Osteoarthritis (OA) is a highly prevalent degenerative joint disease, characterized by pain, deformity and limited function, which represents a substantial burden for affected individuals, families, and the society. Knee OA accounts for the highest proportion. Primary clinics take the community as the service object. Compared with large-scale hospitals, primary clinics pay more attention to the universal, efficient and practical preventions and interventions related to diseases, aiming to achieve following comprehensive role, including prevention, health care and rehabilitation. The present guideline was initiated by the Joint Surgery Branch of the Chinese Orthopaedic Association and Peking University Arthritis Institute. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, the Reporting Items for Practice Guidelines in Healthcare (RIGHT) checklist, and Scientificity, Transparency, and Applicability Rankings (STAR) Guideline Quality Evaluation Checklist were utilized. Finally, a total of 11 evidence-based recommendations were formulated based on 11 most concerned clinical questions in practitioners in primary clinics in China. This guideline intended to improve the scientificity of knee OA diagnosis and treatment medical services in primary clinics.

Axial spondyloarthritis (axial SpA, ax-SpA) is a group of diseases which are characterised by chronic progressive inflammation of the axial joints of spine and the surrounding tissues. In the early stage, an ax-SpA lacks specific symptoms and it is often missed, misdiagnosed or delayed in diagnosis. In the late stage, it causes ankylosing deformities of spine or the affected spinal joints, often leads to a lifelong disability. The Joint Surgery Group of Orthopaedic Branch of the Chinese Medical Association and Physicians Branch of the Chinese Medical Doctor Association assembled an experts editing group to draft a newer version of an expert consensus in order to effectively improve an early and comprehensive diagnosis and treatment of ax-SpA. Base on the 2019 version of expert consensus, comprehensive reviews of international guidelines for the diagnosis and treatment of axial spinal arthritis was conducted, evidences of evidence-based medicine were analysed, and recommendations were concluded through multiple rounds of discussions. A new version of the expert consensus on the diagnosis and treatment of axial spondyloarthritis is hereby created.

Hip osteoporosis fracture (also known as hip brittle fracture) refers to a fracture that occurs after minor trauma resulted from a serious consequence of osteoporosis. Hip fracture is also a common type of fracture in the elderly. In recent years, the incidence of hip fracture in China has shown a significant upward trend. The surgical treatment methods for elderly hip fractures commonly include internal fixation or hip joint replacement. However, if osteoporosis hip fractures are not diagnosed correctly in time and receive standardized, effective, and comprehensive anti osteoporosis treatment after surgery, there would be a great risk of re-fracture and prosthesis loosening. Therefore, developing personalized treatment plans target to the specific risks and health status of patients and using of anti osteoporosis drugs timely and correctly are key to reducing postoperative complications. This guideline aims to provide clinical guidance on the selection and management of anti-osteoporosis drugs after osteoporosis hip fracture surgery, help clinician to choose drug treatment plans more reasonably, help patients with hip fracture surgery to recover as soon as possible, reduce bedridden time, and reduce the incidence of re-fracture and prosthesis loosening.

Osteoarthritis (OA) is a highly prevalent degenerative joint disease, characterized by pain, deformity and limited function, which represents a substantial burden for affected individuals, families, and the society. Topical medicine is a large class of commonly used interventions for the treatment of OA. However, in current clinical practice, there are various types of topical medicine with different components, mechanisms of action and varied dosage forms. At present, there is no consensus on the application of topical medicine in clinical implementation. Therefore, how to choose topical medicine effectively and correctly is an issue that clinicians concern about. The present guideline was initiated by the Joint Surgery Branch of the Chinese Orthopaedic Association. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, the scientificity, transparency and applicability ranking tools (STAR), the Appraisal of Guidelines for Research and Evaluation (AGREE)Ⅱ, and the Reporting Items for Practice Guidelines in Healthcare (RIGHT) were utilized to formulate nine evidence-based recommendations based on nine most concerned clinical questions from practitioners in primary clinics in China. This guideline intended to improve the scientificity of topical medicine for OA ultimately.

Borderline developmental dysplasia of the hip (BDDH) is a special type in adult between developmental dysplasia of the hip (DDH) and normal hip. Its diagnosis and treatment is controversial and has always been a hot spot and difficulty in sports medicine and hip preservation. In order to further improve the standardization of diagnosis and treatment of the BDDH, this consensus was led by the Youth Group and the Sports Trauma of Hip joint Committee of Chinese Society of Sports Medicine of the Chinese Medical Association, the Hip Preservation Group of the Reparative and Reconstruction Surgery Committee of Chinese Association of Rehabilitation Medicine, the Hip Preservation Group of Chinese Association of Orthopaedic Surgeons, the National Clinical Medical Research Center for Orthopaedics and Sports Rehabilitation, and the Sports Medicin Department of Senior Department of Orthopedics, the PLA General Hospital. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach and the Reporting Items for Practice Guidelines in Healthcare (RIGHT) checklist were adopted. Finally, 38 evidence-based recommendations were formulated based on 13 most concerned clinical problems. This consensus intended to improve the scientific nature of BDDH diagnosis and treatment and ultimately improve the quality of patient centered medical services.

Anterior cruciate ligament(ACL) reconstruction of the knee is associated with a certain risk of failure, and the failure rate is higher in high-risk patients. With the discovery and recognition of roles of anterolateral structure(ALS) in maintaining the rotation stability in normal knee, it is possible to augment or reconstruct ALS in combination with ACL reconstruction to reduce the failure rate in the patients with high-risk factors for ACL injuries. Therefore, on the basis of evidence-based medicine, the expert group summarized and discussed literature on the definition, preoperative evaluation, surgical indications, surgical techniques and strategies, principles in postoperative rehabilitation, and prevention and management of complications for the ALS of knee, and developed this consensus. The proposed consensus will provide physicians with a complete set of clinical routines and pathways for the diagnosis and managment in selecting ALS augmentation or reconstruction when performing ACL reconstruction in the patients with high risks of failure and revision surgeries.

2022年8月6日，《中华关节外科杂志(电子版)》第四届编委会成立大会顺利在西安召开。西安交通大学第二附属医院骨关节外科杨佩教授主持会议，会议特别邀请北京协和医院邱贵兴院士、广州医科大学附属第一医院余楠生教授、西安交通大学第二附属医院李宗芳院长、西安交通大学第二附属医院王坤正教授、广州医科大学附属第一医院白波教授、中华医学电子音像出版社李军亮主任、中华医学会期刊部卢全同志、《中华关节外科杂志(电子版)》编辑部主任、广州医科大学附属第一医院卢伟杰教授出席会议。

2022年8月6日，《中华关节外科杂志(电子版)》迎来了第四届编辑委员会的成立。

In order to develop Chinese guideline for diagnosis, treatment and rehabilitation of knee osteoarthritis in primary clinics, the guideline working group was established in March 2022 by the Joint Surgery Branch of the Chinese Orthopaedic Association and Peking University Arthritis Institute. The Guideline Working Group developed the guideline in accordance with the World Health Organization (WHO) guidelines , the Methodology for Developing Clinical Practice Guidelines, the definition of institution of Medicine (IOM) , the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, the Reporting Items for Practice Guidelines in Healthcare (RIGHT) checklist, and STAR guideline quality evaluation checklist.

In order to promote the effective and correct selection and application of topical drugs for osteoarthritis in China, the Clinical Practice Guidelines for Topical Drugs for Osteoarthritis in China was initiated by the Joint Surgery Group of the Chinese Academy of Orthopedics, and a group of professionals working on the guidelines was set up in strict accordance with the definitions in latest guidelines of the Institution of Medicine (IOM) and to complete the prospectus of guidelines according to the guidelines for developing methodology issued by World Health Organization (WHO), Grade of Recommendations Assessment, Development and Evaluation (GRADE), Reporting Items for Practice Guidelines in Healthcare (RIGHT) and Appraisal of Guidelines Research and Evaluation II (AGREE II).

Ankle is the main load-bearing joint of a human body. Ankle osteoarthritis (OA) can be induced by various causes such as injury and strain. It is a degenerative, chronic osteoarthropathy characterised by degenerative damage of articular cartilage and reactive hyperplasia of bone at edges of joint and sub-cartilage. The common clinical manifestations are chronic pain, tenderness and limited movement of ankle, as well as symptoms of ankle deformity and bone fricative, etc.. In an early ankle OA, conservative treatment is used, including exercise therapy, physiotherapies, non-steroidal anti-inflammatory drugs (NSAIDs), traditional Chinese medicine and interventional therapies such as intraarticular injection of drugs to relieve pains and delay the disease progression. For an advanced ankle OA, surgical treatment such as ankle arthrodesis, ankle arthroplasty and other surgeries are applied according to the affected ankle. At present, there have been ever more in-depth studies on injection of plateletvrich plasma (PRP), cartilage or periosteum graft and osteotomy in the treatment of ankle arthritis in early and middle stage. This article reviewed the progress in treatment of ankle osteoarthritis.

患者女，14岁，因"右侧臀部疼痛10 d，加重5 d"入住广州医科大学附属第三医院关节外科。患者10 d前长跑后出现右侧臀部疼痛，为持续性隐痛，无向他处放射，行走及弯腰时疼痛明显，休息后疼痛可缓解，对侧无明显疼痛，无下肢麻木、发凉、肿胀；无盗汗、发热畏寒、头晕头痛、腰痛等不适。5 d前，患者自觉右侧臀部疼痛加重，并出现右侧臀部皮疹，伴行走困难及双下肢乏力，在外院就诊，查尿液分析提示尿白细胞阳性，外院予止痛、消肿、抗感染等治疗后，疼痛稍缓解，使用抗生素后尿白细胞由阳转阴，但仍存在行走困难伴双下肢乏力。入院当天早晨患者出现低热(体温37.9 ℃)，伴畏寒，无伴鼻塞流涕、咳嗽咳痰。在广州医科大学附属第三医院门诊查生化分析显示：肌红蛋白<21 ng/ml(25～28 ng/ml)，白蛋白33.6 g/L(42～56)，淀粉酶30 U/L(35～135)，肌酸激酶同工酶、肌酸激酶、乳酸脱氢酶均正常。入院时体温37 ℃、脉搏101次/min、呼吸20次/min；血压107/73 mmHg。发育正常，痛苦面容，神志清楚，右侧骶髂关节局部压痛，右髋活动明显痛性受限，髋关节屈伸活动度患者疼痛无法完成，右下肢其余关节、肌力、感觉功能等均正常，骨盆挤压试验(＋)。

Total hip arthroplasty (THA) is a major procedure that plays an important role in relieving pain and restoring function in end-stage hip related diseases, and the number of THA procedures continues to grow at a high rate. Unfortunately, there is no guideline or expert consensus on the choice of THA approach in China or abroad. Therefore, to formulate the clinical practice guidelines for THA approach selection based on evidence-based medicine is of major importance. The guidelines were developed by the Joint Surgery Group of the Orthopaedic Branch of the Chinese Medical Association and Chinese Journal of Joint Surgery (Electronic Edition) and were designed and developed in accordance with the World Health Organization Manual for the Development of Guidelines and the Basic Methods and Procedures for the Development/Revision of Clinical Guidelines. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach and the Reporting Items for Practice Guidelines in Healthcare (RIGHT) checklist were adopted. Finally, 11 clinical questions were selected, resulting in 11 evidence-based medical recommendations. The guidelines are intended to guide the clinical practice of a wide range of relevant healthcare professionals in relation to surgical approach selection and to normative guidelines for a good prognosis for patients with THA.

Gouty arthritis of knee is a kind of crystal arthritis, which is common in clinic. Due to excessive production or reduced excretion of uric acid in the body, the level of blood uric acid increases and urate deposits in the knee joint. Although medical treatment can obtain good treatment results, patients with advanced gouty knee arthritis often have joint dysfunction, even infection and sinus formation, which seriously affect the quality of life of patients. At this time, the curative effect of drug intervention can not meet the clinical expectation, and corresponding surgical treatment should be taken. This review introduced the progress of surgical treatment of gouty arthritis of knee in recent years.

This prospectus was released to set up a plan in developing the expert consensus for diagnosis and treatment of the borderline developmental dysplasia of hip, and to ensure the objectivity, transparency, standardization and scientific nature of the formulation of consensus. This consensus was leaded by the Department of Sports Medicine, Senior Department of Orthopedics, the PLA General Hospital, and established the multi-disciplinary expert group. The International Standardization Organization (ISO) for the definition of expert consensus, the World Health Organization (WHO) guidelines for manuals, the Grading of Recommendations Assessment, Development and Evaluation(GRADE)and the Reporting Items for Practice Guidelines in Healthcare (RIGHT) were referenced to make the protocol. The Consensus Expert Working Group was established in Dec 2021, which clarified the composition and responsibilities of the Consensus Steering Committee, Development Expert Group, Compilation Group, External Experts and Secretary Group. The protocol defined the declaration of interests and funding support, the clinical problems and the outcome indicators, evidence searched and assessment, developing recommendations, external review of consensus, reporting publication and updating of the consensus, promotion and evaluation, the target and user population. The aim was to develop a practical, scientific, rigorous, open and transparent consensus.

Joint replacement registries have been demonstrated to be a potent tool for the outcome evaluation after joint replacement surgeries. Until now, many countries in the world have established relatively complete artificial joint replacement registries. These systems register the patients’ preoperative data, surgical conditions, postoperative effects, and follow-up in detail, through which the national epidemiological data are obtained and risk factors for revision are analyzed so as to reduce the revision rate while improve the quality of treatment. However, China has not yet built a decent artificial joint replacement registration and follow-up system on national scales. This review introduced the establishment, development and functions of the major joint replacement registries in the world, with the expectation to provide a reference for the establishment of a Chinese national joint replacement registry.

Anterior cruciate ligament (ACL) injury has always been the most common sport injury of the knee. It is necessary to provide timely and effective medical treatment to patients suffering anterior cruciate ligament injury. However, clinicians have confusion in diagnosis of anterior cruciate ligament injury, surgical indications, surgical methods, graft types, rehabilitation program as well as return-to-sport tests. Thus s series of ACL treatment guidelines and consensuses have been published by some international research organizations based on the available knowledge. Besides, there are inheritance, development and even controversies among these guidelines. In this article, treatment suggestions to controversial clinical issues were summarized after thoroughly interpretation and analysis of these guidelines. It is hoped to provide reference for clinicians.