International Orthopaedics最新文献

{"title":"Survival of anterior cruciate ligament  reconstruction in patients with Ehlers-Danlos syndrome: A comparison with anatomic risk factors in existing literature.","authors":"Sebastian Schmidt, Chilan Bou Ghosson Leite, Alexander Bumberger, Domenico Franco, Cale Andrew Jacobs, Lars Richardson, Nikolaos Paschos, Simon Goertz, Eric Berkson, Peter Asnis, Christian Lattermann","doi":"10.1007/s00264-025-06632-y","DOIUrl":"10.1007/s00264-025-06632-y","url":null,"abstract":"<p><strong>Background: </strong>Ehlers-Danlos Syndrome (EDS) is a connective tissue disorder characterized by joint hypermobility, ligamentous laxity, and frequent joint injuries. These features could increase the risk of anterior cruciate ligament (ACL) tears, typically managed through ACL reconstruction (ACLR). Surgical intervention in EDS is challenging due to potential complications such as poor wound healing and tissue fragility. Limited evidence exists regarding the outcomes of ACLR in EDS patients; therefore, in this study we aimed to evaluate survival rates of primary and revision ACLR and examine associated demographic and anatomic risk factors for failure after ACLR.</p><p><strong>Methods: </strong>A retrospective review of 21 EDS patients (25 knees) who underwent ACLR between 1993 and 2023 was conducted. Patients with vascular EDS were excluded. Demographic and surgical data, including graft type, cause of injury, concomitant procedures such as meniscus repair and anatomical measurements (posterior tibial slope, intercondylar notch width, lateral femoral condyle morphology, tibiofemoral rotation and tibial tubercle- trochlear groove distance), were collected. Survival analysis was performed using Kaplan-Meier curves, with endpoints defined as ACLR failure or conversion to total knee arthroplasty (TKA). A multivariable survival analysis was used to identify predictors of outcomes. In addition, the influence of demographic and anatomical factors on the development of concomitant injuries and concomitant procedures were assessed. Anatomical factors were then compared with non-EDS patients from the existing literature.</p><p><strong>Results: </strong>The overall survival rate was 85.7% at mean follow-up of 50 months. Primary ACLR showed significantly higher survival rates 93.8% compared to revision ACLR 62.5% at 50 months (p = 0.03). Sports injuries, particularly skiing, were the leading cause of ACL tears (62%). Anatomical differences, such as increased lateral femoral condyle ratio (LFCR) and tibiofemoral rotation (TFR), were observed compared to non-EDS, ACL-intact patients from the literature (p < 0.01). However, these factors did not predict failure or influence concomitant injuries.</p><p><strong>Conclusion: </strong>This study demonstrates that ACLR in EDS patients achieves good survival rates. Anatomical risk factors differed significantly from non-EDS, ACL-intact patients, but were not predictive of failure, highlighting ligamentous laxity as the primary challenge.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2433-2442"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12488752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term results of the metaphyseal-loading anterolaterally flared anatomic femoral stem for total hip arthroplasty.","authors":"Makoto Kitade, Tetsuro Tani, Akihiko Matsumine","doi":"10.1007/s00264-025-06624-y","DOIUrl":"10.1007/s00264-025-06624-y","url":null,"abstract":"<p><strong>Background: </strong>Patients with secondary hip osteoarthritis due to developmental dysplasia of the hip (DDH) often have abnormal femoral morphology, making stem design critical for long-term outcomes. The FMS-anatomic stem previously demonstrated favourable mid-term results. Its successor, the Anatomic Fit stem, was developed with a reduced hydroxyapatite-coated area to enhance proximal load transfer and a narrower lateral flare to facilitate insertion. This study aimed to analyze the long-term clinical and radiographic outcomes of these stems.</p><p><strong>Methods: </strong>The one-hundred seventy-eight hips underwent total hip arthroplasty using either the FMS-anatomic or Anatomic Fit stem. After applying exclusion criteria, 119 hips (36 FMS-anatomic and 83 Anatomic Fit) were analyzed. Clinical and radiographic outcomes were assessed, and stem survival was evaluated using Kaplan-Meier analysis with stem revision as the endpoint.</p><p><strong>Results: </strong>The 15- and 20-year survival rates were 97.2% and 94.4% for the FMS-anatomic stem, and 98.8% for the Anatomic Fit stem at both time points, with no significant difference. Spot welds were observed in nearly all cases, but their distribution differed significantly: zones 2 and 6 in the FMS-anatomic group and zones 1 and 7 in the Anatomic Fit group (P < 0.05). Stress shielding of Grade 3 or higher occurred in 16.5% of FMS-anatomic stems and 33.7% of Anatomic Fit stems (P < 0.05).</p><p><strong>Conclusions: </strong>Both stems showed excellent long-term survival and proximal fixation. However, the Anatomic Fit stem did not reduce stress shielding, despite its modified design intended to improve load transfer.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2509-2517"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12488776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of focused low intensity pulsed ultrasound in reducing lower-extremity swelling and pain after total knee arthroplasty: a randomized study.","authors":"Long Zhao, Xiaoling Luo, Duan Wang, Jinwei Xie, Zongke Zhou","doi":"10.1007/s00264-025-06601-5","DOIUrl":"10.1007/s00264-025-06601-5","url":null,"abstract":"<p><strong>Purpose: </strong>Low-intensity pulsed ultrasound (LIPUS) is a non-invasive physiotherapy that is often utilized to treat swelling and pain caused by musculoskeletal trauma. We aimed to evaluate the efficacy and safety of LIPUS in reducing lower-extremity swelling and pain following total knee arthroplasty (TKA).</p><p><strong>Methods: </strong>This randomized, controlled study evaluated 116 patients undergoing primary TKA, randomly assigning them to either an LIPUS group receiving active LIPUS therapy (0.8 MHz, 1.35 W) or a control group receiving sham treatment. The LIPUS intervention was administered to the operated knee for 25-minute sessions, three times daily for three consecutive days, beginning four hours postoperatively. The primary study outcome measured lower extremity swelling during the first 14 postoperative days, while secondary outcomes included knee pain (assessed by visual analogue scale ranging from 0 to 10 points), Hospital for Special Surgery (HSS) score, range of knee motion (ROM), serum levels of C-reactive protein (CRP), interleukin-6 (IL-6), myoglobin, and complications.</p><p><strong>Results: </strong>The LIPUS (n = 55) and control (n = 56) groups showed similar baseline characteristics. LIPUS treatment significantly improved clinical outcomes compared to sham treatment, reducing calf swelling by 2.37-2.74%, thigh swelling by 2.76-4.81%, and patellar swelling by 2.30-3.28% (all p < 0.001). Patients receiving LIPUS also reported less walking pain (1.16-2.48 point reduction, p < 0.001) and showed lower inflammatory markers (CRP reduction of 2.53-13.85 mg/L, p = 0.047; IL-6 reduction of 3.64-17.27 pg/mL, p = 0.041). However, the treatment did not significantly affect resting pain, HSS scores, ROM, serum myoglobin levels, or complication rates.</p><p><strong>Conclusion: </strong>This study found that short-term LIPUS use markedly decreased lower-extremity swelling and walking pain post-TKA, with no major safety concerns. However, future studies are needed to determine the optimal protocol and long-term safety of LIPUS in TKA patients.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2423-2431"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567368","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":"Clinical outcomes of an unplanned second debridement, antibiotics and implant retention (DAIR) procedure in acute postoperative prosthetic joint infections.","authors":"Juan Carlos Perdomo-Lizárraga, Andrés Combalia, Jenaro A Fernández-Valencia, Juan Carlos Martínez-Pastor, Alfonso Alías, Laura Morata, Álex Soriano, Ernesto Muñoz-Mahamud","doi":"10.1007/s00264-025-06617-x","DOIUrl":"10.1007/s00264-025-06617-x","url":null,"abstract":"<p><strong>Introduction: </strong>Debridement, antibiotics, and implant retention (DAIR) is a commonly employed strategy for managing acute postoperative prosthetic joint infections (PJI) while preserving the prosthesis. However, the clinical value of an unplanned second DAIR - performed due to inadequate infection control - remains controversial and is often considered a potential treatment failure. This study aimed to compare the two year clinical outcomes of patients undergoing a single DAIR versus those requiring an unplanned second DAIR for acute postoperative PJI of the hip or knee.</p><p><strong>Methods: </strong>We retrospectively reviewed electronic medical records of patients treated with DAIR for acute postoperative PJI between January 1999 and December 2020. Patients were categorized into two groups: those managed with a single DAIR (DAIR-1 group) and those requiring an unplanned second DAIR within 12 weeks (DAIR-2 group). Treatment failure was defined as any of the following: further debridement beyond 12 weeks, revision surgery with prosthesis removal, initiation of long-term suppressive antibiotic therapy, or PJI-related mortality. Patients lost to follow-up before two years were excluded.</p><p><strong>Results: </strong>A total of 318 patients were included, with 292 in the DAIR-1 group and 26 in the DAIR-2 group. Mean follow-up was 89.4 months. At two years, revision surgery was required in 19.2% (56/292) of DAIR-1 patients and 42.3% (11/26) of DAIR-2 patients (p = 0.005). Overall failure-free survival at two years was observed in 75.3% (220/292) of DAIR-1 patients compared to 46.2% (12/26) of those in the DAIR-2 group (p = 0.001).</p><p><strong>Conclusion: </strong>Unplanned second DAIR procedures are associated with significantly lower success rates at two years. Nonetheless, given that nearly half of these patients remained free of failure, a second DAIR may still be a reasonable therapeutic option in selected cases, provided that the increased risk of a poorer prognosis is taken into account.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2385-2392"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12488757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laminectomy and laminoplasty hybrid decompression versus laminectomy with lateral mass screw fixation for degenerative cervical myelopathy: a propensity score-matched study.","authors":"Qiang Zhang, Yuan Xue, Rongzhi Ma, Shuai Li","doi":"10.1007/s00264-025-06640-y","DOIUrl":"10.1007/s00264-025-06640-y","url":null,"abstract":"<p><strong>Objective: </strong>To compare the clinical and radiological outcomes between posterior laminectomy and laminoplasty hybrid decompression and laminectomy with lateral mass screw fixation in multilevel degenerative cervical myelopathy.</p><p><strong>Methods: </strong>A total of 158 patients for multilevel degenerative cervical myelopathy (DCM) undergoing surgical treatment were enrolled in this study from May 2018 to December 2023, including 97 patients who underwent posterior laminectomy and laminoplasty hybrid decompression (PLLDH) and 61 patients treated with posterior lateral mass screw fixation (PLMSF). To minimize potential confounding factors, propensity score matching was employed for inter-group comparison. Neurological function scores and radiographic parameters were systematically compared between the two surgical groups.</p><p><strong>Results: </strong>Following propensity score matching (PSM), baseline characteristics showed no statistically significant differences between the two surgical groups. The matched cohorts demonstrated that operative duration, intraoperative blood loss, VAS scores, Cobb angle, dural sac cross-sectional area at the narrowest level, and posterior dural displacement had no statistically significant differences(P > 0.05). However, significant inter-group differences were observed in JOA scores (P<0.05), NDI scores (P<0.05), and cervical range of motion (P<0.05) postoperatively.</p><p><strong>Conclusion: </strong>Both PLLDH and PLMSF are effective surgical approaches for treating multilevel DCM, demonstrating satisfactory clinical outcomes. However, PLMSF resulted in greater postoperative loss of cervical mobility compared to PLLDH.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2567-2574"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855218","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":"Waste in orthopaedic surgery; an application of the healthcare sustainability mode and effect analysis.","authors":"Isabella C Klarenbeek, Esther R C Janssen, Paul C Willems, Okke F Lambers Heerspink, Anne C van der Eijk","doi":"10.1007/s00264-025-06629-7","DOIUrl":"10.1007/s00264-025-06629-7","url":null,"abstract":"","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2393-2401"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12488813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing glenoid orientation on the axillary view: a novel technique using the posterolateral acromion-to-coracoid line.","authors":"Michael Hachadorian, Mihir Sheth, Ermyas Kahsai, Anastasia Whitson, Corey Schiffman, Frederick Matsen, Jason Hsu","doi":"10.1007/s00264-025-06661-7","DOIUrl":"https://doi.org/10.1007/s00264-025-06661-7","url":null,"abstract":"<p><strong>Purpose: </strong>In shoulder arthroplasty, three-dimensional computed tomography (3D CT) has become the gold standard for preoperative version assessment. Meanwhile, postoperative version is usually evaluated using radiographs (XR), in particular an axillary view, in which the view of the scapular body is often truncated, preventing the scapular plane from being used as a reference. This study introduces the posterolateral acromion-to-coracoid (PLAC) line, which can be assessed on a standard truncated axillary radiograph.</p><p><strong>Materials and methods: </strong>Forty-six shoulders were studied. Four angles were measured including 3D CT (CT Version), 3D CT PLAC line to glenoid face angle (CT PLAC-GFA), 2) radiographic PLAC line to glenoid face angle (XR PLAC-GFA), and 3) the radiographic glenoid vault line to glenoid face angle (XR GV-GFA). Variation and linear relationship between these angles were calculated.</p><p><strong>Results: </strong>The mean difference between CT PLAC-GFA and XR PLAC-GFA was 1.0º (95% CI -0.7 to 2.8)(IQR = 8.5º, -3.0º to 5.4º), with a strong correlation on linear regression (R² = 0.76, p < 0.001). XR PLAC-GFA and XR GV-GFA demonstrated strong correlations with CT measured version (R² = 0.72 and 0.70, respectively; p < 0.001). Inter-rater reliability was excellent for all metrics (ICC ≥ 0.93).</p><p><strong>Conclusions: </strong>The PLAC and the glenoid vault lines are highly reproducible references on truncated axillary views. These alternative reference lines allow accurate comparison of preoperative and postoperative glenoid orientation using standard axillary radiographs.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199277","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":"Variations in centre of pressure and balance performance induced by footwear drop in healthy adults.","authors":"Raquel Fragua-Blanca, Natalia Tovaruela-Carrión, Manuel Jesús Tena-León, Elena Escamilla-Martínez","doi":"10.1007/s00264-025-06664-4","DOIUrl":"https://doi.org/10.1007/s00264-025-06664-4","url":null,"abstract":"<p><strong>Background: </strong>Posturography is a diagnostic technique that quantifies postural control through Centre of Pressure (CoP) displacement analysis on a force platform. Footwear characteristics, particularly heel-to-toe drop, may influence balance by modifying plantar pressure distribution and proprioceptive feedback. The aim of this study was to evaluate the impact of different footwear drops (0 mm, 5 mm, 10 mm) on postural control in healthy young adults, considering sex, BMI, and shoe size.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in 117 participants (56 men, 61 women) using the Dinascan/IBV^® platform and the Romberg test. CoP displacement and velocity were analyzed.</p><p><strong>Results: </strong>Significant differences were observed in CoP total displacement (p < 0.001), mean velocity (p < 0.001), and medio-lateral dispersion (p = 0.024) when comparing 0 mm to 5 mm and 10 mm drops. Sex differences were significant at 0 mm drop for maximum medio-lateral force (p < 0.001) and mean velocity (p = 0.042), with men exhibiting greater values. At 5 mm drop, men showed significantly higher swept area (p = 0.029) and anteroposterior displacement (p = 0.007) than women.</p><p><strong>Conclusions: </strong>Small variations in footwear drop can affect postural control, particularly in the medio-lateral plane. Sex and BMI significantly influence CoP behavior, suggesting the need to consider these factors in footwear design and clinical balance assessments.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199324","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":"Comment on \"Prevalence, associated factors, and short-term impact of central sensitization in high-altitude patients undergoing total knee arthroplasty\".","authors":"Chia-Hao Hsu","doi":"10.1007/s00264-025-06626-w","DOIUrl":"10.1007/s00264-025-06626-w","url":null,"abstract":"","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2585-2586"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730916","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":"Arthroscopic subscapularis-complex release and conjoint tendon transfer in birth brachial plexus injuries: a case series with evidence-based insights.","authors":"Aditya K S Gowda, Vivek Singh, Rahul Mishra, Cury Sharma, Vikas Maheshwari, Anil Regmi","doi":"10.1007/s00264-025-06630-0","DOIUrl":"10.1007/s00264-025-06630-0","url":null,"abstract":"<p><strong>Purpose: </strong>Shoulder deformities and impaired function in individuals with birth brachial plexus injury (BBPI) are often caused by internal rotator (IR) contractures and abductor weakness, which may progress to glenohumeral dysplasia. Although subscapularis-complex release and tendon transfer is a time-tested procedure, there are controversies regarding the appropriate management of shoulder contractures, especially in preschool children. Therefore, this study examines the efficiency of arthroscopically done progressive controlled release of IR contracture combined with tendon transfer.</p><p><strong>Methods: </strong>This study included 12 children who presented with shoulder soft tissue contractures and functional impairments, specifically, loss of shoulder abduction and external rotation, but with good deltoid function. They underwent a surgical intervention involving arthroscopy-assisted subscapularis-complex release and conjoint muscle transfer onto the infraspinatus footprint on the humeral head. The evaluation of shoulder function was conducted using the Mallet score system, and the range of motion was measured at preoperative and six month postoperative intervals. Statistical analyses were performed to determine the significance of the outcomes.</p><p><strong>Results: </strong>The average age of participants was 4.83 ± 2.1 years. Preoperatively, the mean Mallet score was 14.08 ± 1.4, which improved to 23.83 ± 1.2 postoperatively. The average gain in shoulder abduction was 66.4 ± 5.6°, and external rotation improved by 85.4 ± 16.6° at 18 months final follow-up. All patients exhibited improvements in shoulder function, with a significant correlation (p value = 0.037) between Naraka grading, and clinical outcomes.</p><p><strong>Conclusion: </strong>The combined surgical approach of arthroscopic subscapularis-complex release with conjoint tendon transfer effectively enhances the shoulder function in the studied cohort. Further research and extended follow-up are needed to evaluate the long-term benefits.</p><p><strong>Level of evidence: </strong>Level IV (Therapeutic case series).</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2529-2537"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144794410","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}