［Abstract］　Objective　To construct and internally validate a nomogram model for predicting early tibial component loosening after unicompartmental knee arthroplasty(UKA) in elderly patients with osteoporosis. Methods　The clinical data of 125 elderly patients with osteoporosis who underwent UKA in Yuncheng Central Hospital Affiliated to Shanxi Medical University due to knee osteoarthritis from May 2022 to May 2023 were retrospectively collected. Among the patients, 21 patients had early tibial component loosening after the operation(loosening group), and 104 patients did not have early tibial component loosening after the operation(non-loosening group). Multivariate logistic regression was used to analyze the influencing factors for developing early tibial component loosening after UKA in the elderly patients with osteoporosis. A nomogram model was constructed based on the independent predictors and was internally validated by using Bootstrap(1 000 iterations), and the prediction efficacy of the nomogram model for developing early tibial component loosening after UKA in the elderly patients with osteoporosis was evaluated by using receiver operating characteristic(ROC) curve. Results　Compared with those in the non-loosening group, the maximum total point motion(MTPM) measured by radiostereometric analysis(RSA) was significantly increased(P<0.05), and the volumetric bone mineral density(vBMD) of proximal tibia measured by quantitative computed tomography(QCT) was significantly decreased(P<0.05), and the beta-carboxy-terminal cross-linking telopeptide of type Ⅰ collagen(β-CTX) level was significantly increased in the loosening group(P<0.05). Multivariate logistic regression analysis showed that MTPM measured by RSA［OR(95%CI)=3.32(2.11-5.21)］ and β-CTX［OR(95%CI)=1.13(1.06-1.20)］ were independent risk factors for developing early tibial component loosening after UKA(P<0.05), while the vBMD of proximal tibia measured by QCT［OR(95%CI)=0.63(0.44-0.82)］ was an independent protective factor inhibiting development of early tibial component loosening after UKA(P<0.05). The nomogram model constructed based on the above 3 indicators was verified internally to have good discrimination(C-index=0.785, AUC=0.792), and the decision curve analysis showed that the model had high net clinical benefit within the threshold probability range of 0.15-0.38. Conclusion　The nomogram model constructed according to the vBMD of proximal tibia measured by QCT, MTPM measured by RSA and bone resorption indicator β-CTX has good predictive performance and clinical application potential, and can be used for risk assessment of early tibial component loosening and stratified management.]]> 2026/2/28 11:50:11 1, ZHANG Eryang², WANG Kunzheng^3,4]]> LI Jiangbo¹, ZHANG Eryang², WANG Kunzheng^3,4 5true ［Abstract］　Objective　To observe the safety and effectiveness of “sandwich” bone graft encapsulation technique using gelatin sponge-recombinant human bone morphogenetic protein-2(rhBMP-2) composite bioactive material in preventing graft-related leakage and promoting osseous fusion in oblique lumbar interbody fusion(OLIF). Methods　A retrospective analysis was performed on the clinical data of 834 patients with lumbar degenerative diseases who underwent L_4-5 segment OLIF in West China Hospital, Sichuan University from November 2017 to July 2023. The patients included 380 males(45.6%) and 454 females(54.4%), aged 23-89(63.3±11.8)years. The operation time, intraoperative blood loss and hospital stay of the patients were recorded. The clinical efficacy was evaluated by using Visual Analogue Scale(VAS) scores and Oswestry Disability Index(ODI). Sagittal lumbar three-dimensional computed tomography(3D-CT) was used to measure the disc height(DH) before the operation and 1 day, 12 months and 24 months after the operation. Cage subsidence was graded by using Marchi classification system, and interbody fusion status was assessed according to Bridwell grading criteria. Results　All the patients were operated successfully without any complications such as graft migration, graft leakage or graft-related neurological compression. The average operation time was (87.2±11.8)min. The average intraoperative blood loss was (33.3±7.4)mL, and the average hospital stay was (5.3±1.5)days. The postoperative follow-up duration ranged from 24 to 90 months, with a median follow-up duration of 28(24, 43)months. Compared with those before the operation, the VAS scores for assessing low back pain and leg pain as well as the ODI of the patients at 3 months, 12 months and 24 months after the operation continued to improve significantly, and the differences were statistically significant(P<0.05). Postoperative imaging measurement demonstrated a restoration of DH in the operated lumber vertebra segments at 1 day after the operation, with favorable maintenance at 12 months after the operation. At 24 months after the operation, the imaging fusion rate reached 93.8%(Bridwell grades Ⅰ-Ⅱ), and the incidence of cage subsidence was 22.9%. Conclusion　The application of “sandwich” bone graft encapsulation technique using gelatin sponge-rhBMP-2 composite bioactive material in OLIF shows good safety and feasibility. It has the advantages of simple operation, short operation time and low complication rate. While ensuring the efficiency of minimally invasive surgery, it achieves good clinical efficacy.]]> 2026/2/28 11:50:11 HAN Xu, ZENG Jiancheng, XIE Tianhang, WANG Xiandi, LUO Chuan, HU Xiao, PENG Xingrui 4true ［Abstract］　Objective　To explore the clinical effect of optimized percutaneous vertebroplasty(PVP) in treatment of osteoporotic vertebral fracture nonunion(Kümmell′s disease, KD). Methods　A retrospective analysis was conducted on the clinical data of 153 patients with KD who underwent PVP in the Department of Spinal Surgery of Shanghai Fourth People′s Hospital, Tongji University from January 2021 to January 2024. Among the patients, 78 patients receiving conventional PVP were assigned to the control group, while the other 75 patients receiving optimized PVP(including cross-puncture, filling with gelatin sponge and artificial bone, bone cement trailing and vacuum intravertebral cleft freshness) were assigned to the observation group. The Visual Analogue Scale(VAS) scores for assessing low back pain and the Oswestry Disability Index(ODI), the vertebral body height of the injured vertebrae, the angles formed between the upper endplate and the lower endplate of the injured vertebrae, and the thoracolumbar Cobb angles were collected before the operation, and at 3 days, 1 month, 3 months, 6 months and 12 months after the operation for comparative analysis. Results　The VAS scores and ODI in the two groups at each time point after the operation were significantly lower than those before the operation(P<0.05), but there were no significant defferences between the two groups(P>0.05). The vertebral body height of the injured vertebrae, the angles formed between the upper endplate and the lower endplate of the injured vertebrae, and the thoracolumbar Cobb angles in the two groups at each time point after the operation were significantly improved compared with those before the operation(P<0.05), and the improvement in the observation group was more significant(P<0.05). The incidence of complications in the observation group was lower than that in the control group, with a statistically significant difference between the two groups(2.7% vs 25.6%; χ²=16.392, P<0.001). Conclusion　The optimized PVP can enhance bone cement anchoring, restore and maintain the vertebral height of the injured vertebrae, and significantly alleviate back pain in the KD patients, improve their lumbar function and quality of life.]]> 2026/2/28 11:50:11 LIU Tao, ZHI Zhongzheng, ZHOU Fuchao, ZHANG Rongcheng, PAN Weicheng, KANG Jian, MIAO Jinhao, HE Zhimin 3true ［Abstract］　Osteoporosis(OP) is a globally prevalent skeletal disease that imposes a substantial health and economic burden on society.Homocysteine(Hcy), as a metabolic intermediate of sulfur-containing amino acids, has been confirmed as an independent risk factor for cardiovascular and cerebrovascular diseases when its plasma levels are elevated—a condition known as hyperhomocysteinemia(HHcy). In recent years, some researches have found that HHcy is closely associated with decreased bone mineral density, increased fracture risk and disordered bone metabolism. However, its mechanism of action and clinical significance remain controversial. This paper systematically reviews the research progress in the relationships between Hcy and OP. Firstly, it sorts out epidemiological evidence to clarify the complex relationships between Hcy levels and bone mineral density as well as fracture risk, and summarizes the effects of genetic polymorphisms(e.g., the MTHFR gene) and the levels of B vitamins on these relationships. Secondly, it deeply explores the molecular and cellular biological mechanisms, focusing on the core role of Hcy in disrupting bone metabolic balance via inducing oxidative stress and inflammatory responses, and interfering with specific signaling pathways. Finally, it evaluates the potential and challenges of reducing Hcy levels and preventing and treating OP through nutritional interventions(e.g., supplement with folic acid and vitamin B₁₂) and pharmacological interventions. This review aims to provide a comprehensive perspective for a deeper understanding of the role of Hcy in the pathogenesis of OP and offers a theoretical basis for studying new prevention and treatment strategies for OP.]]> 2026/2/28 11:50:11 1, YANG Lan², LI Lijun³, LI Xinhua⁴]]> JIANG Shangkun¹, YANG Lan², LI Lijun³, LI Xinhua⁴ 2true ［Abstract］　Innate immunity, as the first line of defense for the body against the invasion of pathogens, plays a significant role in maintaining the homeostasis of the immune system, and in recognizing and eliminating the invading pathogens. However, under aseptic conditions, the abnormal activation of innate immunity may induce autoinflammatory diseases. Chronic recurrent multifocal osteomyelitis(CRMO), as a typical representative of autoinflammatory diseases, still has many fundamental theoretical and clinical management problems that need to be urgently solved in clinical diagnosis and treatment. The Pstpip2^-/- mouse model is widely used in the research fields of autoinflammatory diseases and CRMO, which facilitates the understanding of the regulatory mechanisms of CRMO at the molecular and cellular levels. This paper summarizes the clinical manifestations and classifications of general autoinflammatory diseases, with a focus on discussing the role of membrane-regulating protein proline-serine-threonine-phosphatase-interacting protein 2(PSTPIP2) in the Pstpip2^-/- mouse model of CRMO, aiming to provide a reference for analyzing the pathogenesis of osteolytic osteomyelitis and formulating therapeutic strategies.]]> 2026/2/28 11:50:11 1,2,3, DONG Ge^1,2,3, CAI Zhigang^1,2,3]]> HUO Qingran^1,2,3, DONG Ge^1,2,3, CAI Zhigang^1,2,3 1true