Objective To provide a comprehensive overview of the surgical treatments of osteochondral lesion of talus (OLT) and offer valuable insights for clinical practice. Methods The advantages and limitations of surgical treatments for OLT were comprehensively summarized through an extensive review of domestic and abroad relevant literature in recent years. Results Currently, there exist numerous surgical treatments for the OLT, all of which can yield favorable outcomes. However, each method possesses its own set of merits and demerits. The short-term effectiveness of bone marrow stimulation in treating primary OLT with a diameter less than 15 mm is evident, but its long-term effectiveness diminishes over time. Autologous osteochondral transplantation (AOT) and osteochondral allograft transplantation (OAT) are suitable for OLT with large defects and subchondral bone cysts. However, incomplete anatomical matching between the donor and recipient bones may results in the formation of new subchondral bone cysts, while AOT also presents potential complications at the donor site. In contrast to AOT and OAT, particulated juvenile cartilage allograft transplantation obviates the need for additional osteotomy. Furthermore, juvenile cartilage exhibits enhanced potential in delivering active chondrocytes to the site of cartilage defect, surpassing that of adult cartilage in tissue repair efficacy. Cell transplantation has demonstrated satisfactory effectiveness; however, it is associated with challenges such as the requirement for secondary surgery and high costs. Autologous matrix-induced chondrogenesis technology has shown promising effectiveness in the treatment of primary and non-primary OLT and OLT with large defect and subchondral bone cysts. However, there is a scarcity of relevant studies, most of which exhibit low quality. Adjuvant therapy utilizing biological agents represents a novel approach to treating OLT; nevertheless, due to insufficient support from high-quality studies, it has not exhibited significant advantages over traditional treatment methods. Furthermore, its long-term effectiveness remain unclear. Conclusion The optimal choice of surgical treatment for OLT is contingent not only upon the characteristics such as nature, size, and shape but also takes into consideration factors like advancements in medical technology, patient acceptance, economic status, and other pertinent aspects to deliver personalized treatment.
Objective To review current research advances in Pendulum Leg Swing Therapy for the management of knee osteoarthritis (KOA). MethodsRelevant research literature published in recent years was reviewed, and progress in the field was summarized across five dimensions: theoretical origin, mechanisms of action, clinical evidence, limitations of existing research, and future directions. Results Derived from ancient Chinese Daoyin Therapy, Pendulum Leg Swing Therapy activates and strengthens the periarticular musculature of the knee and hip to enhance knee joint stability. On this basis, it optimizes local biomechanical loading of the joint, improves blood circulation and metabolic homeostasis, and modulates the inflammatory microenvironment, exerting synergistic therapeutic effects via multiple targets. In clinical settings, Pendulum Leg Swing Therapy demonstrates notable advantages in pain relief, joint function improvement, muscle strength enhancement, and patient adherence. When administered as monotherapy or in combination with other interventions, its efficacy is non-inferior to that of conventional physiotherapy, structured exercise therapy, pharmacological interventions, and intra-articular injections. Nevertheless, certain safety risks remain. Comprehensive baseline assessments must be performed for all patients prior to treatment. For individuals with lumbar or lower extremity disorders, high habitual physical activity levels, or severe KOA, training intensity should be reduced, movement patterns modified, or adjunctive therapies added to compensate for the limitations of monotherapy. Throughout the treatment course, clinicians are required to strengthen supervision, standardize training protocols, and prohibit patients from independently adjusting training volume or exercise intensity. ConclusionPreliminary and positive progress has been made in clinical research on Pendulum Leg Swing Therapy, covering both efficacy validation and safety evaluation. Going forward, large-sample, multi-centre randomized controlled trials with long-term follow-up are warranted to further elucidate underlying mechanisms and provide robust evidence for the formulation of clinical guidelines and optimization of treatment regimens. Meanwhile, integrating precision medicine frameworks to construct efficacy prediction models and individualized training protocols, alongside biosensor-enabled monitoring for home-based training, will elevate the standardization of this therapy and improve long-term patient adherence.