Clinical Orthopaedics and Related Research®最新文献

{"title":"Long Head of Biceps Tendinopathy Is Associated With Age and Cuff Tendinopathy on MRI Obtained for Evaluation of Shoulder Pain.","authors":"Kathryn Canavan, Qais Zai, David Bruni, Jeremiah Alexander, Koen D Oude Nijhuis, David Ring","doi":"10.1097/CORR.0000000000003342","DOIUrl":"10.1097/CORR.0000000000003342","url":null,"abstract":"<p><strong>Background: </strong>Shoulder pain-mostly related to rotator cuff tendinopathy-is the most common reason adults seek upper limb specialty care. Tendinopathy of the long head of the biceps may be part of rotator cuff tendinopathy, which most of us develop as we age. Evidence that these processes are related and that both are part of human shoulder senescence could contribute to a reconceptualization of shoulder tendinopathy as a single set of age-related changes, which are often well-accommodated, sometimes misinterpreted as an injury, and associated with notable nonspecific treatment effects, thus meriting caution regarding the potential for overtreatment.</p><p><strong>Questions/purposes: </strong>This study reviewed a consecutive series of MRI scans ordered for the evaluation of shoulder pain and asked: (1) Is long head of the biceps tendinopathy associated with advancing age? (2) Is long head of the biceps tendinopathy associated with concomitant degeneration of the rotator cuff tendons?</p><p><strong>Methods: </strong>Five hundred consecutive radiologist interpretations of MRIs of the shoulder obtained between May 2016 and June 2017 for assessment of shoulder pain in adults at a radiology group that provides approximately 80% of the imaging in all practices in our region were reviewed. Patients with bilateral MRIs had one MRI included at random. Patients with fractures, dislocations, previous surgery, and soft tissue masses seen on MRI were excluded, leaving 406 shoulder MRI interpretations for review. The radiology reports were used to identify the presence and severity of rotator cuff and long head of the biceps tendinopathy. Forty-nine percent (197 of 406) were men with a mean ± SD age of 55 ± 14 years, and 54% (220 of 406) were right shoulders. Multivariable analyses accounting for age and gender evaluated the association of long head of the biceps tendinopathy with age and tendinopathy of the rotator cuff tendons.</p><p><strong>Results: </strong>After controlling for tendinopathy of the other rotator cuff tendons, long head of the biceps tendinopathy was more common with advancing age (OR 1.04 [95% CI 1.02 to 1.06] per year; p < 0.001), meaning the prevalence increases by approximately 4% per year. Among people who were imaged for shoulder pain, everyone 85 years or older had both long head of the biceps and rotator cuff tendinopathy. Any rotator cuff pathophysiology was also notably associated with any long head of the biceps pathophysiology (OR 6.9 [95% CI 2.4 to 20]; p < 0.001). About half (49% [162 of 328]) of long head of the biceps tendons were normal in the presence of any supraspinatus tendinopathy, and 5% (9 of 175) of supraspinatus tendons were normal in the presence of any long head of the biceps tendinopathy.</p><p><strong>Conclusion: </strong>The finding that among people seeking care for shoulder pain, long head of the biceps tendinopathy and rotator cuff tendinopathy occur together and are more common with incre","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"869-877"},"PeriodicalIF":4.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hip-Spine Relationship in Femoroacetabular Impingement: Does Hip Arthroscopy Affect Pelvic Mobility?","authors":"Jessica Stambaugh, Patrick Morrissey, Andrew Hurvitz, Ethan Bernstein, Brian Barlow","doi":"10.1097/CORR.0000000000003348","DOIUrl":"10.1097/CORR.0000000000003348","url":null,"abstract":"<p><strong>Background: </strong>Femoroacetabular impingement (FAI) is a well-recognized cause of hip pain in adults. The hip-spine relationship between the femur, pelvis, and lumbosacral spine has garnered recent attention in hip arthroplasty. However, the hip-spine relationship has not been well described in patients with FAI.</p><p><strong>Questions/purposes: </strong>The goal of this study was to determine whether lumbopelvic mobility is altered after hip arthroscopy. Does lumbopelvic motion, defined as the difference between standing and sitting measurements for sacral slope (SS), pelvic tilt (PT), and pelvic-femoral angle (PFA), change after hip arthroscopy for FAI?</p><p><strong>Methods: </strong>Between June 2019 and March 2020, one surgeon performed 43 arthroscopic hip labral repair surgeries for FAI in active-duty military servicemembers. The diagnosis of FAI was made clinically and with standing AP pelvis, Dunn lateral, and false-profile radiographs. All patients underwent advanced imaging, including 3T MRI to identify labral tears and three-dimensional CT to characterize bony morphology. The musculoskeletal radiologist measured alpha angle, lateral center-edge angle, anterior center-edge angle, neck-shaft angle, femoral version, and acetabular version at 1200, 1300, 1400, and 1500 using CT. Patients also underwent a diagnostic fluoroscopic-guided injection with local anesthetic and corticosteroids; > 50% pain relief was considered a positive response to injection. During the study period, the operative surgeon did not perform any open procedures for FAI; all surgical treatment was performed arthroscopically. Preoperative sitting and standing radiographs were obtained from all patients. Ninety-five percent (41 of 43) of the cohort underwent adequate postoperative sitting and standing radiographs obtained 2 months after surgery, which were used for analysis in this retrospective study. The cohort was 71% male (29 of 41) and 29% female (12 of 41), with a mean age of 33 years. Within this military population undergoing primary hip arthroscopy, 30 were enlisted servicemembers and 11 were officers. SS, PT, and PFA were measured by four observers on sitting and standing lateral pelvic radiographs. Interclass correlation statistics indicated high reliability for SS, PT, and seated PFA (κ range 0.75 to 1.00) compared with lower reliability for standing PFA measurements (κ range 0.59 to 0.65). The delta between standing and sitting SS, PT, and PFA was compared perioperatively. Student t-test analysis was used for comparisons (p < 0.05).</p><p><strong>Results: </strong>Lumbosacral motion in the sitting position changed after hip arthroscopy. Measurements of the standing lumbopelvic mobility did not change with hip arthroscopy: ΔSS = 1.8° (p = 0.13), ΔPT = -0.56° (p = 0.50), ΔPFA = 0.54° (p = 0.50). However, measurements of sitting lumbopelvic mobility did change with hip arthroscopy. SS diminished (Δ = -4.3°; p = 0.008), PT increased (Δ = +3.9°; ","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"846-852"},"PeriodicalIF":4.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CORR Insights®: How Is Preoperative Opioid Use Associated With Readmissions and Outcomes in Lower Extremity Trauma?","authors":"Jaimo Ahn","doi":"10.1097/CORR.0000000000003403","DOIUrl":"10.1097/CORR.0000000000003403","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"928-929"},"PeriodicalIF":4.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CORR Insights®: Long Head of Biceps Tendinopathy Is Associated With Age and Cuff Tendinopathy on MRI Obtained for Evaluation of Shoulder Pain.","authors":"Gabriella Ode","doi":"10.1097/CORR.0000000000003411","DOIUrl":"10.1097/CORR.0000000000003411","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"878-880"},"PeriodicalIF":4.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Residency Diary: Practical Immortality.","authors":"Lisa G M Friedman","doi":"10.1097/CORR.0000000000003355","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003355","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"483 5","pages":"803-804"},"PeriodicalIF":4.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Accurate and Effective Are Non-image-guided Thumb Basal Joint Injections When Performed by Experienced Fellowship-trained Hand Surgeons?","authors":"Gerardo E Sanchez-Navarro, Madeline C Rocks, Omri Ayalon, Nader Paksima, Jacques H Hacquebord, Steven Z Glickel","doi":"10.1097/CORR.0000000000003328","DOIUrl":"10.1097/CORR.0000000000003328","url":null,"abstract":"<p><strong>Background: </strong>Corticosteroid injections are widely used for treating thumb carpometacarpal (CMC) arthritis, yet the accuracy of non-image-guided injections in expert hands is uncertain, with prior studies reporting intraarticular placement in about 60% of thumbs when performed by physicians with different levels of training. Despite their common use, there is a need to assess both the accuracy and the short-term clinical efficacy of these injections, particularly when performed without image guidance by fellowship-trained hand surgeons.</p><p><strong>Questions/purposes: </strong>(1) What is the accuracy of thumb CMC injections performed without image guidance by fellowship-trained hand surgeons in an office setting? (2) What is the short-term efficacy of thumb CMC injections performed without image guidance?</p><p><strong>Methods: </strong>We prospectively enrolled 33 patients with a mean ± SD age of 63 ± 12 years, 76% (25) of whom were female, with symptoms of basal joint arthritis that persisted despite conservative treatment, and we administered 1.5-mL corticosteroid injections without image guidance. We used descriptive statistics to analyze the outcomes, which included VAS, QuickDASH (Q-DASH), and Thumb Disability Examination (TDX) scores. Minimum clinically important differences (MCIDs) were defined as 0.9 points for the VAS, 18 points for Q-DASH, and 17 points for TDX.</p><p><strong>Results: </strong>Of the 33 injections analyzed, 79% (26) were intraarticular. At 6 weeks, patients reported a mean improvement of 22 points in QuickDASH, 24 points in TDX, and 4 points in VAS scores. Importantly, 73% (24 of 33), 55% (18 of 33), and 82% (27 of 33) of the patients achieved the MCID in the patient-reported outcomes, respectively, suggesting that even without image guidance, corticosteroid injections can provide effective short-term relief for thumb CMC arthritis.</p><p><strong>Conclusion: </strong>We found that about 79% of injections were placed intraarticularly, which was comparable with the findings of previous studies using image guidance, and provided meaningful improvements in pain and function for 6 weeks. These findings suggest that for experienced fellowship-trained hand surgeons, non-image-guided injections remain a viable option. Future studies should explore long-term outcomes and the potential role of adjunctive treatments such as antiinflammatory medications and splinting to enhance patient care.</p><p><strong>Level of evidence: </strong>Level II, therapeutic study.</p>","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"892-898"},"PeriodicalIF":4.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CORR Synthesis: What Is the Impact of Frailty on Postoperative Complications After Spinal Surgery?","authors":"Anant Tewari, Stephen D Lockey","doi":"10.1097/CORR.0000000000003382","DOIUrl":"10.1097/CORR.0000000000003382","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"808-819"},"PeriodicalIF":4.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fracture of the Anteromedial Facet of the Coronoid is More Common Than Previously Thought in Combined Fractures of the Coronoid and Radial Head.","authors":"Huub H de Klerk, Neal C Chen, Nadia Azib, Nadalini Nettuno, Robert Kaspar Wagner, Michel P J van den Bekerom, Abhiram R Bhashyam, Job N Doornberg","doi":"10.1097/CORR.0000000000003337","DOIUrl":"10.1097/CORR.0000000000003337","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The terrible triad injury involves an ulnohumeral dislocation, radial head fracture, and coronoid process fracture. According to traditional teaching, these injuries are strongly associated with anterolateral coronoid tip fractures and can be addressed via a lateral approach to the elbow. However, recent small clinical series suggest that some terrible triad injuries have larger coronoid fractures involving the anteromedial facet. It is important to understand how often these larger coronoid fractures occur because anteromedial facet fractures may need a different approach and different implants for fixation. An improved understanding of coronoid fracture morphology in terrible triad injuries may help surgeons construct a surgical plan.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Questions/purposes: &lt;/strong&gt;To better define coronoid fracture morphology in combined coronoid and radial head fractures, we therefore asked: What is the distribution of anterolateral facet versus anteromedial facet coronoid fragments in combined coronoid and radial head fractures without an ulnar shaft fracture?&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective, multicenter descriptive study evaluated preoperative CT scans from adult patients (18 years or older) diagnosed with combined coronoid and radial head fractures. Between February 2014 and March 2023, we identified 10,016 adult patients with elbow or forearm injuries who underwent CT scans. Among these patients, we considered those diagnosed with combined coronoid and radial head fractures without an ulnar shaft fracture based on elbow CT scans performed within 4 weeks of the injury as potentially eligible. During that time, elbow CT scans were generally ordered to assess complex fractures, confirm diagnoses when radiographs were inconclusive, evaluate joint involvement, or plan for surgical interventions. Based on that, 2% (175 of 10,016) were eligible; a further 0.001% (8 of 10,016) were excluded because of preexisting elbow pathology, prior surgery, or low-quality CT images (including slice thickness greater than 2 mm, motion artifacts, and incomplete visualization of the osseous structure of the elbow and all its articulations), leaving 2% (167 of 10,016) for analysis. The mean age was 50 ± 15 years, and more than half of the patients were female (54% [90 of 167]). Coronoid fractures in patients with combined coronoid and radial head fractures were classified using the O'Driscoll classification into three types: Type 1 (anterolateral tip fractures), Type 2 (anteromedial facet fractures), and Type 3 (base fractures). Each type was further subcategorized based on specific fracture characteristics. Two of three trained researchers independently classified the coronoid fracture type of each patient using radiographs, two-dimensional (2D) CT scans, three-dimensional (3D) CT scans, and intraoperative findings, with interrater reliability assessed by the Cohen kappa, yielding a substantial agreement value of 0.6","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"881-888"},"PeriodicalIF":4.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: Arthroscopic Partial Meniscectomy for a Degenerative Meniscus Tear Is Not Cost Effective Compared With Placebo Surgery: An Economic Evaluation Based on the FIDELITY Trial Data.","authors":"Stuart A Green","doi":"10.1097/CORR.0000000000003308","DOIUrl":"10.1097/CORR.0000000000003308","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"954-955"},"PeriodicalIF":4.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142562721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contralateral THAs More Than 1 Year Apart: Do PROMs and Healthcare Utilization Differ After Each Procedure?","authors":"Alvaro Ibaseta, Ignacio Pasqualini, Shujaa T Khan, Chao Zhang, Alison K Klika, Nicolas S Piuzzi","doi":"10.1097/CORR.0000000000003339","DOIUrl":"10.1097/CORR.0000000000003339","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Patients who undergo a second THA at least 1 year after the first one may experience different recovery courses after each THA. It is unknown what the clinically relevant improvements and healthcare utilization are after each THA in patients undergoing contralateral THA &gt; 1 year apart.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Questions/purposes: &lt;/strong&gt;(1) Do patient-reported outcome measures (PROMs) differ at baseline and 1 year after THA for the first and second hip arthroplasty? (2) Does the likelihood of achieving minimum clinically important difference (MCID) and patient acceptable symptom state (PASS) thresholds differ for the first and second hip arthroplasty? (3) Does utilization of healthcare within 90 days of THA, using discharge disposition, length of stay (LOS), and 90-day readmission risk as proxies, differ between the first and second hip arthroplasty?&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Between January 2016 and December 2021, a total of 14,023 primary THAs for hip osteoarthritis were performed at a large tertiary academic center, and data from each were longitudinally maintained in an institutional database. In this retrospective study, we excluded nonelective (n = 265), simultaneous bilateral (n = 89), staged bilateral &lt; 1 year apart (n = 1856), unilateral THAs (n = 7541), and those who were lost prior to the minimum study follow-up of 1 year or had incomplete data sets (n =3618), leaving 654 contralateral THAs &gt; 1 year apart (327 patients) for analysis here. The median (range) patient age was 64 years (26 to 88) at the time of the first THA and 66 years (27 to 88) at the second THA. The mean (IQR) time from first THA to second THA was 696 days (488 to 1008). In all, 62% (204 of 327) of patients were women, and 89% (286 of 321) were White. The median (range) BMI was 29 kg/m 2 (first THA 16 to 60, second THA 18 to 56) at both THAs. PROMs were obtained preoperatively and at 1 year after each of the THAs and included Hip Disability and Osteoarthritis Outcome Score pain (HOOS-pain), physical function (HOOS-PS), and joint replacement (HOOS-JR) scores, as well as the Veterans Rand 12-Item Health Survey mental component summary score. Each was scored from 0 to 100, with higher scores representing better patient perceived outcomes. A distribution-based method was used to calculate the MCID thresholds (HOOS-pain 8.35, HOOS-PS 9.47, and HOOS-JR 7.76), while an anchor-based method was utilized for the PASS thresholds (HOOS-pain 80.6, HOOS-PS 83.6, and HOOS-JR 83.6). Healthcare utilization outcomes included discharge disposition, LOS, and 90-day readmission rates.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Patients had slightly lower baseline PROM scores in all HOOS subdomains before the first THA compared with the second THA (median HOOS-pain 38 versus 42, p &lt; 0.001; HOOS-PS 54 versus 58, p &lt; 0.001; HOOS-JR 43 versus 47, p &lt; 0.001). The difference between baseline and 1-year postoperative scores was slightly larger in all HOOS subdomains after the f","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"832-842"},"PeriodicalIF":4.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}