Abstract:Objective To observe the clinical efficacy of Yangxue Zhitong pills combined with arthroscopic debridement on patients with knee osteoarthritis(KOA)and its influence on serum inflammatory factors.Methods A prospective analysis was conducted on 99 patients with KOA treated at Luoyang Orthopedic Hospital from June 2023 to June 2024.According to the random number table method,they were divided into control group(48 cases)and intervention group(51 cases).The control group was treated with arthroscopic debridement only,and the intervention group received additional Yangxue Zhitong pills.The levels of serum inflammatory factors and bone metabolism indexes,as well as knee function,daily living ability and incidence of adverse reactions were compared between the two groups.Results At one month after treatment,the levels of serum inflammatory factors(C-reactive protein,interleukin-6,plateletcrit),bone metabolism indexes(type I collagen C-terminal peptide,osteoprotegerin and osteocalcin),Hospital for Special Surgery(HSS)score,and knee injury and osteoarthritis outcome score were significantly improved compared with those before the treatment,and the above indicators and the excellent and good rate of HSS score in the intervention group at one month after treatment were all better than those in the control group,with statistically differences(P<0.05).The comparison of incidence of adverse reactions between the two groups showed no statistically difference(P>0.05).Conclusion Compared with arthroscopic debridement,additional Yangxue Zhitong pills treatment for KOA patients could further improve the serum inflammation and bone metabolism levels,enhance knee joint function,and increase their daily living ability with good safety.

Abstract:Osteoporosis is a chronic metabolic bone disease mainly related to the imbalance of osteoblast and osteoclast metabolism in the body.Gut microbiota(GM)are symbiotic bacteria that reside in the intestine and have important functions such as maintaining the intestinal mucosal barrier function,regulating host metabolism,and maintaining immune homeostasis of the body.In recent years,there are sufficient evidences indicating that GM can regulate bone mass,mainly through the interaction between GM,GM metabolites and the immune,endocrine,and nervous systems of the body.This article conducts a literature review including three aspects of GM introduction,the correlation between GM and the onset of osteoporosis,and the mediation of the occurrence and development of osteoporosis by GM through the immune-endocrine-nervous system,with the aim of providing references and strategies for the further prevention and treatment of osteoporosis.

Abstract:Objective To compare the early clinical efficacy between medial-pivot(MP)and posterior-stabilized(PS)prostheses in the treatment of end-stage knee osteoarthritis(KOA),and to compare the differences in stress peak and distribution of knee prostheses using finite element analysis.Methods A prospective analysis was performed on 60 patients with end-stage KOA who underwent total knee arthroplasty(TKA)in the First Affiliated Hospital of Bengbu Medical University from September 2021 to September 2023.The patients were randomly divided into two groups,the MP group(undergoing MP-TKA,n=30)and the PS group(undergoing PS-TKA,n=30).Perioperative indicators were compared between the two group,and finite element analysis was conducted.Results At 1,3,and 6 months postoperatively,the American Knee Society scores and Lysholm scores in the MP group were significantly higher than those in the PS group,with statistical differences(P<0.05).Finite element analysis showed that stress was distributed on both the medial and lateral sides of the gasket in both groups;the maximum stress in the MP group was distributed on the medial side of the gasket,while that in the PS group was distributed on the lateral side.Conclusion MP prostheses have significant advantages over PS prostheses in terms of early clinical efficacy and finite element biomechanics.

Abstract:Objective To explore the application effect of multi-module mobile education system in the specialized nursing of total hip replacement(THR)under the background of"Internet+".Methods A total of 156 patients undergoing initial unilateral THR from June 2021 to June 2022 were randomly divided into two groups,control group and mobile group,with 78 cases in each group.Patients in the control group received traditional intervention with whole-course oral and paper-based health education,while patients in the mobile group were given multi-module mobile system intervention with personalized health education(text,videos,interactive Q&A etc.)via the WeChat platform.Educational knowledge mastery score,Harris hip function score and nursing satisfaction were compared between the two groups at 1 day before discharge.Results At 1 day prior to discharge,knowledge mastery score,harris score and nursing satisfaction in the mobile group was(71.87±11.43)points,(79.10±5.85)points,and(90.69±5.38)%respectively,which was higher than(67.14±9.20)points,(76.86±5.05)points and(88.59±5.35)%in the control group,showing statistical differences between the two groups(P<0.05).Additionally,the mobile education group achieved an 87.18%(68/78)rehabilitation exercise compliance rate,which was higher than control group's 69.75%(53/78),with a statistical difference between the two groups(P<0.05).Conclusion The multi-module mobile education system could improve knowledge mastery of the patients,promote hip function rehabilitation and elevate the nursing satisfaction for THR patients.

Abstract:Objective To explore the application effect of early rehabilitation nursing combined with core muscle group training in elderly patients with osteoporotic vertebral compression fractures(OVCF).Methods A total of 128 elderly patients with OVCF who received surgical treatment in the First Affiliated Hospital of Xiamen University from May 2021 to May 2023 were randomly divided into the observation group and the control group using a random number table method(n=64).The control group received early rehabilitation nursing,while the observation group received early rehabilitation nursing combined with core muscle group training.The lumbar spine function,pain level,balance ability,self-efficacy,activities of daily living(ADL),and incidence of complications were compared between the two groups.Results After the intervention(at 12 d postoperatively),the Oswestry disability index,visual analogue scale scores and incidence of complications of the observation group were lower than those of the control group,the Berg balance scale,osteoporosis self efficacy scale scores as well as modified Barthel index were higher than those in the control group.The differences between the two groups had statistical significance(P<0.05).Conclusion For elderly patients with OVCF,early rehabilitation nursing combined with core muscle group training could improve the lumbar function,reduce pain,enhance self-efficacy,balance ability and ADL,and reduce the risk of complications.

Abstract:Objective To compare the differences of clinical efficacy,biomechanical indicators and safety between intramedullary nail and locking plate in the treatment of intertrochanteric femoral fractures.Methods A total of 86 patients with intertrochanteric femur fractures admitted to Zhenping County Maternal and Child Health Hospital from May 2023 to November 2024 were enrolled.Using a randomized digital table method,they were divided into two groups,intramedullary nail group(n=43)and locking plate group(n=43).The study compared preoperative and postoperative Harris score,range of motion(ROM)of hip joint,and bone mineral density(BMD)of the proximal femur between the two groups.Finite element analysis was conducted to evaluate stress distribution at the fracture site,and the complication rates were recorded.According to Evans classification,patients in two groups were divided into stable fracture subgroup(each,25 cases)and unstable fracture subgroup(each,18 cases),the above indicators of patients in the subgroups were compared and analyzed respectively.Results At 3 and 6 months postoperatively,the Harris score of hip joint in the intramedullary nail group was higher than that in the locking plate group(P<0.05).At 6 months postoperatively,the intramedullary nail group showed greater ROM in flexion,extension and other directions,as well as higher proximal femoral BMD when compared to those in the locking plate group,while both maximum and average stress at fracture sites were lower than those in the locking plate group(P<0.05).The complication rate in the intramedullary nail group was lower than that in the locking group(9.30%vs 23.26%),but the difference between two groups showed no statistically significance(P<0.05).For both stable and unstable fracture subgroups,the intramedullary nail group showed higher Harris scores,proximal femoral BMD and lower maximum,average stress than those in the locking plate group at 6 months postoperatively(P<0.05).Conclusion Iintramedullary nail internal fixation is a safe and effective treatment option for stable and unstable intertrochanteric fractures of the femur,which is superior to locking plate fixation in terms of joint function recovery and biomechanical stability.

Abstract:Objective To investigate the causal relationships between the use of acetaminophen,ibuprofen and intervertebral disc degeneration(IVDD).Methods GWAS datasets for acetaminophen and ibuprofen were obtained from the UK Biobank database,eligible single nucleotide polymorphisms(SNPs)were screened as instrumental variables,and SNPs related to three types of intervertebral disc degeneration from the FinnGen database were used as outcome variables for a two-sample Mendelian randomization(MR)analysis.The inverse variance weighted(IVW)method was employed as the primary approach to assess causal effects,supplemented by the MR-Egger and weighted median methods.Heterogeneity was evaluated using the Cochrane Q test,while horizontal pleiotropy was assessed using the MR-Egger and MR-PRESSO methods,and sensitivity was analyzed using the leave-one-out method.Results The IVW analysis revealed significant causal associations between acetaminophen use and cervical disc degeneration(OR=3.392,95%CI:1.609-7.147,P<0.001),lumbar disc degeneration(OR=2.678,95%CI:1.704-4.2010,P<0.001),and early lumbar disc herniation(OR=3.916,95%CI:1.918-7.996,P<0.001).No causal relationship was observed between ibuprofen usage and disc degeneration.Reverse MR analyses indicated that disc degeneration did not increase acetaminophen use;however,lumbar disc degeneration was positively associated with a higher likelihood of ibuprofen use(OR=1.006,95%CI:1.002-1.010,P<0.001).Conclusions The usage of acetaminophen showed a positive causal association with disc degeneration,suggesting that it may be a potential risk factor for disc degeneration.Conversely,lumbar disc degeneration was postively associated with increased ibuprofen use,implying that this condition may be a potential factor leading to greater ibuprofen consumption..

Abstract:Elderly patients undergoing orthopedic surgery have a significantly increased incidence of perioperative pulmonary complications due to the decline in physiological functions and the increase of comorbidities.These complications not only delay the postoperative recovery process of patients,but may also lead to more serious adverse consequences.Currently,researches on perioperative pulmonary complications mainly focus on pneumonia,atelectasis,and respiratory tract infections,but there are still many problems in clinical practice,such as the lack of efficient risk assessment tools and standardized prevention protocols.In view of this,the article intends to explore the common perioperative pulmonary complications in elderly orthopedic patients,conduct an in-depth analysis of pathogenesis,risk assessment,prevention strategies,and treatment methods,aiming to provide references for clinical practice and further improve the prognosis of the patients.

Abstract:Objective To investigate the influence of calcium sulfate combined with polymethylmethacrylate(PMMA)bone cement during percutaneous kyphoplasty(PKP)on bone cement leakage and postoperative recovery in elderly patients with osteoporotic vertebral compression fractures(OVCFs).Methods The clinical data of 120 elderly patients with OVCFs who received PKP in Nanyang Zhang Zhongjing Hospital from July 2021 to July 2024 were retrospectively analyzed.According to the different bone cement filling methods during surgery,they were divided into group A(n=63,PMMA bone cement filling only)and group B(n=57,calcium sulfate combined with PMMA bone cement filling).The differences in perioperative parameters,incidence of bone cement leakage,preoperative and postoperative visual analogue scale(VAS),Oswestry disability index(ODI),anterior vertebral height(AVH)and kyphosis Cobb angle,as well as occurrence of complications were compared between the two groups.Results The PMMA bone cement injection volume,incidence of bone cement paravertebral venous leakage and total incidence of bone cement leakage,pain VAS score and ODI at 1 week after surgery in group B were less or lower than those in group A(P<0.05).There were no statistical differences in injured vertebra AVH recovery rate and Cobb angle improvement immediately after surgery and at the last follow-up,as well as incidence of postoperative adjacent vertebral re-fracture between the two groups(P>0.05).No serious complications such as pulmonary embolism,infection,symptomatic nerve root stimulation or spinal cord compression occurred in the two groups.Conclusions The application of calcium sulfate combined with PMMA bone cement during PKP has good safety for elderly patients with OVCFs.The procedure could effectively restore the vertebral height and correct the kyphosis deformity,meanwhile,it could further lower the PMMA bone cement volume,reduce the risk of bone cement leakage,improve the pain symptoms and the vertebral function during early postoperative period,and is more conducive to postoperative early recovery of patients.

Abstract:Objective To explore the surgical effects of arthroscopic Orthocord suture binding combined with autologous hamstring tendon reconstruction in the treatment of old posterior cruciate ligament(PCL)tibial insertion avulsion fracture.Methods Clinical data of 10 patients with old PCL tibial insertion avulsion fracture treated by arthroscopic Orthocord suture binding combined with autologous hamstring tendon reconstruction in Nanyang Traditional Chinese Medicine Hospital from January 2018 to October 2023 were retrospectively analyzed.The anterior-posterior displacement of the knee joint was examined before the surgery and at the latest follow-up,and the International Knee Documentation Committee(IKDC)score and Lysholm score were evaluated at the same time.Results The operation was completed smoothly in both groups.The follow-up time ranged from 6 to 26 months,with a mean follow-up time of(17.30±2.48)months.The anterior-posterior displacement of the knee joint,IKDC score,and Lysholm score improved from preoperative values of(10.10±1.52)mm,(51.60±6.20)points,and(50.10±6.74)points to the latest follow-up values of(1.70±0.67)mm,(91.70±3.53)points,and(93.70±3.53)points,respectively.Differences of these indicators before and after surgery showed statistical significance(P<0.05).Conclusion Arthroscopic Orthocord suture binding combined with autologous hamstring tendon reconstruction could achieve satisfactory short-term effects in the treatment of old PCL tibial avulsion insertion fractures with improvement of the knee joint stability and function scoring.

Abstract:Objective To investigate the quality of life and determine the influencing factors in elderly hip fracture patients from Shouguang City.Methods A retrospective analysis was conducted on clinical data of 100 elderly patients with hip fractures who were admitted to Shouguang People's Hospital from January 2020 to December 2020.The quality of life and influencing factors were evaluated.Results The EuroQol five-dimensional questionnaire 5-level version(EQ-5D-5L)index,hip disability and osteoarthritis outcome score-physical function shortform(HOOS-PS)scores,and visual analogue scale(VAS)scroes for health self-assessment of 100 elderly patients with hip fractures were(0.56±0.10),(17.00±2.93),and(7.15±0.60)points,respectively.Univariate analysis showed that the presence of hip joint history was an important factor affecting the EQ-5D-5L index in elderly hip fracture patients(P<0.05).Multivariate linear regression analysis further indicated that hip joint history had a significant impact on the quality of life(β=﹣0.190,P<0.05).Conclusion The history of hip joint disease is a independent risk factor affecting the quality of life of elderly patients with hip fracture in Shouguang City.

Abstract:Objective To investigate the clinical efficacy and safety of enoxaparin sodium combined with pneumatic compression pump in preventing venous thromboembolism(VTE)in elderly surgical patients with orthopedic trauma.Methods A retrospective analysis of the clinical data of 96 elderly patients with limb or pelvic fractures who underwent surgical treatment from April 2024 to January 2025 at Zhengzhou Central Hospital was conducted.According to different VTE prevention measures after the surgery,the patients were divided into the observation group(54 cases)and the control group(42 cases).The observation group was given enoxaparin sodium combined with pneumatic compression pump,while the control group was given enoxaparin sodium alone.The coagulation function indexes,hemodynamic parameters,distal collateral circulation,VTE incidence and drug-related adverse events were compared between the two groups.Results The activated partial thromboplastin time and prothrombin time of the observation group were longer than those of the control group,and the levels of fibrinogen and D-dimer were lower than those of the control group(P<0.05).In the observation group,whole-blood viscosity and plasma viscosity were lower,and hematocrit was higher than those in the control group,but the inter-group difference was not statistically significant(P>0.05).The peak systolic blood flow velocity was higher,and the resistance index was lower in the observation group than those in the control group(P<0.05).The incidence of VTE was lower in the observation group than that in the control group(P<0.05).The incidence of drug-related adverse events in the two groups had no statistical difference(P>0.05).Conclusion Compared with enoxaparin sodium alone,combination with pneumatic compression pump after the surgery is a safe and effective prevention measure of VTE with further improvement of the coagulation function indexes and promotion of distal collateral circulation for elderly patients with orthopedic trauma.

Abstract:Objective To explore the clinical effect of internal fixation with clavicular hook plate under stress control in the treatment of acromioclavicular joint dislocation.Methods A retrospective analysis was conducted on the clinical data of 45 patients with acromioclavicular joint dislocation who underwent internal fixation with clavicular hook plates from February 2020 to April 2024.Among them,24 patients fixed with clavicle hook plate were included into the control group,21 patients treated with stress-controlled clavicle hook plate internal fixation were included into the observation group.The stress control method included 3 steps,increasing the hook angle at the distal end of the clavicle hook plate,removing the bony tissue 2-5 mm above the posterior acromion end of the clavicle,and bending the hook plate,so as to control the stress of the clavicle hook plate between the clavicle and the acromion.Vertical distance between clavicle and the inner side of hook plate in the stress-free state after implantation was measured,and after pressing the plate attached to the clavicle,the stress when the inner side of the plate close to the clavicle was also measured.Visual analogue scale(VAS)scores at 12 d after the operation,the Karlsson standard assessment results of the shoulder joint at 1 and 3 months postoperatviely,and the Constant-Murley score at the last follow-up of patients in the two groups were observed,and the occurrence of postoperative complications was recorded.Correlations between the stress and the plate-clavicle vertical distance was analyzed,and the reasonable range of stress control during the internal fixation by clavicle hook plate was determined.Results All patients were followed up with an average follow-up time of 11 months(ranging from 7 to 19 months).VAS score at 12 d after the operation,the assessment results of the Karlsson standard of the shoulder joint at 1 and 3 months after the operation,and the Constant-Murley score at the last follow-up in the observation group were all better than those in the control group,the difference between the two groups was statistically significant(P<0.05).At the last follow-up,there were 2,6 cases of shoulder pain,1,4 cases of significant shoulder joint movement limitation,and 4,6 cases of subacromial bone resorption in the observation group and the control group respectively.The incidence of complications in the control group was significantly higher than that in the observation group(66.7%vs 33.3%,P<0.05).The linear regression analysis indicated that the vertical distance between the inner side of the clavicle hook plate and the clavicle had a significant effect on the stress;Compared with that of the control group,the vertical distance between the inner side of the plate and the clavicle in the observation group had a more significant effect on the stress when pressing the plate attached the clavicle(P<0.05).The regression analysis of relations between stress and Constant-Murley score at the last follow-up indicated that the reasonable range of stress control for internal fixation of acromioclavicular hook plate in the treatment of acromioclavicular joint dislocation was 17-25 N,and the vertical distance was 8-13 mm.Conclusion The internal fixation of the clavicular hook plate under stress control for the treatment of acromioclavicular joint dislocation could better improve the postoperative shoulder joint function,relieve pain symptom and reduce the risk of postoperative complications by regulating the stress of the hook plate between the clavicle and the acromion.

Abstract:Objective To explore the therapeutic effect of bridge combined internal fixation system assisted with double reverse traction technology in the treatment of femoral shaft fractures.Methods A total of 69 patients with femoral shaft fractures who received bridge combined internal fixation system treatment at Yellow River Sanmenxia Hospital from March 2020 to April 2023 were selected and randomly divided into a control group(35 cases)and an observation group(34 cases).Patients in the control group received treatment using a bridge combined internal fixation system with traction bed,while patients in the observation group received treatment using a bridge combined internal fixation system assisted with double reverse traction technology.The surgical related indicators(reduction time,operation time,incision type,intraoperative blood loss,and intraoperative fluoroscopy frequency),fracture healing time,as well as hip and knee joint function at 6 and 12 months postoperatively were observed in both groups.The incidence of postoperative complications was compared between the two groups.Results There was no statistical differences in the type of incision,intraoperative blood loss,fracture healing time,and the incidence of complications between the two groups(P>0.05).The observation group had shorter reduction time and operation time,and fewer intraoperative fluoroscopy times compared with the control group(P<0.05).Harris hip score and American Hospital of Special Surgery knee joint score at 12 months after surgery in both groups were higher than those at 6 months after surgery(P<0.05),and the observation group had higher Harris hip score and American HSS knee joint score than the control group at 6 months after surgery(P<0.05).Conclusions For patients with femoral shaft fractures,the combination of bridging internal fixation system and double reverse traction technique or traction bed can both achieve good fracture healing.However,the former procedure can shorten reduction time and surgical time,reduce intraoperative fluoroscopy frequency,and improve early postoperative joint function better when compared with the latter procedure.

Abstract:Objective To analyze the risk factors for adjacent segment degeneration(ASD)in elderly patients with lumbar spinal stenosis(LSS)after posterior lumbar interbody fusion(PLIF).Methods The clinical data of 78 elderly patients with LSS who were treated by PLIF in Zhengzhou First People's Hospital from March 2015 to February 2023 were retrospectively analyzed.The data of gender,age,number of fusion segments,body mass index(BMI),comorbidity(diabetes or osteoporosis),preoperative lumbar nerve roots compression(LNRC)grading,and other data were collected.The risk factors of ASD were determined by multivariate Logistic regression analysis.Results All patients were followed up for 2 to 5 years,and a total of 18 cases(23.1%)of ASD were found.The results of multivariate Logistic regression analysis showed that the number of fusion segments(OR=3.606,95%CI:1.104-11.774,P=0.034),osteoporosis(OR=3.162,95%CI:1.067-9.367 P=0.038),and preoperative LNRC grading(OR=6.057,95%CI:1.790-20.493,P=0.004)were risk factors for ASD in elderly LSS patients after PLIF surgery.Conclusion Osteoporosis,number of fusion segments,and preoperative LNRC grading are risk factors for ASD in elderly LSS patients undergoing PLIF surgery.

Abstract:Objective To explore the predictive value of the American Society of Anesthesiologists(ASA)classification and comorbidity assessment for postoperative cognitive dysfunction(POCD)after total hip arthroplasty(THA)in elderly patients,and to provide a basis for formulating individualized preventive strategies.Methods A total of 98 elderly patients who underwent THA in Zhengzhou 15th People's Hospital from January 2018 to December 2023 were prospectively enrolled.Preoperative ASA classification and modified Charlson comorbidity index(mCCI)were evaluated,and neuropsychological scale combinations were used to assess cognitive function before surgery,and 7 days and 30 days after surgery.Logistic regression was used to analyze the risk factors of POCD,and a prediction model was constructed and its efficacy was verified.Results The incidence of POCD at 7 days after surgery was 21.43％,mainly involving the executive function(76.19％)and attention and working memory domains(71.43％).Multivariate Logistic regression analysis showed that age≥73.6 years(OR=2.373),educational duration≤8.5 years(OR=2.113),ASA grade Ⅲ(OR=2.824),and mCCI score≥2.8 points(OR=2.237)were independent risk factors for POCD.The prediction model showed good discrimination(AUC=0.839,95％CI:0.762-0.916,P<0.001),with a sensitivity of 82.4％and a specificity of 78.6％.Conclusions The combination of ASA classification and comorbidity assessment can effectively predict the cognitive risk after THA,providing a standardized assessment tool for perioperative management by orthopedic surgeons.It helps identify high-risk patients and formulate targeted preventive measures,which is of great clinical value for improving the safety of THA in elderly patients.

Abstract:Objective To explore the influencing factors of bone cement leakage in patients after percutaneous vertebroplasty(PVP),and to construct nomogram model based on the influencing factors with the aim of providing a reference for accurate clinical prediction of the risk of bone cement leakage.Methods A retrospective analysis was conducted on the clinical data of 161 patients with osteoporotic vertebral fractures who underwent PVP surgery at Yancheng Tinghu District People's Hospital from January 2022 to February 2024.The patients were divided into two groups based on whether bone cement leakage occurred within 12 months after surgery.Among them,48 patients with bone cement leakage were included in the leakage group,and the remaining 113 patients without bone cement leakage were included in the non leakage group.The baseline data of patients were compared between the two groups,the univariate analysis and multiple Logistic regression analysis was used to screen influencing factors for bone cement leakage,and then a predictive nomogram model based on these factors was constructed.Results Univariate analysis showed that there were no statistical differences in vertebral fissure sign,timing of bone cement injection,fracture morphology,puncture path,and bone density between the two groups(P>0.05).In the leakage group,the proportion of severe vertebral compression,preoperative Cobb angle,and bone cement injection volume were all greater than those in the non leakage group,the differences were statistically significant(P<0.05).The results of binary Logistic regression analysis showed that severe vertebral compression,large preoperative Cobb angle,and high injection volume of bone cement were all factors affecting the occurrence of bone cement leakage after PVP(P<0.05).The degree of vertebral compression,preoperative Cobb angle,and bone cement injection volume were then included in the prediction model to construct a nomogram model.The receiver operating characteristic curve showed that the area under the curve of the training set and validation set were 0.825(95%CI:0.755-0.896)and 0.794(95%CI:0.640-0.948),and the cut-off values were 0.232 and 0.499,indicating good predictive performance of the nomogram model.The calibration curve showed that the deviation between the prediction results of the model and the actual results was relatively small,and the decision curve showed that the model was higher than the None and All curves in most threshold probability ranges.Conclusions Severe vertebral compression,large preoperative Cobb angle,and high injection volume of bone cement are all influencing factors for postoperative bone cement leakage in PVP patients.The nomagram model based on these three factors has good predictive performance.

Abstract:Objective To extract,assess,and synthesize relevant evidences from domestic and international databases regarding the prevention and management of kinesiophobia in patients undergoing total hip arthroplasty(THA),providing evidence-based medical support for reducing patients'kinesiophobia levels and promoting their joint function recovery.Methods A comprehensive search was conducted for literature related to the prevention and management of kinesophobia in patients who performed THA,retrieved from major domestic and international biomedical literature databases.Types of the retrieved documents included guidelines,expert consensus,systematic reviews and meta-analyses,and clinical decision-making resources,and the time frame for the search was from January 1,2014,to March 30,2024.Two writers separately filtered,estimated the quality,and extracted and intergrated evidences from the final included literature.Results A total of 15 documents were included,comprising 2 guidelines,3 evidence summaries,4 Meta-analysis and 6 expert consensus statements.These sources provided 31 pieces of evidence centered around 6 aspects involving risk assessment,health education,pain intervention,psychological support,rehabilitation exercises,and discharge guidance.Among them,there were 15 A-level and 16 B-level recommendations.Conclusion The best evidence for the prevention and management of kineshobia in THA patients summarized in this study provides a reference for orthopedic practice,which can be applied and transferred by clinical healthcare professionals on the basis of comprehensive evaluation of the actual situation of patients.