Background: An umbrella review was conducted to compare the effectiveness of extracorporeal shock wave therapy (ESWT) versus non-ESWT in the treatment of knee osteoarthritis (KOA). Materials and methods: Three databases including PubMed, Embase and Web of science were searched up to September 2023. Literature screening, quality evaluation, and data extraction were performed according to inclusion and exclusion criteria. Meta-analysis of outcome indicators was performed using Revman 5.4 software. Results: A total of eight meta-analysis were included in this umbrella review. All meta-analysis were graded against a Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2) and scored between 8 and 11. Compared to the sham group, the ESWT group showed better results in WOMAC (Western Ontario and McMaster Universities Arthritis Index) [mean difference (MD)=−2.94, 95% CI: −5.52, −0.37, P=0.03, I²=60%], Visual Analog Scale (VAS) (MD=−2.0, 95% CI: −2.5, −1.5, P<0.01, I²=0%), range of motion (ROM) (MD=17.55, 95% CI: 13.49, 21.61, P<0.00001, I²=0%), and Lequesne index (MD=−2.85, 95% CI: −3.64, −2.07, P<0.00001, I²=48%). Conclusion: Based on the results of our analysis, ESWT is now an effective therapy for improving pain and function in patients with KOA.

Knee ligament injuries are most common in sports injuries. In general, ligament repair or reconstruction is necessary to restore the stability of the knee joint and prevent secondary injuries. Despite advances in ligament repair and reconstruction techniques, a number of patients still experience re-rupture of the graft and suboptimal recovery of motor function. Since Dr. Mackay’s introduction of the internal brace technique, there has been continuous research in recent years using the internal brace ligament augmentation technique for knee ligament repair or reconstruction, particularly in the repair or reconstruction of the anterior cruciate ligament. This technique focuses on increasing the strength of autologous or allograft tendon grafts through the use of braided ultra-high-molecular-weight polyethylene suture tapes to facilitate postoperative rehabilitation and avoid re-rupture or failure. The purpose of this review is to present detailed research progress in the internal brace ligament enhancement technique of knee ligament injury repair as well as the reconstruction from biomechanical and histological research and clinical studies and to comprehensively assess the value of the application of this technique.

Frozen shoulder (FS), characterized by pain and restricted mobility, remains a challenging condition with unclear optimal treatment. This study aims to investigate the development of FS research, identify hotspot treatments, and verify their efficacy. Analyzing 3139 FS-related publications from the Web of Science Core Collection revealed a significant rise in publications (R² = 0.9478), with the United States as a leader in this research area. Our keyword analysis pinpointed suprascapular nerve block (SSNB) as a notable research focus since 2021. To assess the effectiveness of SSNB, we conducted a meta-analysis of eight randomized controlled trials including 435 patients. The results at the 6-8 weeks follow-up showed SSNB significantly reduced pain and improved active shoulder function compared to intra-articular corticosteroid injections (IACI). Specifically, SSNB led to considerable enhancements in abduction (SMD: 12.88; 95 % CI: 4.13, 21.64; p = 0.004; I² = 54 %), flexion (SMD: 9.16; 95 % CI: 6.50, 11.82; p < 0.00001; I² = 0 %), and external rotation (SMD: 18.03; 95 % CI: 6.59, 29.48; p = 0.008; I² = 59 %). Additionally, there was a significant reduction in Shoulder Pain and Disability Index (SPADI) scores (SMD: 4.46; 95 % CIs: 7.75, -1.17; p = 0.008; I² = 59 %). Despite these findings, no differences were observed in the improvement of passive activities between the SSNB and IACI groups at any follow-up. This study supports the short-term benefits of SSNB for FS, prompting further investigation into its long-term efficacy and comparison with other treatments.

Meniscus suture is an important treatment method for meniscus injury and contributes to the preservation of proprioception, restoration of knee biomechanics and alleviation of progressive osteoarthritis. However, there are few visualized analyses concerning the present studies of meniscus suture. This paper aims to evaluate the global trends, highlights and frontiers of meniscus suture. A bibliometric analysis was conducted based on the results of studies related to meniscus suture from web of science core collection. VOSviewer, GraphPad Prism, Microsoft Excel and R-bibliometrix were utilized for the bibliometric analysis of country and institution distribution, chronological distribution, source journals analysis, prolific authors and institutions analysis, keywords analysis, and reference co-citation analysis. A total of 950 publications on meniscus suture from 177 different sources were retrieved over the set time span. These publications were completed by 3177 authors from 1112 institutions in 54 countries. The United States was the most prolific country with 7960 citations and 348 publications (36.63%). Furumatsu Takayuki acted as the most prolific author (51 publications), while Robert F LaPrade with 1398 citations was the most-cited author. And more papers were published in the core journals, including American Journal of Sports Medicine, Arthroscopy-The Journal of Arthroscopic and Related Surgery, Knee Surgery Sports Traumatology Arthroscopy and Arthroscopy Techniques. Furthermore, “meniscus healing,” “meniscus root tear” seem to be the emerging research hotspots. Notably, the publication trend concerning the all-inside suture technique has been rising during the past decade. The number of research publications on meniscus suture has been continuously risen since 2010. The authors, publications and institutions from the United States and East Asia were still the mainstays in this field. And the all-inside suture may become the mainstream surgical technique in the future, with meniscus healing and meniscus root tears being research highlights recently.

Aims: This systematic review aimed to investigate the association between growth differentiation factor 15 (GDF-15) and rheumatoid arthritis (RA) disease activity, explore the differences at the genetic level, and evaluate the value of GDF-15 in diagnosing RA.Methods: A comprehensive literature search was conducted using PubMed, Web of Science, Cochrane Library, and Embase on 23 August 2023. Methodological quality was independently assessed by using the Agency for Healthcare Research and Quality scale. The primary parameters analyzed were the serum GDF-15 concentration, disease activity, and diagnostic sensitivity and specificity.Results: A total of 469 documents were retrieved, and five clinical studies were ultimately included. In the included studies, GDF-15 serum levels were found to be notably greater in RA patients than in healthy individuals, and these levels exhibited a positive correlation with disease severity. Furthermore, increased GDF-15 serum levels were associated with specific gene variations in RA patients, but varied according to ethnicity. In two included studies, GDF-15 showed high diagnostic sensitivity and specificity for highly active RA, demonstrating its utility as a diagnostic biomarker of RA.Conclusion: GDF-15 expression is increased in RA patients and is associated with disease activity; thus, GDF-15 is potentially an effective diagnostic biomarker for RA. However, additional high-quality studies, especially randomized controlled trials and cohort studies with follow-up data, are needed to assess the role of GDF-15 in RA.Cite this article: Bone Joint Res 2025;14(5):389–397.

Bone is a multifunctional organ essential for structural support, protection, hematopoiesis, and endocrine regulation. Emerging research increasingly highlights the pivotal role of the nervous system in bone metabolism, repair, and musculoskeletal disease progression, particularly the autonomic nervous system (ANS), which precisely regulates bone tissue cells via sympathetic and parasympathetic pathways. The ANS regulates the activity of mesenchymal stem cells (MSCs), osteoblasts, osteoclasts, chondrocytes, and nucleus pulposus cells (NPCs) via neurotransmitters such as norepinephrine (NE), acetylcholine (ACh), neuropeptide Y (NPY), and vasoactive intestinal peptide (VIP), thereby modulating core pathological processes in bone-related disorders including osteoporosis (OP), osteoarthritis (OA), intervertebral disc degeneration (IVDD), and traumatic fractures. Targeted neuromodulation is emerging as a promising therapeutic strategy for musculoskeletal disorders. This review aims to summarize the regulatory roles of the ANS in bone cell metabolism and bone-related pathologies and to evaluate current ANS-bone axis-based interventions to promote skeletal health and alleviate the burden of musculoskeletal diseases.