International Orthopaedics最新文献

{"title":"Development of a clinical risk score for common peroneal nerve palsy after total knee arthroplasty using a Japanese nationwide database.","authors":"Shingo Kurihara, Shimon Furusato, Kazuhisa Hatayama, Kiyohide Fushimi, Sayuri Shimizu","doi":"10.1007/s00264-026-07057-x","DOIUrl":"https://doi.org/10.1007/s00264-026-07057-x","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to develop a clinical risk score to stratify the risk of post-operative common peroneal nerve palsy (CPNP) following total knee arthroplasty (TKA), based on pre-operative factors.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of adult patients undergoing primary TKA using a Japanese nationwide database (from 2014 to 2024). The outcome was post-operative CPNP identified by International Classification of Diseases, Tenth Revision codes. Candidate predictors included 24 clinical and hospital-level variables. Least Absolute Shrinkage and Selection Operator (LASSO) regularization was applied for predictor selection. Multivariable logistic regression was used as the primary model, with penalized and Firth logistic models as sensitivity analyses. Model performance and internal validation were assessed using the area under the curve (AUC), calibration, and bootstrap resampling.</p><p><strong>Results: </strong>A total of 328,314 patients were eligible and CPNP occurred in 340 cases (0.10%). LASSO identified four predictors, and a 0-7 point risk score was developed: knee valgus deformity (3 points), knee contracture (2 points), low BMI < 18.5 (1 point), and spinal disorder (1 point). The observed risk rose from 0.09% (score 0) to 0.56% (score 3), and to 0.68% for scores ≥ 3, while categories of score ≥ 4 were sparsely populated. The risk score showed limited discrimination (AUC = 0.55) but favourable calibration (intercept = - 0.001, slope = 1.03).</p><p><strong>Conclusion: </strong>We developed a clinical risk score for CPNP after TKA based on knee valgus deformity, knee contracture, low BMI, and spinal disorder. This score may support pre-operative risk assessment and informed consent in high-risk patients.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Kerboull cross-plate: from the birth of a concept to the current indications.","authors":"Julien Wegrzyn, Luc Kerboull, Jacques Béjui-Hugues, Moussa Hamadouche","doi":"10.1007/s00264-026-07059-9","DOIUrl":"https://doi.org/10.1007/s00264-026-07059-9","url":null,"abstract":"<p><strong>Purpose: </strong>Reconstruction of major acetabular bone loss remains a demanding challenge during revision total hip arthroplasty. Since its original description, the Kerboull acetabular reinforcement device, also known as the Kerboull cross-plate or cage, has been developed to restore the native hip centre of rotation, to protect bone graft from early mechanical overload, and to allow cementation of a conventional full-polyethylene or a dual mobility cup.</p><p><strong>Methods: </strong>This narrative review traces the evolution of the Kerboull cross-plate from its original conception to its current indications.</p><p><strong>Results: </strong>We describe the biomechanical rationale of the device, supported by finite-element analyses demonstrating a marked load-sharing effect that protects the underlying bone graft in comparison with other reinforcement devices or unprotected cemented cups. We detail the surgical technique, as originally reported by Kerboull and Hamadouche, together with subsequent refinements aimed at standardising plate positioning. The principles governing graft selection are discussed: segmental structural defects require a structural graft, whereas morselised graft should be reserved for the filling of contained cavitary defects. The biological and mechanical quality of the graft is dependent on its processing, cryopreserved femoral head allograft being preferable to gamma-irradiated allograft. Finally, we review the mid- to long-term outcomes reported with the Kerboull cross-plate, including the more recent trend towards cementing a dual mobility cup within the device to reduce the risk of instability, and we outline the current indications of this technique of reconstruction.</p><p><strong>Conclusion: </strong>The Kerboull cross-plate retains its place as a reliable and time-tested option within the modern armamentarium for severe acetabular bone loss reconstruction.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolution of minimally invasive surgery (MIS) techniques in forefoot deformity corrections.","authors":"Chin Yik Tan, Gowreeson Thevendran","doi":"10.1007/s00264-026-07060-2","DOIUrl":"https://doi.org/10.1007/s00264-026-07060-2","url":null,"abstract":"<p><strong>Purpose: </strong>To review the historical evolution and technical progression of minimally invasive surgery (MIS) in forefoot deformity corrections, tracing its development from early medical concepts and general surgery milestones to modern, highly specialized foot and ankle interventions.</p><p><strong>Methods: </strong>An extensive electronic search of the medical and historical literature was performed and complemented by manual review of scientific sources. Historical reports describing the origins of minimally invasive techniques, the evolution of surgical instrumentation, and advancing treatment strategies for forefoot deformities were critically analysed within their scientific and chronological contexts.</p><p><strong>Results: </strong>The history of forefoot MIS represents a continuous process of conceptual evolution. The procedure's trajectory mirrors the disruptive history of laparoscopic surgery, transitioning from early enthusiasm and high complication rates in the United States to a European-led renaissance grounded in strict anatomical landmarks and technological advancements, such as the Shannon burr and image intensifiers. For hallux valgus, the procedure has progressed through four distinct generations distinguished by specific osteotomy and fixation strategies, moving toward true three-dimensional deformity correction. In the treatment of hallux rigidus, MIS provides effective joint-preserving options through percutaneous cheilectomies and decompressive osteotomies, as well as joint-sacrificing arthrodesis. For lesser toe deformities, treatment paradigms have shifted toward more standardised classification, and utilizing hardware-free metatarsal and phalangeal osteotomies that rely on strict postoperative weight-bearing to achieve optimal anatomical alignment.</p><p><strong>Conclusions: </strong>The historical maturation of forefoot MIS illustrates a continuous refinement of surgical \"processes\" and hardware \"ingredients\" aimed at optimizing clinical outcomes. Understanding this evolutionary framework provides a crucial foundation for future innovations, including the integration of bioabsorbable implants, 3D-printed instrumentation, and artificial intelligence in foot and ankle surgery.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for postoperative recurrence of sacral chordoma: an eleven-year single-centre retrospective study.","authors":"Xinhui Du, Hua Wei, Boya Zhang, Xiaoxiao Liang, Weitao Yao","doi":"10.1007/s00264-026-07058-w","DOIUrl":"https://doi.org/10.1007/s00264-026-07058-w","url":null,"abstract":"<p><strong>Purpose: </strong>Chordoma is a rare, low-grade malignant bone tumour that most commonly arises in the sacrococcygeal region. Reported prognostic factors for recurrence are inconsistent and the role of postoperative adjuvant treatment is undefined. We investigated risk factors for recurrence in a consecutive single-centre cohort of sacral chordoma in which R0 resection was achieved in every patient.</p><p><strong>Methods: </strong>We retrospectively reviewed 34 consecutive patients with sacral chordoma treated with curative resection at our centre between 2013 and 2024. Clinical, surgical, adjuvant and follow-up data were recorded. Recurrence-free survival (RFS) was estimated using the Kaplan-Meier method, and independent risk factors for recurrence were identified using multivariate Cox regression.</p><p><strong>Results: </strong>The cohort comprised 24 men and ten women (mean age 62.1 years). Recurrence occurred in 19 of 34 patients (55.9%) after a median follow-up of 36 months; median RFS was 33 months (95% CI 16.7-49.3) and nine patients (47.4%) developed distant metastases. Maximum tumour diameter ≥ 65 mm (HR 3.42, 95% CI 1.18-9.92; p = 0.024) and a history of previous surgery (HR 4.57, 95% CI 1.52-13.73; p = 0.007) were independent risk factors for recurrence, whereas postoperative targeted therapy was associated with lower recurrence risk (HR 0.31, 95% CI 0.10-0.94; p = 0.038).</p><p><strong>Conclusion: </strong>Recurrence of sacral chordoma was common even after R0 resection. Large tumour diameter and previous surgery were independent risk factors for recurrence. The association between postoperative targeted therapy and lower recurrence risk should be interpreted with caution because treatment was not randomised.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Femoral de-escalation during revision total hip arthroplasty using a rectangular-taper shortened stem.","authors":"Arnaud Fischbacher, Jaad Mahlouly, Nathan Lacheux, Alexander Antoniadis, Julien Wegrzyn","doi":"10.1007/s00264-026-07049-x","DOIUrl":"https://doi.org/10.1007/s00264-026-07049-x","url":null,"abstract":"<p><strong>Purpose: </strong>Long stems with diaphyseal fixation are widely used in revision total hip arthroplasty (RTHA) but may increase surgical complexity and compromise femoral bone stock. Primary femoral stems, used as a de-escalation strategy, could simplify RTHA in selected patients as a bone preserving strategy. This study aimed to evaluate the clinical and radiographic outcomes of this technique using a cementless rectangular-taper shortened stem during both components RTHA.</p><p><strong>Methods: </strong>Between January 2019 and January 2025, 301 both components RTHA were prospectively included in our institutional total joint registry. Among them, 23 RTHA (20 patients, 14 men, mean age at revision = 63 years [54-71]) with femoral de-escalation with the use of a cementless rectangular-taper shortened stem and a dual mobility cup construct were identified and retrospectively reviewed at latest follow-up, focusing on complications related to this reconstruction technique. Clinical outcome was evaluated with the Harris Hip Score (HHS).</p><p><strong>Results: </strong>At a mean follow-up of 48 months (23-75), no postoperative periprosthetic fracture, mechanical failure or early loosening of the femoral reconstruction occurred. One early dislocation occurred at 41 days, managed by closed reduction without recurrence at latest follow-up. The mean HHS significantly improved from 70 (59-83) preoperatively to 94 (64-100) postoperatively, with 96% of patients achieving HHS ≥ 80 at latest follow-up.</p><p><strong>Conclusions: </strong>In selected patients undergoing RTHA with limited femoral bone loss, femoral de-escalation with a cementless rectangular-taper shortened stem demonstrated reliability for femoral reconstruction with no component-related complication and significant functional improvement at short-term follow-up.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic assistance reduces operative time variability in reverse shoulder arthroplasty: a retrospective single-surgeon study.","authors":"Matthew Frederickson, Dilpreet Singh, Mariano E Menendez","doi":"10.1007/s00264-026-07056-y","DOIUrl":"https://doi.org/10.1007/s00264-026-07056-y","url":null,"abstract":"<p><strong>Background: </strong>Robotic assistance for reverse total shoulder arthroplasty (rTSA) improves the accuracy and consistency of implant positioning, but whether this reproducibility extends to the surgical workflow is unknown. This study sought to compare operative time variability between conventional and robotic-assisted rTSA using the Mako robotic system (Stryker, Kalamazoo, MI).</p><p><strong>Methods: </strong>We retrospectively reviewed consecutive elective primary rTSAs performed by a single fellowship-trained shoulder surgeon. Operative time was defined as incision start to incision closure. The first 23 robotic-assisted cases using the Mako robotic system were designated the learning phase based on a prior internal operative time learning curve analysis and were excluded. Post-learning curve robotic-assisted cases were compared with conventional cases from the same period. The primary outcome was operative time variability, quantified using the standard deviation (SD) and coefficient of variation, and compared with the Brown-Forsythe test and the variance ratio with 95% confidence interval (CI). Native glenoid retroversion and RSA angle were compared as markers of case complexity.</p><p><strong>Results: </strong>Thirty-nine robotic-assisted cases were compared with 38 conventional cases. Robotic operative time was substantially less variable than conventional operative time (SD 9.9 vs. 19.7 min; coefficient of variation 13.3% vs. 25.0%; variance ratio 4.01; 95% CI, 2.09-7.69; Brown-Forsythe P < .001), while mean operative time was equivalent (74.2 vs. 78.8 min; P = .20). The groups did not differ in native glenoid retroversion (9.2° vs. 8.7°; P = .77) or RSA angle (14.3° vs. 15.1°; P = .57).</p><p><strong>Conclusion: </strong>Robotic-assisted rTSA was associated with more consistent operative times than conventional rTSA, with no significant difference in mean operative time. These findings suggest that the value of robotic assistance in rTSA may extend beyond implant positioning to the reproducibility of surgical workflow.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Five-year implant-related complication rates of total hip arthroplasty performed for osteonecrosis were not improved by robotic-assisted or computer-navigated techniques.","authors":"Nils Becker, Lucas Y Kim, Lee E Rubin, Jonathan N Grauer, Daniel H Wiznia","doi":"10.1007/s00264-026-07050-4","DOIUrl":"https://doi.org/10.1007/s00264-026-07050-4","url":null,"abstract":"<p><strong>Background: </strong>Osteonecrosis of the femoral head (ONFH) is associated with hip deformity and variable bone quality compared with osteoarthritis (OA). We hypothesised that robotic and navigation-assisted total hip replacement (rTHA, nTHA, together referred to as r-nTHA) might have benefits for this indication.</p><p><strong>Methods: </strong>A national administrative database was used to identify THA patients diagnosed with ONFH or OA. The use of r-nTHA versus manual THA (mTHA) was trended and compared by indication. In THA for ONFH patients, cases with rTHA or nTHA were separately matched to mTHA 1:4 by age, sex, Elixhauser comorbidity index, and surgery year. The 90-day medical adverse events were assessed relative to mTHA. Five-year implant-related complications were compared for those with laterality indicators.</p><p><strong>Results: </strong>The utilisation of r-nTHA for ONFH was similar to that for OA until 2021, and lagged behind in 2022 (17.8% versus 23.1%, p = 0.0217). After matching and relative to mTHA, rTHA showed higher odds ratios (OR) for transfusions (OR = 2.67) and readmissions (OR = 2.14), whereas nTHA demonstrated lower OR for adverse events and emergency department visits (ORs 0.48 to 0.67) (p < 0.001 for each). The five-year odds of each of the assessed implant-related complications was comparable between both rTHA and nTHA relative to mTHA.</p><p><strong>Conclusions: </strong>As implant-related complications were similar between rTHA, nTHA, and mTHA at midterm follow-up, the current study does not provide clear evidence favouring routine use of the technology-assistance over mTHA for ONFH, although cost-effectiveness, surgeon experience, and the potential for increased accuracy in component positioning in anatomically complex cases were not assessed. Prospective studies accounting for ONFH aetiology and disease severity are needed before definitive recommendations can be made. The association of some 90-day outcomes with r-nTHA may be correlated with the pathologies associated with ONFH.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orthopaedics at crossroads: are we ready for the responsible use of artificial intelligence in research?","authors":"Raju Vaishya, Abhishek Vaish, Philippe Hernigou, Marius M Scarlat","doi":"10.1007/s00264-026-07055-z","DOIUrl":"https://doi.org/10.1007/s00264-026-07055-z","url":null,"abstract":"","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robot-assisted total hip arthroplasty: does improved precision translate into better clinical outcomes? A systematic review.","authors":"Ernesto Muñoz-Mahamud, Miquel Cortés-Rovira, Alfonso Alías-Petralanda, Jenaro-Angel Fernández-Valencia, Andrés Combalia","doi":"10.1007/s00264-026-07052-2","DOIUrl":"https://doi.org/10.1007/s00264-026-07052-2","url":null,"abstract":"<p><strong>Purpose: </strong>Robot-assisted total hip arthroplasty (R-THA) is being adopted progressively because of its potential to improve implant positioning and restore hip biomechanics more accurately than conventional techniques. However, whether these technical advantages translate into meaningful clinical benefits remains uncertain. This systematic review compared robot-assisted and conventional THA regarding implant positioning, restoration of hip biomechanics, functional outcomes, and complications.</p><p><strong>Materials and methods: </strong>A systematic review was performed according to the PRISMA guidelines. PubMed and Scopus were searched for comparative studies published between 2015 and September 2025 evaluating robot-assisted versus conventional THA. After applying predefined eligibility criteria, 13 studies were included. Methodological quality was assessed using the MINORS and RoB 2 tools, and findings were synthesized qualitatively.</p><p><strong>Results: </strong>Robot-assisted THA was consistently associated with greater accuracy of acetabular component placement within established safe zones and more precise restoration of limb length. Functional outcomes were inconsistent across studies, with no clear evidence of superior patient-reported outcomes or overall clinical benefit. Several studies reported lower rates of dislocation and reoperation following robot-assisted THA, although differences in overall complication rates were less consistent.</p><p><strong>Conclusions: </strong>Robot-assisted THA improves the accuracy of implant positioning and better reproduces the preoperative surgical plan than conventional THA. However, these technical advantages have not translated into superior functional outcomes in the short to medium term. Longer-term studies are needed to determine their impact on implant survival.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical complications and implant survival of the Osseointegrated Prostheses for the Rehabilitation of Amputees system in patients with combat-related limb loss: a retrospective cohort study.","authors":"Stanislav Bondarenko, Oleksandr Haluzynskyi, Valentyna Maltseva, Oleksandr Linenko, Mykhailo Rudas","doi":"10.1007/s00264-026-07054-0","DOIUrl":"https://doi.org/10.1007/s00264-026-07054-0","url":null,"abstract":"<p><strong>Purpose: </strong>To assess implant survival, postoperative complications, and infection-related risk factors in veteran amputees treated with a bone-anchored prosthetic system.</p><p><strong>Methods: </strong>This retrospective study analysed clinical data from 49 veterans of the Russo-Ukrainian war who underwent implantation of the Osseointegrated Prostheses for the Rehabilitation of Amputees (OPRA) system for upper or lower limb amputation in 2023-2024. Implant survival and complication rates were analysed at one-year follow-up after the second surgical stage (S2).</p><p><strong>Results: </strong>The first stage of OPRA was performed in 49 patients (51 implants): 21 transfemoral, 27 transhumeral, and transtibial. Three patients declined S2, and one humeral implant was explanted after S1. The S2 was completed in 45 patients (47 implants). At one-year follow-up after S2, implant survival was 97.9% with one of 47 implants explanted because of septic loosening. Infectious complications occurred in 18% of patients, including Grade 4 infection in 2%. Beyond one year (median follow-up, 18.7 months), two additional implants were explanted (periprosthetic fracture, n = 1; septic loosening, n = 1).</p><p><strong>Conclusion: </strong>OPRA implantation in veteran amputees demonstrated favourable short-term implant survival (97.9% at one-year follow-up after S2), although longer-term follow-up is required.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}