Acute isolated meniscal injury is a common sports-related knee injury in clinical practice. In June 2024, the American Academy of Orthopaedic Surgeons (AAOS) released the latest Clinical Practice Guideline for the Management of Acute Isolated Meniscal Pathology. Based on rigorous evidence-based methodology, the guideline provides systematic recommendations regarding physical examination, imaging evaluation, and both non-operative and operative management strategies, classifying these recommendations according to the strength of evidence. This article aims to interpret the key points in the diagnosis and management of acute isolated meniscal injury, to inform clinical practice and guide future research.
Objective To analyze the current status and temporal trends of the disease burden of osteoarthritis (OA) in China from 1990 to 2023, stratified by anatomical sites (knee, hip, hand, and other), utilizing data from the 2023 Global Burden of Disease (GBD) study, and to explore the site-specific heterogeneity of disease burden attributed to high body mass index (BMI), providing a scientific basis for formulating precision prevention and control strategies.Methods Based on the GBD 2023 database, data on the incidence, prevalence, and years lived with disability (YLDs), as well as their corresponding age-standardized rates of OA in China from 1990 to 2023, were collected and stratified by gender, age, and anatomical site (knee, hip, hand, and other). A log-linear regression model was employed to calculate the estimated annual percentage change (EAPC) to analyze temporal trends. Additionally, the population attributable fraction (PAF) was used to quantify the contribution of high BMI to OA across different sites and to analyze the heterogeneity of this attribution. Results In 2023, the disease burden of OA in China increased. In terms of anatomical distribution, knee OA constituted the heaviest burden, with 115.0032 million prevalent cases, accounting for approximately 65.78% of the total. Attribution analysis showed that knee OA was slightly more affected by high BMI than hip OA, and the PAF increased significantly over time. In 2023, the PAFs for knee and hip OA in females (29.49% and 28.57%, respectively) were substantially higher than those in 1990 (19.10% and 18.38%). A similar upward trend was observed in males (26.65% and 25.92% in 2023). Regarding attribution differences, female PAF levels were consistently higher than those of males across all years and sites. Hand OA exhibited the fastest growth rate, with the EAPC of its age-standardized YLDs rate reaching 1.64%, far exceeding that of knee OA (0.43%). Demographically, all burden indicators were higher in females than in males. Hand OA demonstrated an intergenerational cumulative effect. The difference in YLDs rates between 2023 and 1990 widened with age, reaching 123.29 per 100 000 in the >95 years old group, highlighting the severe challenges posed by population aging. Conclusion From 1990 to 2023, the disease burden of OA in China continued to rise. Knee OA remains the heaviest burden category and is significantly driven by high BMI, whereas hand OA shows the fastest growth trend. Prevention and control strategies should focus on weight management for knee and hip OA, while prioritizing the prevention and care of hand OA in the elderly population.
Objective To analyze the current status and trends in the burden of musculoskeletal diseases in China from 1990 to 2023, providing evidence-based support for formulating and optimizing prevention and control strategies for musculoskeletal diseases in China. Methods Based on the 2023 Global Burden of Disease (GBD) study database, the study integrated incidence, prevalence, disability-adjusted life years (DALYs), and age-standardized rates of musculoskeletal diseases in the Chinese population from 1990 to 2023, stratified by gender and age. The proportional contribution to all-cause prevalence was calculated, and regression models were constructed using Joinpoint software to assess temporal trends. ResultsIn 2023, the five major musculoskeletal diseases collectively accounted for approximately 25.0% of all-cause prevalence in China. Among these, osteoarthritis contributed the most (11.68%), followed by low back pain (6.89%) and neck pain (3.52%). Gout (1.28%) and rheumatoid arthritis (0.36%) had relatively lower contributions. From 1990 to 2023, the overall burden of the five major musculoskeletal diseases remained substantial, with heterogeneous temporal patterns across diseases. Stratified by age and gender, the five diseases exhibited low levels during childhood and adolescence, increased significantly in middle and older adulthood, and peaked in the elderly. Except for gout, the burden of the other four diseases was higher in females than in males across most age groups. The scale of each disease varied considerably. Osteoarthritis showed the most significant increase in prevalence, with prevalent cases increasing from 53.7668 million to 161.7424 million, and the age-standardized DALYs rate rising by 16.19%. Gout showed the fastest growth in disease burden, with age-standardized DALYs rates rising from 19.88/100 000 to 25.14/100 000 (a 26.46% increase). Although low back pain showed a decline, it remained a major source of disability over the long term, with the age-standardized DALYs rate decreasing from 740.83/100 000 to 551.92/100 000 (a 25.49% decrease). Neck pain remained generally stable with a age-standardized DALYs rate increase of 1.18%. The age-standardized incidence rate of rheumatoid arthritis increased by 19.41%, and the age-standardized DALYs rate decreased by 8.38%.Conclusion Over the past 30 years, the burden of musculoskeletal diseases in China has shown a persistent upward trend with significant gender and age disparities. Future prevention and control strategies should place greater emphasis on early identification and proactive interventions, advocating for more targeted comprehensive measures for high-risk populations. Concurrently, efforts must be made to enhance standardized diagnosis and treatment capabilities at the primary care level, alongside strengthening continuous rehabilitation management.
ObjectiveTo analyze the changing trends in the burden of gout disease attributable to high body mass index (BMI) and impaired kidney function in China from 1990 to 2023, and predict the burden of gout disease attributable to high BMI and impaired kidney function in China from 2024 to 2035, to provide a scientific basis for gout prevention and control. Methods Based on the 2023 Global Burden of Disease (GBD) study data, this study analysed the characteristics of the burden of gout attributable to high BMI and impaired kidney function by gender and age group. It employed the Joinpoint regression model to examine trends in the age-standardized disability-adjusted life years (DALYs) rate and utilized the autoregressive integrated moving average (ARIMA) model to predict the disease burden trend from 2024 to 2035. Results From 1990 to 2023, the age-standardized DALYs rate for gout attributable to high BMI in China increased (1990: 3.79 per 100 000, 95%UI: 2.15 per 100 000-6.24 per 100 000; 2023: 7.34 per 100 000, 95%UI: 4.22 per 100 000-11.39 per 100 000). Joinpoint analysis results showed that from 1990 to 2023, the age-standardized DALYs rate for gout attributable to high BMI in China exhibited an overall upward trend [average annual percent change (AAPC) for males=2.12%, 95%CI: 2.02%-2.22%; AAPC for females=1.92%, 95%CI: 1.79%-2.04%, both P<0.05]. For gout attributable to impaired kidney function, the age-standardized DALYs rate showed a slow overall increase in males, while the change in females was not significant (AAPC for males=0.36%, 95%CI: 0.27%-0.45%, P<0.05; AAPC for females=0.11%, 95%CI: ?0.11%-0.33%). According to the ARIMA model predictions, by 2035, the age-standardized DALYs rates of gout attributable to high BMI in males and females and attributable to impaired kidney function in females were projected to stabilize at 10.85 per 100 000, 3.48 per 100 000, and 1.75 per 100 000, respectively. In contrast, the age-standardized DALYs rate of gout attributable to impaired kidney function in males was predicted to continue rising until 2035, reaching an estimated 5.98 per 100 000. Conclusion The disease burden of gout associated with high BMI and impaired kidney function continues to worsen in China. The age-standardized DALYs rate for gout attributable to impaired kidney function in males is projected to continue rising until 2035. Therefore, there is an urgent need to improve population-wide BMI management strategies and enhance medical support for patients with kidney diseases, with targeted interventions prioritized among specific groups such as middle-aged obese individuals and middle-aged and elderly patients with kidney diseases.
