The role of the lymphatic system in musculoskeletal system health and disease: research progress and future directions

The lymphatic system is widely distributed in skeletal muscles, joints, and skeletal tissues and plays a key role in maintaining immune homeostasis, regulating inflammatory responses, and tissue repair. In recent years, an increasing number of studies have shown that morphological and functional changes in lymphatic vessels are closely associated with the onset and progression of a variety of musculoskeletal disorders (MSDs), such as osteoarthritis (OA), fractures, and muscular dystrophy. However, the specific mechanisms of the lymphatic system's role in these diseases have not been fully elucidated, and their potential clinical value remains to be thoroughly explored. In this review, we review the recent research progress on the structure, function, and pathophysiological role of the lymphatic system in the musculoskeletal system, and we focus on the association between lymphangiogenesis, dysfunction, and MSDs, and systematically summarize the therapeutic strategies targeting the lymphatic system. In addition, we summarize the limitations of current studies and propose key directions for future research, with a view to providing new ideas for basic research and clinical intervention in MSDs.