International Orthopaedics最新文献

{"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":"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}

{"title":"Femoral rotational osteotomy for posterior hip impingement in young adults with increased femoral version.","authors":"Khaled M Emara, Ramy Ahmed Diab, Ahmed K Emara, Mohamed Eissa, Ahmed Ezzat, Mohamed Amr Hemida, Hassan Abdel Hamid Abdel Fattah","doi":"10.1007/s00264-025-06646-6","DOIUrl":"10.1007/s00264-025-06646-6","url":null,"abstract":"<p><strong>Purpose: </strong>Posterior femoro-acetabular impingement in patients with increased femoral version can result in significant hip pain, chondro-labral injury, and limited range of motion. Femoral rotational osteotomy may address these issues by correcting excessive femoral anteversion.</p><p><strong>Methods: </strong>This retro-spective case series included 25 adolescents (mean age 14.8 years) with symptomatic increased femoral version (> 35°) treated between 2015 and 2022. Inclusion required hip pain, limited range of motion, and increased femoral version confirmed on computed tomography. Patients underwent femoral external rotational osteotomy targeting a post-operative femoral version of ~ 15°. Outcomes assessed included femoral version, hip range of motion, and Harris Hip Score pre-operatively, at six months, and at two years post-operatively.</p><p><strong>Results: </strong>Mean femoral version improved significantly from 39° ± 3° pre-operatively to 19° ± 7° post-operatively (P < 0.001). Internal rotation decreased from 54° ± 9° to 32° ± 8°, while external rotation increased from 38° ± 4° to 44° ± 5° (P < 0.001). Mean Harris Hip Score improved from 62.5 ± 10.3 to 86.1 ± 6.4 at 6 months, with sustained results at two year follow-up. Radiographic union was achieved in all patients, and no major complications were observed.</p><p><strong>Conclusion: </strong>Femoral rotational osteotomy is a safe and effective treatment for posterior hip impingement in young patients with excessive femoral version.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2473-2479"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12488824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954090","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":"Prevalence of radiographic knee osteoarthritis in China: a national survey of thirty thousand, four hundred and fifty five individuals cross-sectional study.","authors":"Hongzhi Lv, Zhiyong Hou, Yanbin Zhu, Ran Sun, Jianzhao Wang, Guangzhao Hou, Bing Yin, Song Liu, Guang Yang, Xiao Chen, Bo Liu, Peizhi Yuwen, Fei Zhang, Shilun Li, Juan Wang, Wei Chen, Yingze Zhang","doi":"10.1007/s00264-025-06643-9","DOIUrl":"10.1007/s00264-025-06643-9","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Knee osteoarthritis (KOA) is a major health burden for adults and the elderly globally; however, national radiological and epidemiological data and predictive models for KOA are lacking in China. Most of the existing studies are limited to regional samples, which cannot accurately reflect disease burden and risk factors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;This study aimed to systematically analyze the prevalence and risk factors of adult radiology KOA in China for the first time using a national representative sample and to develop a prediction model to provide a basis for public health strategies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A multi-stage stratified random sampling method was employed to select 30 cities and 10 rural counties from 10 provinces, consisting of 30,455 participants aged 50 years and older who had lived in the area for at least five years. Knee X-rays were assessed using the Kellgren-Lawrence grading system, and demographic, clinical, and geographic data were collected. Samples were randomly divided into modeling and validation groups. A predictive model was developed using multiple logistic regression, and its performance was validated using receiver operating characteristic curves, calibration plots, and decision curve analysis. Further, an interactive web calculator based on R Shiny was developed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;This study enrolled 31,206 individuals. Questionnaires from 751 (2.5%) individuals were ultimately excluded due to missing items, insufficient responses, or logical errors. After exclusions, 30,455 (97.5%) individuals participated in the Chinese National KOA Study, consisting of 11,605 (38%) and 18,850 (62%) from urban and rural areas and 13,444 (44%) and 17,011 (56%) men and women, respectively. A total of 9,145 participants were diagnosed with radiographic KOA, and 3,515 participants, including 969 men and 2,546 women, had symptomatic knees. The population-weighted prevalence of radiographic KOA in China was 27.9 (95% confidence interval: 24.8-31.1) per 1000 people. A predictive model for KOA was developed, and its validity was verified among male and female patients. Significant risk factors for men included age, education, body mass index (BMI), central obesity, and residence in the hills; whereas, for women, age, education, BMI, previous knee impairment, more than two childbirths, and hypertension were risk factors. Two interactive web calculators based on R shiny were developed to access the probability of KOA. The website address for male patients was https://kneeosteoarthritisnomogram.shinyapps.io/DynNomapp/ , and for female patients was https://femalekneeosteoarthritisnomogram.shinyapps.io/DynNomapp/ .&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Our results provide detailed information on knee joint incidence, distribution, and risk factors, which is considered the latest clinical evidence basis for national healthcare planning and prevention efforts in China and other ","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2489-2507"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12488765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954233","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":"Minimal invasive open tibial fracture model in mice.","authors":"Stefanie Hoelscher-Doht, Marietta Herrmann, Takahiro Higuchi, Klara Lill, Andrea Ewald, Rainer Meffert, Sebastian Haeusner, Mila M Paul","doi":"10.1007/s00264-025-06644-8","DOIUrl":"10.1007/s00264-025-06644-8","url":null,"abstract":"<p><strong>Purpose: </strong>Fracture models in animals are essential to analyze bone healing in musculoskeletal research fields. Especially in small animals, fractures are difficult to simulate and stabilize. Therefore, a fracture model is desirable with a short operation time, high safety of the model without stabilization failure and low costs. Aim of this study is the evaluation of a new open tibial shaft model in mice for musculoskeletal research.</p><p><strong>Methods: </strong>In 12 eight week-old wild type mice, an open tibial shaft fracture was simulated and stabilized with a retrograde over the fracture inserted intramedullary pin. X-rays confirmed the correct fracture localization and stabilization. After eight weeks of follow-up, the mice were euthanized. Fracture healing and biomechanical stability were analyzed in a micro-CT scan and in torsional load-to-failure tests.</p><p><strong>Results: </strong>The whole operations lasted in mean eight min and 50 s. All mice recovered very quickly after the operative intervention and started using the operated leg again on the first postoperative day onwards if not earlier. No infections or failure of the stabilization occurred. All fractures healed completely within 8 weeks and substantial callus formation was confirmed in the micro-CT analysis. Biomechanically, higher torsional moment and stiffness were found for the operated tibia compared to the non-operated tibia in the same mouse.</p><p><strong>Conclusion: </strong>The presented tibial fracture model with open osteotomy and retrograde pin insertion revealed minimal operative intervention and anesthesia, quick recovery and fracture healing with big callus formation. It is an easy to address fracture model for musculoskeletal research.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2575-2582"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12488761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954242","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 cementless humeral head resurfacing for humeral head osteonecrosis - a monocentric longitudinal observational study.","authors":"Matthias Bülhoff, Amina Gurda, Johannes Weishorn, David Spranz, Kevin Knappe, Patric Raiss, Raphael Trefzer","doi":"10.1007/s00264-025-06622-0","DOIUrl":"10.1007/s00264-025-06622-0","url":null,"abstract":"<p><strong>Purpose: </strong>Humeral head osteonecrosis (HHN) is a joint-destructive condition, for which cementless humeral head resurfacing (CHHR) offers a bone-preserving treatment option. The aim of this study was to report long-term outcomes and implant survival of CHHR in patients with HHN.</p><p><strong>Methods: </strong>Patients with humeral head osteonecrosis treated with cementless humeral head resurfacing (CHHR) between 2004 and 2007 were included. Implant survival was assessed according to Kaplan-Meier analysis. Clinical evaluation included Constant-Murley-Score (CMS), Simple Shoulder Test (SST), Subjective Shoulder Value (SSV) and patient centered outcomes regarding satisfaction and quality of life. Radiographs were evaluated for glenoid erosion, Walch glenoid types as well as signs of implant loosening. Statistical comparison was performed using students t-tests with a significance level set to p < 0.05.</p><p><strong>Results: </strong>Seventeen shoulders were retrospectively included in the implant survival analysis. Two patients underwent revision surgery. five patients died with the implant and were therefore censored. Cumulative survival rate was 100% after ten years and 93.3% after 15 years. Seven shoulders were available for clinical and radiological evaluation at a mean follow-up of 19 years (range 17-22 years). Age- and sex-adjusted CMS improved from preoperative to the latest follow-up (44.4% vs. 82.9%; p < 0.01). No glenoid erosion of higher degree (Sperling grade > 2) and no signs of implant loosening were observed. All patients had Walch type A glenoids preoperatively.</p><p><strong>Conclusion: </strong>In this small cohort with long-term follow-up of 17-22 years, CHHR showed promising durability and functional outcomes in carefully selected patients.</p><p><strong>Level of evidence: </strong>Level IV Case series with no comparison group.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2539-2547"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12488748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873183","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":"Periprosthetic fracture in the setting of periprosthetic joint infection of the hip: evaluation and management of a single-centre cohort with forty six patients.","authors":"Markus Jaschke, Stavros Goumenos, Carsten Perka, Ulrich Stöckle, Andrej Trampuz, Sebastian Meller","doi":"10.1007/s00264-025-06636-8","DOIUrl":"10.1007/s00264-025-06636-8","url":null,"abstract":"","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2463-2471"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12488837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954277","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}