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.

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.

Background: Osteoporosis (OP) is a systemic bone disease often undiagnosed until fractures occur. Metabolites may influence OP, offering potential biomarkers or therapeutic targets. This study investigates the causal relationship between circulating metabolites and OP-related phenotypes using Mendelian Randomization (MR). Methods: GWAS data on 233 metabolic traits from 136,016 participants were analyzed through two-sample MR. Linkage disequilibrium score regression (LDCS) was used to estimate genetic correlations between metabolic traits and OP-related phenotypes, leveraging European ancestry linkage disequilibrium scores to account for polygenicity and stratification. MR employed the inverse-variance weighted (IVW) method, with sensitivity analyses via MR-Egger, MR-PRESSO, and weighted median methods to address pleiotropy and confounders. Results: LDCS identified significant genetic correlations between metabolites and bone mineral density (BMD) phenotypes, with total body BMD (toBMD) showing the strongest associations. Thirty-five metabolite traits, including apolipoprotein A-I, exhibited significant linkages. Among 79 metabolites influencing BMD, serum acetate levels were significantly associated with femoral neck BMD (OR: 1.28, 95% CI: 1.02–1.62), lumbar spine BMD (OR: 1.73, 95% CI: 1.32–2.27), and total body BMD (OR: 1.21, 95% CI: 1.04–1.42). Creatinine levels were consistently linked to reduced BMD, including lumbar spine BMD (OR: 0.88, 95% CI: 0.79–0.99). Triglycerides in IDL and VLDL particles also contributed to BMD variation. Conclusions: Significant genetic correlations and causal relationships were observed between specific metabolites and OP, highlighting key traits as potential biomarkers of bone health. These findings enhance the understanding of OP pathogenesis and suggest future preventive strategies.

Introduction Arthroscopic-assisted medial patellofemoral ligament reconstruction (MPFLR) is a common surgical procedure for patellar dislocation. We present the protocol of a randomised controlled clinical trial to compare postoperative pain, knee function and quality of life outcomes of MPFL reconstruction using the non-absorbable surgical sutures (FiberWire) and semitendinosus tendon. Methods and analysis This single-blind, randomised controlled trial enrolled patients with patellar dislocation who were undergoing inpatient surgery at the Department of Orthopedics, Xiangya Hospital, Central South University. Participants were randomly allocated to either the experimental or the control group using a random number table method, with an equal number of 15 subjects in each group. The experimental group was treated with a FiberWire for the MPFLR, whereas the control group received reconstruction using the semitendinosus tendon. A standardised postoperative rehabilitation protocol was implemented for both groups. All subjects will be evaluated for imaging, pain, knee function and quality of life at five time points: preoperatively and at 1 month, 3 months, 6 months and 12 months postoperatively. MRI scans will be performed preoperatively and at 12 months postoperatively to assess changes in patellar tilt angles and congruence angles. Pain assessment is performed using the Visual Analogue Scale (VAS). Knee function will be assessed using the Kujala score, Lysholm score and International Knee Documentation Committee (IKDC) knee function score. Quality of life was assessed using the 12-Item Short Form Survey scale. Ethics and dissemination The trial was approved by the Medical Ethics Committee of Xiangya Hospital of Central South University on 26 October 2021 (ethics number: 202110478) and registered in the China Clinical Trials Registry on 15 March 2022. Data will be published in peer-reviewed journals and presented at national and international conferences. Trial registration number ChiCTR2200057574.

Introduction: Continuing medical education (CME) and related continuing education for health professionals support lifelong learning and professional competence, yet a comprehensive synthesis of this CME-centered literature remains limited. Methods: A bibliometric analysis was conducted using the Web of Science Core Collection. Original articles and reviews published since 1999 were retrieved. VOSviewer, CiteSpace, and R were used to analyze publication trends, national and institutional contributions, coauthorship networks, reference cocitation, and keyword evolution. Results: A total of 1567 publications were identified. Annual publication output followed a quadratic growth pattern and accelerated substantially after 2019. The United States had the highest publication output, while emerging countries such as China showed rapid growth. Institutional analysis highlighted the role of academic medical centers, particularly the University of Toronto and its affiliated University Health Network. CME studies were mainly published in medical education and continuing education journals, including the Journal of Continuing Education in the Health Professions , BMC Medical Education , and Medical Teacher . Cocitation analysis showed that the knowledge base of CME research is grounded in early evidence evaluating CME effectiveness and later educational evaluation frameworks. Keyword analyses indicated a recent shift toward continuing professional development. Discussion: Research on CME and related continuing education for health professionals has expanded substantially over the past two decades and is increasingly embedded within a broader framework of professional learning and competency development. The growing prominence of continuing professional development reflects an evolving emphasis on lifelong learning, performance improvement, and the integration of education with health care system outcomes.

Purpose: To critically evaluate the role or effect of platelet-rich plasma (PRP) in anterior cruciate ligament (ACL) reconstruction in terms of clinical and radiological outcomes. Method: We conducted a systematic search of PubMed, Embase, the Cochrane Library, and Web of Science to identify relevant studies. Clinical outcomes included the Visual Analogue Scale (VAS), International Knee Documentation Committee (IKDC) subjective and objective evaluations, Lysholm score, Tegner score, anterior knee laxity, Knee Injury and Osteoarthritis Outcome Score (KOOS), Kujala score, Victorian Institute of Sport Assessment (VISA) scale, proprioception, isokinetic strength, and physical examination tests (anterior drawer, Lachman, and pivot-shift tests). Radiological outcomes encompassed measures obtained via magnetic resonance imaging (MRI), computed tomography (CT), X-ray, and ultrasound. Statistical significance was defined as a p value < 0.05, and all analyses were performed using R software (version 4.1.3). Results: A total of 23 studies, including 19 randomized controlled trials, met the inclusion criteria, encompassing 1072 patients overall. The meta-analysis showed significant differences between PRP group and non-PRP group with regard to VAS score at 6- and 12-month follow-up, Lysholm score at 6-month follow-up, and Tegner score at 6-month follow-up. Meta-regression showed that the two group differences in VAS score changed significantly with follow-up time (p < 0.01). In terms of radiological findings, about half of the assessments favored PRP to facilitate the graft maturation and integration at 6-month follow-up. Conclusions: PRP application in ACL reconstruction compared with non-PRP, may produce short-term but not long-term clinical outcomes such as VAS score, Lysholm score and Tegner score. While some short-term statistical differences exist, their magnitude and durability do not yet justify routine clinical adoption of PRP in ACL reconstruction. Larger samples and higher-quality studies are needed to support our results and further explore the advantages of PRP in other aspects. Level of evidence: Level II.