Introduction: Developmental dysplasia of the hip (DDH) is a common musculoskeletal disorder that has pain and loss of joint function as major pathological features. In the present study, we explored the mechanisms of possible involvement and regulation of substance P (SP) and calcitonin gene-related peptide (CGRP) in the pathological and inflammatory processes of arthritis in DDH. Methods: Blood, synovial tissue and fluid samples were collected from patients diagnosed with different severities of DDH and from patients with femoral neck fracture. Levels of SP, CGRP and inflammatory cytokines in synovium and synovial fluid (SF) in the different groups were evaluated by immunohistochemistry, real-time PCR and enzyme-linked immunosorbent assay (ELISA). Correlations between neuropeptides and inflammatory cytokines in SF were evaluated by partial correlation analysis. The proinflammatory effects of SP and CGRP on synoviocytes obtained from patients with moderate DDH were investigated in vitro by real-time PCR and ELISA. The mechanisms of those effects were evaluated by Western blot analysis and nuclear factor κ-light-chain-enhancer of activated B cells (NF-κB) DNA binding assay. Results: Significantly increased levels of neuropeptides and inflammatory cytokines were observed in synovium and SF from patients in the severe DDH group compared with the moderate DDH and control groups. In moderate DDH samples, SP in SF correlated with tumor necrosis factor (TNF)-α, and CGRP in SF correlated with TNF-α and interleukin (IL)-10. In the severe DDH group, SP in SF correlated with interleukin (IL)-1β, TNF-α and IL-10. CGRP in SF correlated with TNF-α. Additionally, SP might have had obvious proinflammatory effects on synoviocytes through the activation of NF-κB. Conclusions: The upregulation of SP and CGRP in synovium and SF might participate in the inflammatory process of arthritis in DDH. The activation of the NF-κB pathway seems indispensable in the proinflammatory effect of SP on synoviocytes. This original discovery may indicate a potential clinical drug target and the development of innovative therapies for DDH.

The tachykininergic neurotransmitters have been proved to be involved in the inflammatory progress and chronic pain in series of disease. The present study was undertaken to evaluate the levels of substance P (SP) and its receptors NK-1 receptor (NK-1R) in both serum and synovial tissues of hip joint from patients with different stages of DDH, and to detect the possible correlation of serum SP levels with pain sensation and dysfunction of the hip joint.

Objective: This study aimed to compare the effectiveness of telerehabilitation to traditional face-to-face physical therapy for patients with degenerative meniscal tears in Shanghai, China. Design: A two-arm, single-blinded, randomized controlled trial was conducted across two hospitals in Shanghai, China Subjects/Patients: Participants with clinically diagnosed degenerative meniscal tears were randomly assigned to either the telerehabilitation group or the face-to-face physical therapy group. Methods: Both groups underwent a 12-week intervention. Participants in telerehabilitation group used a digital platform for remote physical therapy, while participants in physical therapy group received traditional clinic-based rehabilitation. A predefined non-inferiority margin of 10 points on the Knee Injury and Osteoarthritis Outcome Score (KOOS) was applied to determine clinical equivalence between the interventions. Results: Both groups demonstrated significant improvements in knee function and quality of life, with no significant differences in the KOOS, SF-36, or functional tests at any time point (p > 0.05). Both groups had high adherence rates, with no significant differences in exercise completion or satisfaction scores. The TELE group had a significantly lower total cost compared to the PT group (p < 0.001), demonstrating greater cost-effectiveness. Conclusion: Telerehabilitation was found to be clinically non-inferior to face-to-face physical therapy for improving knee function, pain, and quality of life in patients with degenerative meniscal tears. It offered significant cost savings, making it a cost-effective alternative to traditional in-person rehabilitation.