Osteoarthritis (OA) is the most common joint disease affecting approximately 10% of men and 18% of women older than 60. Its pathogenesis is still not fully understood; however, emerging evidence has suggested that chronic low-grade inflammation is associated with OA progression. The pathological features of OA are articular cartilage degeneration in the focal area, including new bone formation at the edge of the joint, subchondral bone changes, and synovitis. Conventional drug therapy aims to prevent further cartilage loss and joint dysfunction. However, the ideal treatment for the pathogenesis of OA remains to be defined. Macrophages are the most common immune cells in inflamed synovial tissues. In OA, synovial macrophages undergo proliferation and activation, thereby releasing pro-inflammatory cytokines, including interleukin-1 and tumor necrosis factor-α, among others. The review article discusses (1) the role of synovial macrophages in the pathogenesis of OA; (2) the progress of immunoregulation of synovial macrophages in the treatment of OA; (3) novel therapeutic targets for preventing the progress of OA or promoting cartilage repair and regeneration.

To explore the relationship between the magnetic resonance imaging (MRI) characteristics of osteoporotic vertebral compression fractures (OVCFs) and the efficacy of percutaneous vertebroplasty (PVP). A prospective study was conducted to analyze the clinical and imaging data of 93 patients with OVCFs treated via PVP. A visual analogue scale (VAS), the Oswestry Disability Index (ODI), and the Medical Outcomes Study(MOS) 36-Item short-form health survey (SF-36) were completed before surgery as well as 1 day and 1, 6, and 12 months after surgery. In addition, postoperative complications were recorded. According to the degree and ranges of bone marrow edema on MRI, the patients were divided into three groups: the mild (group A), moderate (group B), and severe (group C) bone marrow edema groups. Pain and dysfunction scores were compared across the three groups of patients before surgery as well as 1 day and 1, 6, and 12 months after surgery. The VAS, ODI, and SF-36 scores showed significant differences (P < 0.05) before and after surgery among the three groups. The ODI and SF-36 scores were significantly different (P < 0.05) at 1 day and 1 month after surgery among the three groups. Groups A and B showed significantly better pain relief than group C. Group B experienced better pain relief than group A. These results indicate that PVP was associated with better pain relief effects among patients with a greater extent of bone marrow edema. The edema ranges of the vertebral fractures were negatively correlated with the postoperative VAS and ODI scores 1 month after surgery, whereas the ranges were positively correlated with postoperative SF-36 scores 1 month after surgery. PVP is an effective treatment for OVCFs. Better outcomes were observed among patients with severe or moderate bone marrow edema rather than those with mild bone marrow edema. A greater degree of pain relief after PVP was correlated with faster recovery of the postoperative function. However, this correlation gradually became weak over time and disappeared 6 months after surgery. Therefore, PVP should be an option for early stage OVCFs, especially among patients with bone marrow edema signs on MRI.

The rotator cuff is prone to tear under degenerative changes or mechanical injury, leading to excessive inflammation, extracellular matrix degradation, and unsatisfactory prognosis. Interleukin-4 (IL-4) was used to induce macrophages polarization toward M2 phenotype. By mapping IL 4-activated pathways and applying peptidome profiling, macrophage-derived peptide 1 (MDP1) was identified and shown to promote the phosphorylation of STAT3 and STAT6, thereby inducing the polarization of M0 macrophages toward the anti-inflammatory M2 phenotype. A functionally graded scaffold woven from electrospun nanofiber yarns was developed, with MDP1 and hydroxyapatite (HA) loaded onto its corresponding interfaces. During rotator cuff repair process, the scaffold functioned as an augmentation patch, with mechanical properties (Young's modulus, ca. 280 MPa) comparable to native tendons, prevented rotator cuff re-tearing in an early stage. MDP1 was incorporated into scaffolds to modulate an excessive inflammatory response, while HA was used to enhance bio-mineralization for enhanced osteointegration. Through a multidimensional collaborative repair strategy, this functionally graded scaffold not only mimicked the tendon–bone interface, but also significantly suppressed local inflammation at the interface, as evidenced by a 60.6 % and 66.5 % reduction in IL-6–positive areas at 2 and 4 months, respectively, compared with the control group. Furthermore, it promoted tissue regeneration in the damaged region, resulting in a 32.6 % increase in Young's modulus, thereby ultimately enhancing rotator cuff performance. The multifunctionally graded scaffold may offer an invaluable solution to promote rotator cuff tear healing and potentially other related disciplines.

Objectives This cross-sectional study aimed to explore the knowledge, attitude and practice (KAP) of patients with rotator cuff tears towards arthroscopic shoulder surgery (ASS), based on the hypothesis that the knowledge of the procedure among patients would be sufficient, which in turn might influence their practice and attitude. Design Cross-sectional study. Setting Patients were recruited from Tong Ren Hospital between September and October 2022. Participants A total of 588 patients were included in the study. Interventions No interventions were administered. Primary and secondary outcome measures Knowledge, attitude and practice scores were measured using a self-administered questionnaire. Results Out of 588 patients included, 50.51% had undergone ASS. Lower education level and monthly income, shorter weekly exercise time and shorter disease duration were identified as independent risk factors for the KAP total score. Structural equation modelling revealed a direct positive effect of knowledge on attitude, but neither knowledge nor attitude influenced practice scores. Conclusions Patients with rotator cuff tears demonstrated relatively poor knowledge, a neutral attitude and moderate practice towards ASS, highlighting the need for patient education and counselling to enhance understanding and decision-making regarding ASS.