ObjectiveTo develop an exercise intervention program for patients undergoing total knee arthroplasty based on the daily goal management pathway, and preliminarily verify its clinical feasibility and effectiveness. MethodsThe intervention program was formulated based on the daily goal management pathway and hope theory, combined with literature analysis, qualitative interviews and expert consultation. Feasibility evaluation was conducted among orthopedic nurses and patients in Beijing Bo'ai Hospital from September to November, 2025. A controlled pilot study was performed with 15 patients in each group: the control group received routine rehabilitation care, while the experimental group received the developed intervention program. The Hospital for Special Surgery Knee Score (HSS), range of motion (ROM) of knee, functional exercise compliance score, Visual Analogue Scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were compared between two groups. ResultsThe program covered three themes from admission to three weeks postoperatively, including seven training methods and 32 specific recommendations. Feasibility results showed 100% patient recruitment rate, 93.75% retention rate and 96.94% program acceptance rate. A total of 21 orthopedic nurses scored ≥ 4.5 on all four dimensions of the program. After intervention, HSS score and knee ROM significantly increased (|t| > 6.205, P < 0.001), while WOMAC and VAS score decreased (t = 9.127, Z = -3.415, P < 0.01) in the experimental group; in the control group, VAS score decreased (Z = -3.122, P = 0.002), and knee ROM reduced (t = -2.622, P = 0.015), with no significant improvement in other indicators (P > 0.05); all the indexes were better in the experimental group than in the control group (|t| > 7.949, |Z| > 2.990, P < 0.01), including the functional exercise compliance (t = -8.565, P < 0.001). ConclusionThe exercise intervention program based on the daily goal management pathway is scientific, feasible and preliminarily effective, which can provide a new structured and humanized nursing for early exercise training of patients during hospitalization for total knee arthroplasty.

Periprosthetic infection is a catastrophic complication after joint replacement. Choosing appropriate treatment for patients with different infection characteristics is the key to improve the success rate. The one-stage revision has been applied and studied more and more in clinical work because of its advantages in treatment cycle, functional recovery, complications and cost. Grasping the indications and contraindications, comprehensive analysis and selection of appropriate patients, considering intraoperative details and postoperative anti-infection treatment meticulously, are crucial to reduce the recurrence rate of infection. The purpose of this paper is to describe the main points of the one-stage revision in the treatment of periprosthetic infection, and to summarize the classic and recent research on the one-stage revision.

Objective:To investigate the effects of posterior condylar offset (PCO) change on functional recovery after high-flexion posterior-stabilized total knee arthroplasty (TKA).Methods:From December 2018 to May 2019, a total of 76 patients (7 males and 69 females) who underwent primary TKA were included. The age of patients was 67.78±5.13 years (56-75 years). Preoperative and postoperative radiological PCO were measured by lateral knee X-ray. The true preoperative PCO was defined as the sum of radiological PCO and the thickness of posterior condylar cartilage. According to the changing of PCO (ture preoperative PCO - postoperative PCO), the subjects were divided into four groups, namely 28 cases in ≤-3 mm group, 23 cases in -3 mm- group, 15 cases in 0 mm- group and 10 cases in ≥3 mm group. The parameters, including age, body mass index, range of motion (ROM), Knee Society Scores (KSS) and visual analogue score (VAS) before the operation, were not significantly different among four groups. ROM, KSS, VAS at 2 weeks, 1 month, 3 months, 6 months after the operation were compared among the four groups.Results:There were good inter-observer reliabilities regarding the parameters measured in this study ( ICC>0.75). The KSS, ROM, VAS of all the subjects after operation were significantly better than those before the operation ( F=318.768, 64.983, 361.749; P=0.000). In all groups, the recovery of KSS and VAS last to 6 months after the operation. The ROM trended to be stable at the 3 months after the operation. At 6 months after operation, ROM, KSS and VAS of ≤-3 mm group was 116.07°±9.66°, 156.25±21.49, and 1.18±0.94, respectively. These parameters of -3 mm- group was 119.57°±7.52°, 162.17±17.09, and 1.26±0.86. However, these parameters of 0 mm- group was 126.07°±5.25°, 161.86±8.86, 1.00±0.55, respectively. These of ≥3 mm group was 118.00°±4.21°, 156.60±16.98 and 1.30±0.95. The KSS, KSS anatomy score, KSS function score and VAS were not significantly different at any follow-up point among four groups. The ROM of 0 mm- group at 1 month, 3 months and 6 months after operation (118.57°±13.07°, 25.00°±6.20°, 126.07°±5.25°) was significantly different from other three groups ( F=4.966, P=0.003; F=4.179, P=0.006; F=5.262, P=0.003), while 0 mm- group's ROM were greater than other three groups ( P<0.05). Conclusion:Increasing within 3 mm of PCO was related to larger postoperative ROM in high-flexion posterior-stabilized TKA. However, change of PCO had no influence on the outcomes of KSS recovery and pain relief.

Through analysis and summary of the biological characteristics of various biomarkers, to explore the reliability of different markers for early diagnosis of osteoarthritis. Cartilage oligomeric matrix protein, N-terminal crosslinked telopeptide of type Ⅰ collagen and C-terminal crosslinked telopeptide of type Ⅱ collagen are the possible effective markers in osteoarthritis early diagnosis. Hyaluronic acid and C-terminal crosslinked telopeptide of type I collagen are more suitable for evaluating the ollurrence and derelopment of osteoarthritis. The efficacy of miRNA and lncRNA in osteoarthritis diagnosis and evaluation remains to be proved. Each marker may has two or more biological effect, this paper will focus on finding out an accurate and stable marker with the analysis and summary of present bio-markers.