in HCF hydrogel may synergistically enhance the therapeutic efficacy of osteochondral defect repair of the knee joints.

A Global Burden of Disease (GBD) study reported that 9.6 million years lived with disability (YLDs) were lost due to hip and knee osteoarthritis (KOA) in 2017. Although the GBD study presents the disease burden at the global level, there is no information on any Central Asian country. This study aims to investigate the epidemiology of knee osteoarthritis in Kazakhstan. The data of 56,895 people with KOA between 2014–2020 was derived from the Unified National Electronic Health System of Kazakhstan and retrospectively analyzed. The majority of the cohort (76%) were women, of Kazakh ethnicity (66%), and older than 50 years of age (87%). The risk of gonarthrosis escalated for women after 50 years and peaked at 75 years with a rate of 3062 females admitted to hospital per 100,000 women in the population. This observation is approximately three times higher than for men of the same age group. A geographical analysis showed that the Jambyl oblast, West Kazakhstan, North Kazakhstan, and the Akmola oblast have the highest burden of disease. During the observation period, 127,077 age-adjusted YLDs were lost due to knee osteoarthritis. This is the first study in Kazakhstan to investigate the burden of knee osteoarthritis. This research recognizes age and sex-based differences, and regional disparities in the incidence of knee osteoarthritis. This knowledge can lead to the development of more specific diagnostic approaches and gender-personalized therapy protocols for patients.

One of the most common manifestations of cardiac injury because of trauma is myocardial contusion. Today, the blurred definition and wide range of nonspecific clinical presentations led to absence in consensus of diagnostic pathways and criteria. Currently, the marker of cardiac injury measured at clinical level is troponin and instrumental diagnostic tool is ECG. The patients with elevated troponin level after the chest trauma should be suspected to have myocardial contusion as cardiogenic shock or arrhythmia might take place as a complication. The release of DAMPs after the trauma has been observed as a part of inflammatory response to it. HMGB1 protein and histone levels were found to be elevated in patients with trauma and associated to recruit the inflammation. In this review the potential of these molecules to be used as diagnostic markers of myocardial contusion is discussed. Moreover, the obstacles for implementing DAMPS to clinical protocols and future research directions are included.

Myocardial injury following polytrauma is a significant yet often underdiagnosed condition that contributes to acute cardiac dysfunction and long-term cardiovascular complications. This review examines the role of systemic inflammation, oxidative stress, neuro-hormonal activation, and immune dysregulation in trauma-induced myocardial damage. Key immunological markers, including interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1β), monocyte chemoattractant protein-1 (MCP-1), and adhesion molecules (ICAM-1, VCAM-1), are implicated in endothelial dysfunction, myocardial apoptosis, and ventricular remodeling. The interplay between these factors potentially exacerbates cardiac injury, increasing the risk of heart failure. Biomarker-guided approaches for early detection, combined with advanced imaging techniques such as speckle-tracking echocardiography and cardiac MRI, offer promising avenues for risk stratification and targeted interventions. Anti-inflammatory and oxidative stress-modulating therapies may mitigate myocardial damage and improve outcomes. This article highlights the clinical relevance of integrating immunological markers into diagnostic and therapeutic strategies to enhance the management of trauma-related cardiac dysfunction and reduce long-term morbidity.

Post-traumatic cardiac dysfunction is a clinically under-recognized complication of polytrauma, often occurring in the absence of overt structural injury. Traditional diagnostic tools frequently fail to detect early or subclinical myocardial impairment, underscoring the need for more sensitive assessment methods. This review explores the utility of global longitudinal strain (GLS), derived from speckle-tracking echocardiography (STE), as a sensitive biomarker for identifying and managing cardiac dysfunction following traumatic injury. It outlines the complex pathophysiology of trauma-induced myocardial impairment, including mechanical injury, systemic inflammation, oxidative stress, and neuro-hormonal activation. The limitations of conventional diagnostic approaches, such as electrocardiography, left ventricular ejection fraction (LVEF), and cardiac biomarkers, are critically assessed and contrasted with the enhanced diagnostic performance of GLS. GLS has demonstrated superior sensitivity in detecting subclinical myocardial dysfunction even when LVEF remains preserved and is associated with increased risk of long-term cardiovascular complications, including arrhythmias and heart failure. The manuscript highlights the clinical utility of GLS in early diagnosis, risk stratification, treatment monitoring, and long-term follow-up. Integration of GLS with inflammatory and oxidative biomarkers (e.g., IL-6, TNF-α, and MPO) and artificial intelligence-based diagnostic models offers potential for improved precision in trauma cardiology.