Sarcopenia,a progressive and systemic skeletal muscle disorder marked by the accelerated deterioration of both muscle function and mass,is highly prevalent among the elderly population,significantly contributing to an...Sarcopenia,a progressive and systemic skeletal muscle disorder marked by the accelerated deterioration of both muscle function and mass,is highly prevalent among the elderly population,significantly contributing to an elevated risk of adverse outcomes,including falls,fractures,and muscle weakness.Clinical investigations have identified a strong correlation between sarcopenia and several prevalent degenerative skeletal muscle disorders.This correlation is attributed to imbalances in joint mechanics resulting from localized muscle atrophy and the influence of musculoskeletal secretory factors.In this review,we discuss the broader implications of sarcopenia and critically evaluate the currently established assessment methods.Furthermore,the clinical significance of prevalent musculoskeletal disorders(including osteoporosis,osteoarthritis,and spinal pathologies)in relation to sarcopenia,alongside the underlying mechanisms influencing this relationship,is summarized.Additionally,the effects of sarcopenia on the therapeutic efficacy of medications and surgical interventions for musculoskeletal conditions are reviewed.Sarcopenia is intricately linked to the onset,progression,and prognosis of musculoskeletal disorders.Future research should prioritize elucidating the potential mechanisms that connect muscle loss with skeletal muscle diseases,and investigating whether mitigating sarcopenia symptoms could decelerate the progression of these disorders,thereby paving new pathways for therapeutic interventions.展开更多
While bulk RNA sequencing and single-cell RNA sequencing have shed light on cellular heterogeneity and potential molecular mechanisms in the musculoskeletal system in both physiological and various pathological states...While bulk RNA sequencing and single-cell RNA sequencing have shed light on cellular heterogeneity and potential molecular mechanisms in the musculoskeletal system in both physiological and various pathological states,the spatial localization of cells and molecules and intercellular interactions within the tissue context require further elucidation.Spatial transcriptomics has revolutionized biological research by simultaneously capturing gene expression profiles and in situ spatial information of tissues,gradually finding applications in musculoskeletal research.This review provides a summary of recent advances in spatial transcriptomics and its application to the musculoskeletal system.The classification and characteristics of data acquisition techniques in spatial transcriptomics are briefly outlined,with an emphasis on widely-adopted representative technologies and the latest technological breakthroughs,accompanied by a concise workflow for incorporating spatial transcriptomics into musculoskeletal system research.The role of spatial transcriptomics in revealing physiological mechanisms of the musculoskeletal system,particularly during developmental processes,is thoroughly summarized.Furthermore,recent discoveries and achievements of this emerging omics tool in addressing inflammatory,traumatic,degenerative,and tumorous diseases of the musculoskeletal system are compiled.Finally,challenges and potential future directions for spatial transcriptomics,both as a field and in its applications in the musculoskeletal system,are discussed.展开更多
BACKGROUND Studies have shown that locomotive syndrome(LS)is significantly correlated with adverse outcomes,such as decreased self-care abilities,fractures,and increased mortality.Subthreshold depression(StD)is consid...BACKGROUND Studies have shown that locomotive syndrome(LS)is significantly correlated with adverse outcomes,such as decreased self-care abilities,fractures,and increased mortality.Subthreshold depression(StD)is considered an independent predictor of clinical depression,regarded as its prodromal stage,and even linked to increased mortality risk.Limited research has addressed the prevalence and relationship between LS and StD in elderly cancer patients.Understanding the prevalence of LS and StD among elderly cancer patients and elucidating their relationship will provide evidence to support the development of targeted interventions,thereby improving health outcomes in this population.AIM To investigate the relationship between musculoskeletal system function and predepressive states in elderly cancer patients.METHODS A convenience sampling method was employed to recruit 500 elderly cancer patients undergoing follow-up visits at the Department of Oncology,Affiliated Hospital of Jiangnan University,from April 2024 to December 2024.Participants completed the general information questionnaire, the 25-question Geriatric Locomotive Function Scale, and theGeriatric Depression Scale-Short Form-15. Influencing factors were analyzed, and correlation analyses wereperformed.RESULTSA total of 483 elderly cancer patients successfully completed the study. The prevalence of LS and StD amongparticipants was 56.5% and 38.7%, respectively. Logistic regression analysis identified age, tumor metastasis,exercise habits, and the presence of StD as significant risk factors for LS in elderly cancer patients. Additionally,having three or more chronic diseases and LS were significant predictors for developing StD. Spearman’s correlationanalysis revealed a significant positive correlation between LS and StD (r = 0.424, P < 0.001).CONCLUSIONElderly cancer patients exhibit a high prevalence of LS and StD, conditions which are positively correlated andmutually influential. Thus, it is critical to monitor and address pre-depressive states while evaluating and managingmotor function in this population.展开更多
Ultrasound is an essential modality within musculoskeletal imaging, with the recent addition of elastography. The elastic properties of tissues are different from the acoustic impedance used to create B mode imaging a...Ultrasound is an essential modality within musculoskeletal imaging, with the recent addition of elastography. The elastic properties of tissues are different from the acoustic impedance used to create B mode imaging and the flow properties used within Doppler imaging, hence elastography provides a different form of tissue assessment. The current role of ultrasound elastography in the musculoskeletal system will be reviewed, in particular with reference to muscles, tendons, ligaments, joints and soft tissue tumours. The different ultrasound elastography methods currently available will be described, in particular strain elastography and shear wave elastography. Future directions of ultrasound elastography in the musculoskeletal system will also be discussed.展开更多
Disorders of the musculoskeletal system are the major contributors to the global burden of disease and current treatments show limited efficacy.Patients often suffer chronic pain and might eventually have to undergo e...Disorders of the musculoskeletal system are the major contributors to the global burden of disease and current treatments show limited efficacy.Patients often suffer chronic pain and might eventually have to undergo end-stage surgery.Therefore,future treatments should focus on early detection and intervention of regional lesions.Microrobots have been gradually used in organisms due to their advantages of intelligent,precise and minimally invasive targeted delivery.Through the combination of control and imaging systems,microrobots with good biosafety can be delivered to the desired area for treatment.In the musculoskeletal system,microrobots are mainly utilized to transport stem cells/drugs or to remove hazardous substances from the body.Compared to traditional biomaterial and tissue engineering strategies,active motion improves the efficiency and penetration of local targeting of cells/drugs.This review discusses the frontier applications of microrobotic systems in different tissues of the musculoskeletal system.We summarize the challenges and barriers that hinder clinical translation by evaluating the characteristics of different microrobots and finally point out the future direction of microrobots in the musculoskeletal system.展开更多
Chronic pain and general physical discomfort are common symptoms among those seeking medical or physiotherapy treatment, as it relates to disorders found in the Human Musculoskeletal System (HMS). Since this system is...Chronic pain and general physical discomfort are common symptoms among those seeking medical or physiotherapy treatment, as it relates to disorders found in the Human Musculoskeletal System (HMS). Since this system is highly complex and large in scale, clinical pain research has been confounded by many complex factors. The goal of our research is to overcome these obstacles by applying multidisciplinary approaches including systems engineering, traditional oriental techniques, conventional medicine and related sciences. To pursue such an integrated approach this paper examines the therapist-guided exercise for restoring human musculoskeletal balance called the Somatic Balance Restoration Therapy (SBRT). The SBRT is a simple but effective self-exercise therapy with minimal assistance by a trained therapist. This therapy is analyzed by a mechanical engineering method by modeling the human body as a multi-body subject to a static equilibrium condition. In addition, the wording has been rewritten in functional anatomical terms, enabling smooth communication between specialists of three different disciplines: therapy, conventional medicine and systems engineering. Examples will be given to demonstrate an integrated and systematic approach for identifying and remedying malfunctions within the HMS.展开更多
Musculoskeletal injuries are among the most common causes of disability worldwide,with early detection and appropriate intervention critical to minimizing long-term complications.Infrared thermography(IRT)has emerged ...Musculoskeletal injuries are among the most common causes of disability worldwide,with early detection and appropriate intervention critical to minimizing long-term complications.Infrared thermography(IRT)has emerged as a noninvasive,real-time imaging modality that captures superficial temperature changes reflecting underlying physiological processes such as inflammation and vascular alterations.This review explores the fundamental principles of medical thermography,differentiates between passive and active approaches,and outlines key technological advancements including artificial intelligence integration.The clinical utility of IRT is discussed in various contexts–ranging from acute soft tissue injuries and overuse syndromes to chronic pain and rehabilitation monitoring.Comparative insights with conventional imaging techniques such as ultrasound and magnetic resonance imaging are also presented.While IRT offers functional imaging capabilities with advantages in portability,safety,and speed,its limitations–such as lack of deep-tissue penetration and protocol standardization–remain significant barriers to broader adoption.Future directions include the integration of IRT with other imaging modalities and digital health platforms to enhance musculoskeletal assessment and injury prevention strategies.展开更多
Molecular hydrogen(H2)demonstrates selective antioxidant and anti-inflammatory properties with therapeutic potential across musculoskeletal conditions including osteoarthritis,rheumatoid arthritis,exercise-induced mus...Molecular hydrogen(H2)demonstrates selective antioxidant and anti-inflammatory properties with therapeutic potential across musculoskeletal conditions including osteoarthritis,rheumatoid arthritis,exercise-induced muscle damage,chronic pain syndromes,tendinopathies,and muscle atrophy.This review critically evaluates preclinical and clinical evidence for H2 therapy and identifies research gaps.A comprehensive search of PubMed,EMBASE,and Cochrane Library(up to April 2025)yielded 45 eligible studies:25 preclinical and 20 clinical trials.Preclinical models consistently showed reductions in reactive oxygen species,inflammatory cytokines,and improved cell viability.Clinical trials reported symptomatic relief in osteoarthritis,decreased Disease Activity Score 28 in rheumatoid arthritis,and accelerated clearance of muscle damage markers.Delivery methods varied-hydrogen-rich water,gas inhalation,and saline infusion-hindering direct comparison.Mechanistic biomarkers were inconsistently reported,limiting understanding of target engagement.Common limitations included small sample sizes,short durations,and protocol heterogeneity.Despite these constraints,findings suggest H2 may serve as a promising adjunctive therapy via antioxidant,anti-inflammatory,and cytoprotective mechanisms.Future research should prioritize standardized delivery protocols,robust mechanistic endpoints,and longer-term randomized trials to validate clinical efficacy and optimize therapeutic strategies.展开更多
Musculoskeletal disorders are common in clinical practice.Repairing critical-sized defects in musculoskeletal systems remains a challenge for researchers and surgeons,requiring the application of tissue engineering bi...Musculoskeletal disorders are common in clinical practice.Repairing critical-sized defects in musculoskeletal systems remains a challenge for researchers and surgeons,requiring the application of tissue engineering biomaterials.Successful application depends on the response of the host tissue to the biomaterial and specific healing process of each anatomical structure.The commonly-held view is that biomaterials should be biocompatible to minimize local host immune response.However,a growing number of studies have shown that active modulation of the immune cells,particularly macrophages,via biomaterials is an effective way to control immune response and promote tissue regeneration as well as biomaterial integration.Therefore,we critically review the role of macrophages in the repair of injured musculoskeletal system soft tissues,which have relatively poor regenerative capacities,as well as discuss further enhancement of target tissue regeneration via modulation of macrophage polarization by biomaterial-mediated immunomodulation(biomaterial properties and delivery systems).This active regulation approach rather than passive-evade strategy maximizes the potential of biomaterials to promote musculoskeletal system soft tissue regeneration and provides alternative therapeutic options for repairing critical-sized defects.展开更多
Importance:There are a variety of musculoskeletal malformations and injuries that can occur in newborns.These can be a significant cause of perinatal death or a reason for miscarriage and can lead to long-term functio...Importance:There are a variety of musculoskeletal malformations and injuries that can occur in newborns.These can be a significant cause of perinatal death or a reason for miscarriage and can lead to long-term functional issues if not managed appropriately.There is no systematic and well-established screening program for neonatal musculoskeletal malformations and injuries in China now.Objective:To report the incidence and types of congenital musculoskeletal malformations in two hospitals in Shenzhen City,to explore and discuss the details of the screening procedure and improve future prevention and treatment.Methods:From October 2013 to May 2014,2564 one-day-old newborns were screened by a pediatric orthopedic physical examination,in combination with ultrasonography when required,and the incidence and variety of diseases were recorded statistically.Results:Among 2564 screened newborns,the following musculoskeletal conditions were identified:congenital muscular torticollis(CMT)(seven cases,0.27%),hip subluxation(four cases,0.16%),hip dysplasia(47 cases,1.83%),congenital talipes equinovarus(CTEV)(two cases,0.08%),congenital talipes calcaneovalgus(15 cases,0.58%),polydactyly(nine cases,0.35%),syndactyly(one case,0.04%),and spinal hemivertebra(one case,0.04%).Additionally,there were five(0.19%)neonates with birth injuries.Interpretation:It is feasible to carry out neonatal screening and identification of musculoskeletal malformations and birth injuries in China.This is helpful as timely detection and early intervention for many of these conditions can avoid permanent functional impairment in these children.展开更多
Infection and rejection in musculoskeletal trauma often pose challenges for natural healing,prompting the exploration of biomimetic organ and tissue transplantation as a common alternative solution.Polyhydroxyalkanoat...Infection and rejection in musculoskeletal trauma often pose challenges for natural healing,prompting the exploration of biomimetic organ and tissue transplantation as a common alternative solution.Polyhydroxyalkanoates(PHAs)are a large family of biopolyesters synthesised in microorganism,demonstrating excellent biocompatibility and controllable biodegradability for tissue remodelling and drug delivery.With different monomer-combination and polymer-types,multi-mechanical properties of PHAs making them have great application prospects in medical devices with stretching,compression,twist in long time,especially in musculoskeletal tissue engineering.This review systematically summarises the applications of PHAs in multiple tissues repair and drug release,encompassing areas such as bone,cartilage,joint,skin,tendons,ligament,cardiovascular tissue,and nervous tissue.It also discusses challenges encountered in their application,including high production costs,potential cytotoxicity,and uncontrollable particle size distribution.In conclusion,PHAs offer a compelling avenue for musculoskeletal system applications,striking a balance between biocompatibility and mechanical performance.However,addressing challenges in their production and application requires further research to unleash their full potential in tackling the complexities of musculoskeletal regeneration.展开更多
Background: Musculoskeletal injuries(MSkIs) are a leading cause of health care utilization, as well as limited duty and disability in the US military and other armed forces. MSkIs affect members of the military during...Background: Musculoskeletal injuries(MSkIs) are a leading cause of health care utilization, as well as limited duty and disability in the US military and other armed forces. MSkIs affect members of the military during initial training,operational training, and deployment and have a direct negative impact on overall troop readiness. Currently, a systematic overview of all risk factors for MSkIs in the military is not available.Methods: A systematic literature search was carried out using the PubMed, Ovid/Medline, and Web of Science databases from January 1, 2000 to September 10, 2019. Additionally, a reference list scan was performed(using the “snowball method”). Thereafter, an international, multidisciplinary expert panel scored the level of evidence per risk factor, and a classification of modifiable/non-modifiable was made.Results: In total, 176 original papers and 3 meta-analyses were included in the review. A list of 57 reported potential risk factors was formed. For 21 risk factors, the level of evidence was considered moderate or strong. Based on this literature review and an in-depth analysis, the expert panel developed a model to display the most relevant risk factors identified, introducing the idea of the “order of importance” and including concepts that are modifiable/nonmodifiable, as well as extrinsic/intrinsic risk factors.Conclusions: This is the qualitative systematic review of studies on risk factors for MSkIs in the military that has attempted to be all-inclusive. A total of 57 different potential risk factors were identified, and a new, prioritizing injury model was developed. This model may help us to understand risk factors that can be addressed, and in which order they should be prioritized when planning intervention strategies within military groups.展开更多
Background: Upper limb amputations are one of the unpleasant war injuries that armed forces are exposed to frequently. The present study aimed to assess the musculoskeletal and peripheral nervous systems in Iraq-Iran ...Background: Upper limb amputations are one of the unpleasant war injuries that armed forces are exposed to frequently. The present study aimed to assess the musculoskeletal and peripheral nervous systems in Iraq-Iran war veterans with bilateral upper extremity amputation.Methods: The study consisted of taking a history and clinical examinations including demographic data, presence and location of pain, level of amputation, passive and active ranges of movement of the joints across the upper and lower extremities and spine, manual palpation, neurological examination, blood circulation pulses and issues related to a prosthetic limb. In this study, 103 Iranian bilateral upper extremity amputees(206 amputations) from the IranIraq war were evaluated, and a detailed questionnaire was also administered.Results: The most common level of amputation was the finger or wrist level(108, 52.4%). Based on clinical examination, we found high frequencies of limited active and passive joint range of movement across the scapula, shoulder, elbow, wrist and metacarpophalangeal, interphalangeal and thumb joints. Based on muscle strength testing, we found varying degrees of weakness across the upper limbs. Musculoskeletal disorders included epicondylitis(65, 31.6%), rotator cuff injury(24, 11.7%), bicipital tendonitis(69, 33.5%), shoulder drop(42, 20.4%) and muscle atrophy(19, 9.2%). Peripheral nerve disorders included carpal tunnel syndrome in 13(6.3%) and unilateral brachial plexus injury in 1(1%). Fifty-three(51.5%) were diagnosed with facet joint syndrome at the level of the cervical spine(the most frequent site). Using a prosthesis was reported by 65(63.1%), both left and right sides. The back was the most common site of pain(71.8%).Conclusion: The high prevalence of neuro-musculoskeletal disorders among bilateral upper extremity amputees indicates that they need regular rehabilitation care.展开更多
Multibody musculoskeletal modeling of human gait has been proved helpful in investigating the pathology of musculoskeletal disorders.However,conventional inverse dynamics methods rely on external force sensors and can...Multibody musculoskeletal modeling of human gait has been proved helpful in investigating the pathology of musculoskeletal disorders.However,conventional inverse dynamics methods rely on external force sensors and cannot capture the nonlinear muscle behaviors.Meanwhile,the forward dynamics approach is computationally demanding and only suited for relatively simple tasks.This study proposed an integrated simulation methodology to fulfill the requirements of estimating foot-ground reaction force,tendon elasticity,and muscle recruitment optimization.A hybrid motion capture system,which combines the marker-based infrared device and markerless tracking through deep convolutional neural networks,was developed to track lower limb movements.The foot-ground reaction forces were determined by a contact model for soft materials,and its parameters were estimated using a two-step optimization method.The muscle recruitment problem was first resolved via a static optimization algorithm,and the obtained muscle activations were used as initial values for further simulation.A torque tracking procedure was then performed by minimizing the errors of joint torques calculated by musculotendon equilibrium equations and inverse dynamics.The proposed approach was validated against the electromyography measurements of a healthy subject during gait.The simulation framework provides a robust way of predicting joint torques,musculotendon forces,and muscle activations,which can be beneficial for understanding the biomechanics of normal and pathological gait.展开更多
A variety of indications have been published regarding the use of percutaneous thermal ablation for treating tumors of the musculoskeletal system,including bone and soft tissue lesions,benign and malignant lesions,and...A variety of indications have been published regarding the use of percutaneous thermal ablation for treating tumors of the musculoskeletal system,including bone and soft tissue lesions,benign and malignant lesions,and primary and metastatic tumors.In the appropriately selected patient,the advantages of percutaneous thermal ablation include decreased morbidity,decreased cost,and shorter hospitalization stays compared to surgery.The number of different thermal ablation modalities is increasing,and each modality has its advantages and disadvantages.Studies directly comparing the effectiveness of the various thermal ablation modalities are sparse,however,so the choice of ablation modality often depends on availability,user preference,and local expertise.Although the list of uses for percutaneous thermal ablation is ever-expanding,in this article,we will discuss the two most well-established indications,which are palliation of pain attributed to bone and soft tissue metastases and local control of oligometastatic disease.Numerous clinical trials have shown percutaneous thermal ablation to be an effective method of palliating pain due to bone and soft tissue metastases and of achieving local control in the setting of oligometastatic disease with low rates of complication.展开更多
A severe injury can trigger an inflammation response and excessive response can cause multiple organ failure. HMGB1 is an early inflammation mediator in sterile injury and a late inflammation mediator in infection. It...A severe injury can trigger an inflammation response and excessive response can cause multiple organ failure. HMGB1 is an early inflammation mediator in sterile injury and a late inflammation mediator in infection. It is an important mediator in severe sepsis and always associated with the severity of organ failure. Previous studies showed that the administration of systemic lidocaine could inhibit the expression of HMGB1 on septic mice with musculoskeletal injury. Nine male adult Balb/c mice were grouped by simple random sampling method into three groups of intravenous lidocaine injection dosages: 2 mg/kg, 3 mg/kg, 4 mg/kg. Musculoskeletal injury was done by breaking the left femoral bone in a close manner. Peripheral blood sampling was done 4 hours after injury and 2 hours after lidocaine therap. To evaluate the expression level of HMGB1 mRNA, RT-PCR was used. The result of our study showed that intravenous lidoaine administration on the 3 groups could decrease the level of HMGB1. In conclusion, lidocaine hold an important role in clinical diseases by inhibiting HMGB1.展开更多
BACKGROUND Coronavirus disease 2019(COVID-19)has crippled humanity since early 2020.Various sequelae of COVID-19 have been reported in different body systems.Musculoskeletal symptoms are widely reported during COVID-1...BACKGROUND Coronavirus disease 2019(COVID-19)has crippled humanity since early 2020.Various sequelae of COVID-19 have been reported in different body systems.Musculoskeletal symptoms are widely reported during COVID-19 infection,but musculoskeletal complications in long COVID-19 are underreported.However,post-COVID-19 survivors have reported complaints of persisting or new-onset fatigue,myalgia,arthralgia,arthritis,muscle weakness,etc in clinical practice.The well-known detrimental effects of steroids on the musculoskeletal system coupled with their over-the-counter availability can also be anticipated since they were the cornerstone of life-saving management in this pandemic.AIM To determine the musculoskeletal complications in long COVID.METHODS We performed a systematic review of‘systematic reviews and meta-analyses’.RESULTS Of the 63 articles screened,24 articles were included.Two articles specifically discussed children and adolescents.One article discussed rehabilitation intervention.No article addressed rehabilitation of musculoskeletal issues in long COVID-19 in particular.Fatigue was the most common musculoskeletal complication.CONCLUSION Fatigue is found to be very common along with myalgia and arthralgia.There were no studies on rehabilitation intervention in musculoskeletal complications specifically.Considering the lacuna in literature and the needs of the current situation,further studies are warranted to standardize effective rehabilitation interventions in musculoskeletal complications.More homogenous studies are needed.Studies on functional impairment due to musculoskeletal involvement are essential.展开更多
Background:People working outdoors in the Map Ta Phut pollution control area of Thailand require comprehen-sive health monitoring.In the past,studies have been done on the health effects of pollutants.However,there ar...Background:People working outdoors in the Map Ta Phut pollution control area of Thailand require comprehen-sive health monitoring.In the past,studies have been done on the health effects of pollutants.However,there are few studies on musculoskeletal disorders(MSDs),and Thailand is struggling to meet the Sustainable Development Goals.Methods:This cross-sectional study examines access to health services and factors affecting MSDs among outdoor pollution workers(OPWs).The sample group includes OPWs,including local fisherman,street vendors,public car drivers,and traffic police.We studied 50 people from each of these groups,for a total of 200 people.Data were analyzed with inferential statistics using Chi-square test,McNemar test,and Univariate logistic regression.Results:The OPWs reported experiencing significantly more total MSDs pain than they did in the past(P<0.05).Factors affecting current MSDs pain,including occupation and working days per week,were significant(P<0.05).The street vendor group and public car driver group had(odds ratio[OR]=2.253,95%confidence interval[CI]:1.101 to 5.019)and(OR=2.681,95%CI:1.191 to 6.032)times higher risks of MSDs pain,respectively.OPWs who work>5 days per week had a(OR=1.464,95%CI:1.093 to 2.704)times higher risk of MSDs pain.52.7%of OPWs with MSDs,pain(n=110)had received an annual health check-up.In the past year,50.9%had minor illnesses and 21.8%had severe illnesses.OPWs receiving free treatment and visiting health service stations for no cost comprised 77.3%and 51.8%,respectively.60.9%used their right to receive treatment with universal health insurance cards.Conclusions:The study indicates that occupational groups with MSDs pain problems should exercise this right,according to the worker protection law.Local health agencies should organize activities or create accessible media to promote preventive medicine services,as many OPWs believe that health services can only be accessed when illness occurs.展开更多
The intricate hierarchical structure of musculoskeletal tissues,including bone and interface tissues,necessitates the use of complex scaffold designs and material structures to serve as tissue-engineered substitutes.T...The intricate hierarchical structure of musculoskeletal tissues,including bone and interface tissues,necessitates the use of complex scaffold designs and material structures to serve as tissue-engineered substitutes.This has led to growing interest in the development of gradient bone scaffolds with hierarchical structures mimicking the extracellular matrix of native tissues to achieve improved therapeutic outcomes.Building on the anatomical characteristics of bone and interfacial tissues,this review provides a summary of current strategies used to design and fabricate biomimetic gradient scaffolds for repairing musculoskeletal tissues,specifically focusing on methods used to construct compositional and structural gradients within the scaffolds.The latest applications of gradient scaffolds for the regeneration of bone,osteochondral,and tendon-to-bone interfaces are presented.Furthermore,the current progress of testing gradient scaffolds in physiologically relevant animal models of skeletal repair is discussed,as well as the challenges and prospects of moving these scaffolds into clinical application for treating musculoskeletal injuries.展开更多
基金supported by The National Natural Science Foundation of China(82405429)The Medical and Health Science and Technology Program of Hangzhou(ZD20250272)+1 种基金Key Discipline of Traditional Chinese Medicine in Zhejiang Province(2024-XK-57)The Construction Fund of Key Medical Discipline of Hangzhou(2025HZZD16).
文摘Sarcopenia,a progressive and systemic skeletal muscle disorder marked by the accelerated deterioration of both muscle function and mass,is highly prevalent among the elderly population,significantly contributing to an elevated risk of adverse outcomes,including falls,fractures,and muscle weakness.Clinical investigations have identified a strong correlation between sarcopenia and several prevalent degenerative skeletal muscle disorders.This correlation is attributed to imbalances in joint mechanics resulting from localized muscle atrophy and the influence of musculoskeletal secretory factors.In this review,we discuss the broader implications of sarcopenia and critically evaluate the currently established assessment methods.Furthermore,the clinical significance of prevalent musculoskeletal disorders(including osteoporosis,osteoarthritis,and spinal pathologies)in relation to sarcopenia,alongside the underlying mechanisms influencing this relationship,is summarized.Additionally,the effects of sarcopenia on the therapeutic efficacy of medications and surgical interventions for musculoskeletal conditions are reviewed.Sarcopenia is intricately linked to the onset,progression,and prognosis of musculoskeletal disorders.Future research should prioritize elucidating the potential mechanisms that connect muscle loss with skeletal muscle diseases,and investigating whether mitigating sarcopenia symptoms could decelerate the progression of these disorders,thereby paving new pathways for therapeutic interventions.
基金supported by The National Natural Science Youth Foundation of China(Grant No.82102584).
文摘While bulk RNA sequencing and single-cell RNA sequencing have shed light on cellular heterogeneity and potential molecular mechanisms in the musculoskeletal system in both physiological and various pathological states,the spatial localization of cells and molecules and intercellular interactions within the tissue context require further elucidation.Spatial transcriptomics has revolutionized biological research by simultaneously capturing gene expression profiles and in situ spatial information of tissues,gradually finding applications in musculoskeletal research.This review provides a summary of recent advances in spatial transcriptomics and its application to the musculoskeletal system.The classification and characteristics of data acquisition techniques in spatial transcriptomics are briefly outlined,with an emphasis on widely-adopted representative technologies and the latest technological breakthroughs,accompanied by a concise workflow for incorporating spatial transcriptomics into musculoskeletal system research.The role of spatial transcriptomics in revealing physiological mechanisms of the musculoskeletal system,particularly during developmental processes,is thoroughly summarized.Furthermore,recent discoveries and achievements of this emerging omics tool in addressing inflammatory,traumatic,degenerative,and tumorous diseases of the musculoskeletal system are compiled.Finally,challenges and potential future directions for spatial transcriptomics,both as a field and in its applications in the musculoskeletal system,are discussed.
基金Supported by Wuxi Institute of Translational Medicine Project Program,No.LCYJ202336the Scientific and Technological Achievements Promotion Project of Wuxi Municipal Health Commission Project Program,No.T202336+1 种基金the Hospital Management Innovation Research Project of Jiangsu Hospital Association,No.JSYGY-3-2024-601Jiangsu Provincial Traditional Chinese Medicine Science and Technology Development Plan Project,No.MS2024063.
文摘BACKGROUND Studies have shown that locomotive syndrome(LS)is significantly correlated with adverse outcomes,such as decreased self-care abilities,fractures,and increased mortality.Subthreshold depression(StD)is considered an independent predictor of clinical depression,regarded as its prodromal stage,and even linked to increased mortality risk.Limited research has addressed the prevalence and relationship between LS and StD in elderly cancer patients.Understanding the prevalence of LS and StD among elderly cancer patients and elucidating their relationship will provide evidence to support the development of targeted interventions,thereby improving health outcomes in this population.AIM To investigate the relationship between musculoskeletal system function and predepressive states in elderly cancer patients.METHODS A convenience sampling method was employed to recruit 500 elderly cancer patients undergoing follow-up visits at the Department of Oncology,Affiliated Hospital of Jiangnan University,from April 2024 to December 2024.Participants completed the general information questionnaire, the 25-question Geriatric Locomotive Function Scale, and theGeriatric Depression Scale-Short Form-15. Influencing factors were analyzed, and correlation analyses wereperformed.RESULTSA total of 483 elderly cancer patients successfully completed the study. The prevalence of LS and StD amongparticipants was 56.5% and 38.7%, respectively. Logistic regression analysis identified age, tumor metastasis,exercise habits, and the presence of StD as significant risk factors for LS in elderly cancer patients. Additionally,having three or more chronic diseases and LS were significant predictors for developing StD. Spearman’s correlationanalysis revealed a significant positive correlation between LS and StD (r = 0.424, P < 0.001).CONCLUSIONElderly cancer patients exhibit a high prevalence of LS and StD, conditions which are positively correlated andmutually influential. Thus, it is critical to monitor and address pre-depressive states while evaluating and managingmotor function in this population.
文摘Ultrasound is an essential modality within musculoskeletal imaging, with the recent addition of elastography. The elastic properties of tissues are different from the acoustic impedance used to create B mode imaging and the flow properties used within Doppler imaging, hence elastography provides a different form of tissue assessment. The current role of ultrasound elastography in the musculoskeletal system will be reviewed, in particular with reference to muscles, tendons, ligaments, joints and soft tissue tumours. The different ultrasound elastography methods currently available will be described, in particular strain elastography and shear wave elastography. Future directions of ultrasound elastography in the musculoskeletal system will also be discussed.
基金supported by the National Natural Science Foundation of China(No.81572187,No.81871812 and No.52205590)the Natural Science Foundation of Jiangsu Province(No.BK20220834)+1 种基金project supported by Ruihua Charity Foundation(YL20220525)the Start-up Research Fund of Southeast University(No.RF1028623098).
文摘Disorders of the musculoskeletal system are the major contributors to the global burden of disease and current treatments show limited efficacy.Patients often suffer chronic pain and might eventually have to undergo end-stage surgery.Therefore,future treatments should focus on early detection and intervention of regional lesions.Microrobots have been gradually used in organisms due to their advantages of intelligent,precise and minimally invasive targeted delivery.Through the combination of control and imaging systems,microrobots with good biosafety can be delivered to the desired area for treatment.In the musculoskeletal system,microrobots are mainly utilized to transport stem cells/drugs or to remove hazardous substances from the body.Compared to traditional biomaterial and tissue engineering strategies,active motion improves the efficiency and penetration of local targeting of cells/drugs.This review discusses the frontier applications of microrobotic systems in different tissues of the musculoskeletal system.We summarize the challenges and barriers that hinder clinical translation by evaluating the characteristics of different microrobots and finally point out the future direction of microrobots in the musculoskeletal system.
文摘Chronic pain and general physical discomfort are common symptoms among those seeking medical or physiotherapy treatment, as it relates to disorders found in the Human Musculoskeletal System (HMS). Since this system is highly complex and large in scale, clinical pain research has been confounded by many complex factors. The goal of our research is to overcome these obstacles by applying multidisciplinary approaches including systems engineering, traditional oriental techniques, conventional medicine and related sciences. To pursue such an integrated approach this paper examines the therapist-guided exercise for restoring human musculoskeletal balance called the Somatic Balance Restoration Therapy (SBRT). The SBRT is a simple but effective self-exercise therapy with minimal assistance by a trained therapist. This therapy is analyzed by a mechanical engineering method by modeling the human body as a multi-body subject to a static equilibrium condition. In addition, the wording has been rewritten in functional anatomical terms, enabling smooth communication between specialists of three different disciplines: therapy, conventional medicine and systems engineering. Examples will be given to demonstrate an integrated and systematic approach for identifying and remedying malfunctions within the HMS.
文摘Musculoskeletal injuries are among the most common causes of disability worldwide,with early detection and appropriate intervention critical to minimizing long-term complications.Infrared thermography(IRT)has emerged as a noninvasive,real-time imaging modality that captures superficial temperature changes reflecting underlying physiological processes such as inflammation and vascular alterations.This review explores the fundamental principles of medical thermography,differentiates between passive and active approaches,and outlines key technological advancements including artificial intelligence integration.The clinical utility of IRT is discussed in various contexts–ranging from acute soft tissue injuries and overuse syndromes to chronic pain and rehabilitation monitoring.Comparative insights with conventional imaging techniques such as ultrasound and magnetic resonance imaging are also presented.While IRT offers functional imaging capabilities with advantages in portability,safety,and speed,its limitations–such as lack of deep-tissue penetration and protocol standardization–remain significant barriers to broader adoption.Future directions include the integration of IRT with other imaging modalities and digital health platforms to enhance musculoskeletal assessment and injury prevention strategies.
文摘Molecular hydrogen(H2)demonstrates selective antioxidant and anti-inflammatory properties with therapeutic potential across musculoskeletal conditions including osteoarthritis,rheumatoid arthritis,exercise-induced muscle damage,chronic pain syndromes,tendinopathies,and muscle atrophy.This review critically evaluates preclinical and clinical evidence for H2 therapy and identifies research gaps.A comprehensive search of PubMed,EMBASE,and Cochrane Library(up to April 2025)yielded 45 eligible studies:25 preclinical and 20 clinical trials.Preclinical models consistently showed reductions in reactive oxygen species,inflammatory cytokines,and improved cell viability.Clinical trials reported symptomatic relief in osteoarthritis,decreased Disease Activity Score 28 in rheumatoid arthritis,and accelerated clearance of muscle damage markers.Delivery methods varied-hydrogen-rich water,gas inhalation,and saline infusion-hindering direct comparison.Mechanistic biomarkers were inconsistently reported,limiting understanding of target engagement.Common limitations included small sample sizes,short durations,and protocol heterogeneity.Despite these constraints,findings suggest H2 may serve as a promising adjunctive therapy via antioxidant,anti-inflammatory,and cytoprotective mechanisms.Future research should prioritize standardized delivery protocols,robust mechanistic endpoints,and longer-term randomized trials to validate clinical efficacy and optimize therapeutic strategies.
基金National key R&D program of China(2017YFA0104900)NSFC grants(81874019,81572115,81572157)325 Health High Level Talent project of Zhejiang province,Clinical top young talents cultivation project of Zhejiang university,the Fundamental Research Funds for the Central Universities.
文摘Musculoskeletal disorders are common in clinical practice.Repairing critical-sized defects in musculoskeletal systems remains a challenge for researchers and surgeons,requiring the application of tissue engineering biomaterials.Successful application depends on the response of the host tissue to the biomaterial and specific healing process of each anatomical structure.The commonly-held view is that biomaterials should be biocompatible to minimize local host immune response.However,a growing number of studies have shown that active modulation of the immune cells,particularly macrophages,via biomaterials is an effective way to control immune response and promote tissue regeneration as well as biomaterial integration.Therefore,we critically review the role of macrophages in the repair of injured musculoskeletal system soft tissues,which have relatively poor regenerative capacities,as well as discuss further enhancement of target tissue regeneration via modulation of macrophage polarization by biomaterial-mediated immunomodulation(biomaterial properties and delivery systems).This active regulation approach rather than passive-evade strategy maximizes the potential of biomaterials to promote musculoskeletal system soft tissue regeneration and provides alternative therapeutic options for repairing critical-sized defects.
基金Sanming Project of Medicine in Shenzhen(Grant/Award Number:SZSM202011012)Shenzhen Fund for Guangdong Provincial High-level Clinical Key specialties(Grant/Award Number:No.SZXK035)Shenzhen Innovation Science and Technology Committee(Grant/Award Number:JCYJ20180228175358223)。
文摘Importance:There are a variety of musculoskeletal malformations and injuries that can occur in newborns.These can be a significant cause of perinatal death or a reason for miscarriage and can lead to long-term functional issues if not managed appropriately.There is no systematic and well-established screening program for neonatal musculoskeletal malformations and injuries in China now.Objective:To report the incidence and types of congenital musculoskeletal malformations in two hospitals in Shenzhen City,to explore and discuss the details of the screening procedure and improve future prevention and treatment.Methods:From October 2013 to May 2014,2564 one-day-old newborns were screened by a pediatric orthopedic physical examination,in combination with ultrasonography when required,and the incidence and variety of diseases were recorded statistically.Results:Among 2564 screened newborns,the following musculoskeletal conditions were identified:congenital muscular torticollis(CMT)(seven cases,0.27%),hip subluxation(four cases,0.16%),hip dysplasia(47 cases,1.83%),congenital talipes equinovarus(CTEV)(two cases,0.08%),congenital talipes calcaneovalgus(15 cases,0.58%),polydactyly(nine cases,0.35%),syndactyly(one case,0.04%),and spinal hemivertebra(one case,0.04%).Additionally,there were five(0.19%)neonates with birth injuries.Interpretation:It is feasible to carry out neonatal screening and identification of musculoskeletal malformations and birth injuries in China.This is helpful as timely detection and early intervention for many of these conditions can avoid permanent functional impairment in these children.
基金the National Natural Science Foundation of China,Nos.31900950 and 32000944 and Key Science and Technology Plan Projects in Zigong,No.2022ZCNKY07.
文摘Infection and rejection in musculoskeletal trauma often pose challenges for natural healing,prompting the exploration of biomimetic organ and tissue transplantation as a common alternative solution.Polyhydroxyalkanoates(PHAs)are a large family of biopolyesters synthesised in microorganism,demonstrating excellent biocompatibility and controllable biodegradability for tissue remodelling and drug delivery.With different monomer-combination and polymer-types,multi-mechanical properties of PHAs making them have great application prospects in medical devices with stretching,compression,twist in long time,especially in musculoskeletal tissue engineering.This review systematically summarises the applications of PHAs in multiple tissues repair and drug release,encompassing areas such as bone,cartilage,joint,skin,tendons,ligament,cardiovascular tissue,and nervous tissue.It also discusses challenges encountered in their application,including high production costs,potential cytotoxicity,and uncontrollable particle size distribution.In conclusion,PHAs offer a compelling avenue for musculoskeletal system applications,striking a balance between biocompatibility and mechanical performance.However,addressing challenges in their production and application requires further research to unleash their full potential in tackling the complexities of musculoskeletal regeneration.
文摘Background: Musculoskeletal injuries(MSkIs) are a leading cause of health care utilization, as well as limited duty and disability in the US military and other armed forces. MSkIs affect members of the military during initial training,operational training, and deployment and have a direct negative impact on overall troop readiness. Currently, a systematic overview of all risk factors for MSkIs in the military is not available.Methods: A systematic literature search was carried out using the PubMed, Ovid/Medline, and Web of Science databases from January 1, 2000 to September 10, 2019. Additionally, a reference list scan was performed(using the “snowball method”). Thereafter, an international, multidisciplinary expert panel scored the level of evidence per risk factor, and a classification of modifiable/non-modifiable was made.Results: In total, 176 original papers and 3 meta-analyses were included in the review. A list of 57 reported potential risk factors was formed. For 21 risk factors, the level of evidence was considered moderate or strong. Based on this literature review and an in-depth analysis, the expert panel developed a model to display the most relevant risk factors identified, introducing the idea of the “order of importance” and including concepts that are modifiable/nonmodifiable, as well as extrinsic/intrinsic risk factors.Conclusions: This is the qualitative systematic review of studies on risk factors for MSkIs in the military that has attempted to be all-inclusive. A total of 57 different potential risk factors were identified, and a new, prioritizing injury model was developed. This model may help us to understand risk factors that can be addressed, and in which order they should be prioritized when planning intervention strategies within military groups.
基金the Veterans and Martyrs Affair Foundation (VMAF)Janbazan Medical and Engineering Research Center (JMERC)
文摘Background: Upper limb amputations are one of the unpleasant war injuries that armed forces are exposed to frequently. The present study aimed to assess the musculoskeletal and peripheral nervous systems in Iraq-Iran war veterans with bilateral upper extremity amputation.Methods: The study consisted of taking a history and clinical examinations including demographic data, presence and location of pain, level of amputation, passive and active ranges of movement of the joints across the upper and lower extremities and spine, manual palpation, neurological examination, blood circulation pulses and issues related to a prosthetic limb. In this study, 103 Iranian bilateral upper extremity amputees(206 amputations) from the IranIraq war were evaluated, and a detailed questionnaire was also administered.Results: The most common level of amputation was the finger or wrist level(108, 52.4%). Based on clinical examination, we found high frequencies of limited active and passive joint range of movement across the scapula, shoulder, elbow, wrist and metacarpophalangeal, interphalangeal and thumb joints. Based on muscle strength testing, we found varying degrees of weakness across the upper limbs. Musculoskeletal disorders included epicondylitis(65, 31.6%), rotator cuff injury(24, 11.7%), bicipital tendonitis(69, 33.5%), shoulder drop(42, 20.4%) and muscle atrophy(19, 9.2%). Peripheral nerve disorders included carpal tunnel syndrome in 13(6.3%) and unilateral brachial plexus injury in 1(1%). Fifty-three(51.5%) were diagnosed with facet joint syndrome at the level of the cervical spine(the most frequent site). Using a prosthesis was reported by 65(63.1%), both left and right sides. The back was the most common site of pain(71.8%).Conclusion: The high prevalence of neuro-musculoskeletal disorders among bilateral upper extremity amputees indicates that they need regular rehabilitation care.
基金the National Natural Science Foundations of China(Grant Nos.12102035 and 12125201)the China Postdoctoral Science Foundation(Grant No.2020TQ0042)the Beijing Natural Science Foundation(Grant No.L212008).
文摘Multibody musculoskeletal modeling of human gait has been proved helpful in investigating the pathology of musculoskeletal disorders.However,conventional inverse dynamics methods rely on external force sensors and cannot capture the nonlinear muscle behaviors.Meanwhile,the forward dynamics approach is computationally demanding and only suited for relatively simple tasks.This study proposed an integrated simulation methodology to fulfill the requirements of estimating foot-ground reaction force,tendon elasticity,and muscle recruitment optimization.A hybrid motion capture system,which combines the marker-based infrared device and markerless tracking through deep convolutional neural networks,was developed to track lower limb movements.The foot-ground reaction forces were determined by a contact model for soft materials,and its parameters were estimated using a two-step optimization method.The muscle recruitment problem was first resolved via a static optimization algorithm,and the obtained muscle activations were used as initial values for further simulation.A torque tracking procedure was then performed by minimizing the errors of joint torques calculated by musculotendon equilibrium equations and inverse dynamics.The proposed approach was validated against the electromyography measurements of a healthy subject during gait.The simulation framework provides a robust way of predicting joint torques,musculotendon forces,and muscle activations,which can be beneficial for understanding the biomechanics of normal and pathological gait.
文摘A variety of indications have been published regarding the use of percutaneous thermal ablation for treating tumors of the musculoskeletal system,including bone and soft tissue lesions,benign and malignant lesions,and primary and metastatic tumors.In the appropriately selected patient,the advantages of percutaneous thermal ablation include decreased morbidity,decreased cost,and shorter hospitalization stays compared to surgery.The number of different thermal ablation modalities is increasing,and each modality has its advantages and disadvantages.Studies directly comparing the effectiveness of the various thermal ablation modalities are sparse,however,so the choice of ablation modality often depends on availability,user preference,and local expertise.Although the list of uses for percutaneous thermal ablation is ever-expanding,in this article,we will discuss the two most well-established indications,which are palliation of pain attributed to bone and soft tissue metastases and local control of oligometastatic disease.Numerous clinical trials have shown percutaneous thermal ablation to be an effective method of palliating pain due to bone and soft tissue metastases and of achieving local control in the setting of oligometastatic disease with low rates of complication.
文摘A severe injury can trigger an inflammation response and excessive response can cause multiple organ failure. HMGB1 is an early inflammation mediator in sterile injury and a late inflammation mediator in infection. It is an important mediator in severe sepsis and always associated with the severity of organ failure. Previous studies showed that the administration of systemic lidocaine could inhibit the expression of HMGB1 on septic mice with musculoskeletal injury. Nine male adult Balb/c mice were grouped by simple random sampling method into three groups of intravenous lidocaine injection dosages: 2 mg/kg, 3 mg/kg, 4 mg/kg. Musculoskeletal injury was done by breaking the left femoral bone in a close manner. Peripheral blood sampling was done 4 hours after injury and 2 hours after lidocaine therap. To evaluate the expression level of HMGB1 mRNA, RT-PCR was used. The result of our study showed that intravenous lidoaine administration on the 3 groups could decrease the level of HMGB1. In conclusion, lidocaine hold an important role in clinical diseases by inhibiting HMGB1.
文摘BACKGROUND Coronavirus disease 2019(COVID-19)has crippled humanity since early 2020.Various sequelae of COVID-19 have been reported in different body systems.Musculoskeletal symptoms are widely reported during COVID-19 infection,but musculoskeletal complications in long COVID-19 are underreported.However,post-COVID-19 survivors have reported complaints of persisting or new-onset fatigue,myalgia,arthralgia,arthritis,muscle weakness,etc in clinical practice.The well-known detrimental effects of steroids on the musculoskeletal system coupled with their over-the-counter availability can also be anticipated since they were the cornerstone of life-saving management in this pandemic.AIM To determine the musculoskeletal complications in long COVID.METHODS We performed a systematic review of‘systematic reviews and meta-analyses’.RESULTS Of the 63 articles screened,24 articles were included.Two articles specifically discussed children and adolescents.One article discussed rehabilitation intervention.No article addressed rehabilitation of musculoskeletal issues in long COVID-19 in particular.Fatigue was the most common musculoskeletal complication.CONCLUSION Fatigue is found to be very common along with myalgia and arthralgia.There were no studies on rehabilitation intervention in musculoskeletal complications specifically.Considering the lacuna in literature and the needs of the current situation,further studies are warranted to standardize effective rehabilitation interventions in musculoskeletal complications.More homogenous studies are needed.Studies on functional impairment due to musculoskeletal involvement are essential.
基金grant Fundamental Fund of National Science Research and Innovation Fund(NSRF)via Burapha University of Thailand(Grant number 52/2024).
文摘Background:People working outdoors in the Map Ta Phut pollution control area of Thailand require comprehen-sive health monitoring.In the past,studies have been done on the health effects of pollutants.However,there are few studies on musculoskeletal disorders(MSDs),and Thailand is struggling to meet the Sustainable Development Goals.Methods:This cross-sectional study examines access to health services and factors affecting MSDs among outdoor pollution workers(OPWs).The sample group includes OPWs,including local fisherman,street vendors,public car drivers,and traffic police.We studied 50 people from each of these groups,for a total of 200 people.Data were analyzed with inferential statistics using Chi-square test,McNemar test,and Univariate logistic regression.Results:The OPWs reported experiencing significantly more total MSDs pain than they did in the past(P<0.05).Factors affecting current MSDs pain,including occupation and working days per week,were significant(P<0.05).The street vendor group and public car driver group had(odds ratio[OR]=2.253,95%confidence interval[CI]:1.101 to 5.019)and(OR=2.681,95%CI:1.191 to 6.032)times higher risks of MSDs pain,respectively.OPWs who work>5 days per week had a(OR=1.464,95%CI:1.093 to 2.704)times higher risk of MSDs pain.52.7%of OPWs with MSDs,pain(n=110)had received an annual health check-up.In the past year,50.9%had minor illnesses and 21.8%had severe illnesses.OPWs receiving free treatment and visiting health service stations for no cost comprised 77.3%and 51.8%,respectively.60.9%used their right to receive treatment with universal health insurance cards.Conclusions:The study indicates that occupational groups with MSDs pain problems should exercise this right,according to the worker protection law.Local health agencies should organize activities or create accessible media to promote preventive medicine services,as many OPWs believe that health services can only be accessed when illness occurs.
基金supported by the National Natural Science Foundation of China(Grant No.52473121,52403370 and 52221006)Fundamental Research Funds for the Central Universities(buctrc202020,buctrc202312).
文摘The intricate hierarchical structure of musculoskeletal tissues,including bone and interface tissues,necessitates the use of complex scaffold designs and material structures to serve as tissue-engineered substitutes.This has led to growing interest in the development of gradient bone scaffolds with hierarchical structures mimicking the extracellular matrix of native tissues to achieve improved therapeutic outcomes.Building on the anatomical characteristics of bone and interfacial tissues,this review provides a summary of current strategies used to design and fabricate biomimetic gradient scaffolds for repairing musculoskeletal tissues,specifically focusing on methods used to construct compositional and structural gradients within the scaffolds.The latest applications of gradient scaffolds for the regeneration of bone,osteochondral,and tendon-to-bone interfaces are presented.Furthermore,the current progress of testing gradient scaffolds in physiologically relevant animal models of skeletal repair is discussed,as well as the challenges and prospects of moving these scaffolds into clinical application for treating musculoskeletal injuries.
