Ortopedia, traumatologia, rehabilitacja最新文献

{"title":"Comparison of Suture Configurations for Acromioclavicular Joint Synthetic Reconstruction in Acromioclavicular Joint Separation: Finite Element Analysis.","authors":"Chidchanok Sakdapanichkul, Chamaiporn Sukjamsri, Cholawish Chanlalit","doi":"10.5604/01.3001.0055.4446","DOIUrl":"10.5604/01.3001.0055.4446","url":null,"abstract":"<p><strong>Background: </strong>In acromioclavicular (AC) joint separation, the weight of the upper extremity and scapula causes the scapula to rotate downward and internally along the thoracic cage. This results in displacement of the AC joint along three axes: anteroposterior, mediolateral, and vertical. Finite element models can aid in directing future biomechanical studies on this concept, not just the vertical axis, as has mainly been the focus in the past. This study uses finite element models to evaluate the stress across six suture configurations which reflects the efficacy on restraining AC joint motion after ligament resection with the upper extremity at rest.</p><p><strong>Material and methods: </strong>Three finite element (FE) models were constructed to simulate AC joint stabilisation with six different suture configurations, which were anterior-, posterior-, O-, X-, O-plus-X-, and V-frames. Internal and downward rotations of scapula, along with upward rotation of clavicle were defined following a whole-cadaveric study where the AC and coracoclavicular (CC) ligaments were removed entirely. Stress magnitude and distribution across the strand of each suture configuration were evaluated.</p><p><strong>Results: </strong>There is high stress in sutures that cross posteriorly and insert at the posterior clavicle (171,877-219,489 MPa) and anterior limbs (162,512-177,021 MPa). Suture crossing from the posterolateral to anteromedial point showed 36,573-39,430 MPa of stress.</p><p><strong>Conclusion: </strong>1. There are significant loads on sutures crossing posteriorly across the AC joint and located at the posterior aspect of the distal clavicle, as well as the anterior limbs. 2. The sutures crossing from the posterolateral to anteromedial point experience minimal load. 3. Further biomechanic studies in cadavers and clinical studies are still necessary to strengthen the evidence base for these findings.</p>","PeriodicalId":19622,"journal":{"name":"Ortopedia, traumatologia, rehabilitacja","volume":"27 3","pages":"115-123"},"PeriodicalIF":0.0,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145588458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"K-wire Migration Following Acromioclavicular Joint Fixation: A Case Report.","authors":"Vadym Sulyma, Andrii Sribniak, Roman Bihun, Yevhen Nychvyd, Liliia Lehun, Myroslav Lehun, Bohdan Divnych, Yuliia Divnych Filiak","doi":"10.5604/01.3001.0055.4447","DOIUrl":"10.5604/01.3001.0055.4447","url":null,"abstract":"<p><p>Kirschner wire (K-wire) is commonly used for temporary fixation of bone fractures, particularly in pediatric patients, but it poses risks such as breakage and migration. We present the case of a 67-year-old patient who underwent acromioclavicular joint fixation with K-wires after an injury. Nine months post-surgery, a wire fragment was found to have broken and migrated to the neck area. The migration led to the development of a pseudoaneurysm, which required surgical intervention for removal. The wire fragment was successfully removed, and the aneurysm was repaired after rupture. This case highlights the risks associated with wire migration and underscores the importance of strict adherence to the Tension Band Wiring (TBW) technique. Timely removal of fixation devices and regular radiographic monitoring during follow-up are essential to prevent potentially life-threatening complications.</p>","PeriodicalId":19622,"journal":{"name":"Ortopedia, traumatologia, rehabilitacja","volume":"27 3","pages":"125-129"},"PeriodicalIF":0.0,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145588512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology of Knee Joint Injuries in the Torsional Mechanism Among Pediatric Patients.","authors":"Weronika Kuźnik, Kacper Ruzik, Bartosz Gonera, Piotr Buchcic, Andrzej Borowski","doi":"10.5604/01.3001.0055.3259","DOIUrl":"10.5604/01.3001.0055.3259","url":null,"abstract":"<p><strong>Background: </strong>Knee sprains are a relatively frequent reason for hospitalisation in the paediatric population, with most patients needing a specialized surgical intervention. This article presents the epidemiology of internal torsional injuries to the knee joint among paediatric patients.</p><p><strong>Material and methods: </strong>We analysed data on paediatric patients hospitalised at the Department of Orthopaedics and Paediatric Orthopaedics of the Central Teaching Hospital in Łódź in the years 2018-2023 assigned the ICD codes M23 or S83.</p><p><strong>Results: </strong>We identified a group of 324 patients (163 boys, 161 girls) aged 8-18 years, with most of this group falling into the 14-18 age bracket (85%). 290 of the patients reported first-time injuries, and 34 had recurrent injuries. Among the 414 first-time injuries, the most common types were as follows: meniscal injuries (212), mostly of the medial meniscus (128), anterior cruciate ligament ruptures (125), lateral meniscus injuries (84) and medial patellofemoral ligament ruptures (77).</p><p><strong>Conclusions: </strong>1. Most torsional injuries tot he knee joint in the paediatric population involves multiple knee structures, thus requiring compreensive diagnostic work-up and individualised treatment. 2. In view of the high treatment cost and considerable burden on the health care system, future research should focus on optimising treatment strategies according to patient age, type of injury, risk of complications and cost-effectiveness of techniques used.</p>","PeriodicalId":19622,"journal":{"name":"Ortopedia, traumatologia, rehabilitacja","volume":"27 3","pages":"95-102"},"PeriodicalIF":0.0,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145588464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimally Invasive vs. Classical Technique in Primary Repair of Achilles Tendon in Men Aged 20-40 Years.","authors":"Jagoda Joanna Głodkowska-Sutuła, Kamil Michał Pękala, Tomasz Gromotowicz, Andreas Koufas, Igor Świerkowski","doi":"10.5604/01.3001.0055.3276","DOIUrl":"10.5604/01.3001.0055.3276","url":null,"abstract":"<p><strong>Background: </strong>Injuries to the Achilles tendon in men aged 20-40 years are most commonly caused by intensified physical activity leading to prolonged overload of the tendon. Most injuries affect the tendon's proximal third, which is less vascularised. Surgery for Achilles tendon injuries aims to obtain the best possible gait biomechanics and quickly restore the patient's functional performance. Clinical outcomes vary with the surgical technique used. This article presents the results of a study comparing the minimally invasive technique and the classical technique for primary repair of the Achilles tendon in men aged 20-40 years.</p><p><strong>Material and methods: </strong>A prospective clinical analysis was performed to investigate the treatment outcomes of 10 male patients aged 20-40 years and free from chronic medical conditions. The experimental group consisted of 5 men operated on using a minimally invasive technique in the form of a modified Webb-Bannister technique where the tendon is not sutured, but the tendon stumps are brought close together, resulting in better healing without the tendon being compressed. A control group consisted of 5 men who were subjected to conventional tendon repair.</p><p><strong>Results: </strong>A follow-up of one year found that both techniques of Achilles tendon repair produced positive clinical outcomes, with better effectiveness of the minimally invasive technique noted in the early phase of treatment.</p><p><strong>Conclusion: </strong>Men undergoing surgery for complete rupture of the Achilles tendon experience fewer complications related to surgical wound healing and achieve good mobility in the talocrural joint earlier when minimally invasive surgery is used as compared with conventional (classical) repair.</p>","PeriodicalId":19622,"journal":{"name":"Ortopedia, traumatologia, rehabilitacja","volume":"27 3","pages":"103-114"},"PeriodicalIF":0.0,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145588564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomechanical Changes Following Cervical Disc Arthroplasty.","authors":"Hussein Shoukry, Mohamed Elashhab, Ashraf Ismail Bakr, Abdel Salam Ahmed","doi":"10.5604/01.3001.0055.3258","DOIUrl":"10.5604/01.3001.0055.3258","url":null,"abstract":"<p><p>For more than five decades, anterior cervical discectomy and fusion has been the mainstay of surgical management of symptomatic cervical disc disease. Nonetheless, worries regarding adjacent segment degeneration (ASD) have prompted research into alternative techniques. Cervical disc arthroplasty (CDA), by preserving motion and restoring near-normal spinal biomechanics, seemed to be a promising solution. This review explores normal intervertebral disc (IVD) biomechanics and biomechanical changes following CDA. Evidence from current literature indicates that CDA generally maintains physiological spinal motion, though inevitably, there are changes. The range of motion (ROM) at treated levels approximates normal values. Although complications such as wear and heterotrophic ossification are relatively common, device stability remains satisfactory, and biomechanical comparisons between semi-constrained and unconstrained designs have shown negligible differences. CDA offers a compelling alternative to ACDF in appropriately selected patients. Nevertheless, long-term studies are essential to assess its outcomes comprehensively.</p>","PeriodicalId":19622,"journal":{"name":"Ortopedia, traumatologia, rehabilitacja","volume":"27 3","pages":"87-93"},"PeriodicalIF":0.0,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145588377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hip Arthroplasty in Supra-trochanteric Limb Length Discrepancy Patients.","authors":"Mohamed Samir Gobba, Khaled Abdel-Kader, Mahmoud Awad, Fouad Zamel Sadek","doi":"10.5604/01.3001.0055.6435","DOIUrl":"10.5604/01.3001.0055.6435","url":null,"abstract":"<p><strong>Background: </strong>Limb length discrepancy (LLD) with hip arthritis can lead to disability including impaired gait, low back pain, pelvic obliquity, and the need to use shoe lifts for correction. Total hip arthroplasty (THA) remains the most often performed procedure for patients with hip osteoarthritis. Elimination of LLD is an important goal of any THA procedure as it affects the functional outcome.</p><p><strong>Materials and methods: </strong>Prospective clinical case series. Over 4 years we enrolled 23 cases in our study. All patients had hip arthritis with clinical true LLD of 2 cm or more. Primary total hip arthroplasty and additional soft tissue releases were performed. LLD, range of motion (ROM), pelvic obliquity and Harris hip score (HHS) were compared preoperatively and postoperatively with follow-up for at least one year.</p><p><strong>Results: </strong>The mean Harris hip score improved from 41 (preoperatively) to 88.4 (one year postoperatively). Mean preoperative LLD was -3.1 0.9 cm, while mean postoperative LLD was -0.10.8 cm. Before the operation, 11 patients had pelvic obliquity compared to only one after the operation. No postoperative nerve palsy was reported.</p><p><strong>Conclusion: </strong>Patients with hip arthritis and associated supratrochanteric LLD can be successfully treated with primary THA and additional soft tissue releases.</p>","PeriodicalId":19622,"journal":{"name":"Ortopedia, traumatologia, rehabilitacja","volume":"27 4","pages":"157-165"},"PeriodicalIF":0.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147271693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"S53P4 Bioactive Glass Granules for the Management of Bone, Joint, and Related Soft-Tissue Infections: An Updated Review.","authors":"Chayanin Angthong, Tyler Vichayabhai, Phurin Tatiya-Apitham","doi":"10.5604/01.3001.0055.6433","DOIUrl":"10.5604/01.3001.0055.6433","url":null,"abstract":"<p><strong>Background: </strong>Bioactive glass S53P4 has drawn increasing interest for its use in managing chronic osteomyelitis, infected non-unions, and related soft-tissue infections. This review synthesizes clinical evidence with emphasis on comparative studies versus autologous bone grafts, allografts, and antibiotic carriers.</p><p><strong>Material and methods: </strong>We performed a comprehensive search of PubMed, EMBASE, and Scopus (January 2013 to September 2025) that identified human clinical studies reporting outcomes of S53P4 in bone, joint, and related soft-tissue infections. Search terms combined 'S53P4' OR 'bioactive glass' with 'osteomyelitis', 'bone infection', 'infected non-union', 'joint infection', and 'dead space management'. The data were screened, reviewed, extracted, and analyzed in accordance with the PRISMA guideline.</p><p><strong>Results: </strong>Across heterogeneous cohorts, infection eradication rates typically range from 80-95% with S53P4, bone healing is comparable to autograft, and complication rates are low. Comparative data suggest non-inferior infection control and bone consolidation relative to autograft/antibiotic-polymethylmethacrylate, with potential advantages for one-stage care and reduced length of stay.</p><p><strong>Conclusion: </strong>S53P4 bioactive glass provides infection control and bone regeneration outcomes comparable to autograft and selected antibiotic carriers in chronic osteomyelitis and infected non-unions. Its antimicrobial and osteoconductive properties enable effective one-stage treatment in many cases, with a favorable safety profile and potential cost savings. High-quality randomized trials remain limited, but current evidence supports S53P4 as a viable, cost-effective adjunct in orthopedic infection surgery.</p>","PeriodicalId":19622,"journal":{"name":"Ortopedia, traumatologia, rehabilitacja","volume":"27 4","pages":"143-148"},"PeriodicalIF":0.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147271673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orthopedic Horse-related Injuries in Children.","authors":"Ryszard Tomaszewski, Karol Pethe","doi":"10.5604/01.3001.0055.6434","DOIUrl":"10.5604/01.3001.0055.6434","url":null,"abstract":"<p><strong>Background: </strong>Orthopedic injuries associated with horse-related sports are high-energy injuries. This study aimed to evaluate horse-related orthopedic injuries, primarily spinal, excluding head injuries, based on a single-center analysis and literature review.</p><p><strong>Material and methods: </strong>Between 2020 and 2022, 28 patients were treated at the pediatric trauma and orthopedic unit of the level 1 regional trauma center following horse-related injuries. There were 24 girls and four boys; the average age of the patients was 10.7 (6-14) years. The patients sustained eight spinal injuries, 19 upper and two lower limb injuries. Radiographs were obtained in 28 patients, CT scans in 10, and MRI scans in 6 patients with spinal injuries. The average hospital stay was about four days (1-21), amounting to 3 for spinal injuries (1-12) and 4 for limb injuries (1-21). 20 patients were operated on.</p><p><strong>Results: </strong>Patients with spinal injuries received conservative treatment, whereas other types of injuries required surgical treatment. There was a statistically significant dependence (confirmed by the Wilcoxon test with p&lt;0.05) between the patient's age and the type of treatment employed (surgical vs conservative). The median age of patients requiring surgical treatment (9.5 years) was lower than that (12 years) of patients who did not require surgery.</p><p><strong>Conclusions: </strong>1. Equestrian sports are high-injury sports, especially in children. 2. Horseback riding accidents in children mainly affect the upper limb and spine. 3. Injuries to the upper limb usually require surgical treatment, while spinal injuries are managed conservatively.</p>","PeriodicalId":19622,"journal":{"name":"Ortopedia, traumatologia, rehabilitacja","volume":"27 4","pages":"149-156"},"PeriodicalIF":0.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147271720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peri-Incisional Numbness after Total Knee Arthroplasty: Prevalence, Evolution, and Impact on Functional Outcomes.","authors":"Daniel Godoy Monzon, Patricio Telesca, José Manuel Pascual Espinosa, Rafael Narvaez","doi":"10.5604/01.3001.0055.6436","DOIUrl":"10.5604/01.3001.0055.6436","url":null,"abstract":"<p><strong>Background: </strong>Peri-incisional numbness commonly follows total knee arthroplasty (TKA), primarily due to injury to the infrapatellar branch of the saphenous nerve. While this sensory deficit is often perceived by patients as a minor inconvenience, its effect on clinical and functional outcomes remains debated. To evaluate the prevalence, temporal evolution, and functional impact of postoperative numbness in patients undergoing primary cemented TKA. Secondary objectives included measuring the area of numbness (AON) over time and identifying the rate of persistent skin numbness (PSN).</p><p><strong>Material and methods: </strong>This prospective observational study included 437 patients (267 female, 170 male; mean age 64.1 8.6 years) who underwent primary cemented TKA using a standard medial parapatellar approach. Surgery duration, tourniquet time, wound length, hospital stay, Knee Society Score (KSS), and Roles and Maudsley satisfaction scores were recorded. Sensory assessments for light touch and pinprick were conducted at 6 weeks, 3 months, 6 months, and 1 year postoperatively. AON was quantified at each time point.</p><p><strong>Results: </strong>At 6 weeks postoperatively, 144 patients (32.9%) reported numbness (AON: 10.1 3.6 cm; KSS: 63.8 6.1). Numbness declined over time: 97 patients (22.2%) at 3 months (AON: 8.0 2.1 cm), 54 patients (13%) at 6 months (AON: 6.5 1.6 cm), and 38 patients (8.7%) at 1 year (AON: 4.2 2.8 cm). KSS and satisfaction scores improved across follow-up assessments. At final follow-up, 67% of patients rated outcomes as \"excellent,\" and only 11% reported fair or poor satisfaction. Persistent numbness correlated weakly with patient dissatisfaction. Poor satisfaction was linked to complications such as wound dehiscence (1.6%) and patellar tracking pain (3.6%).</p><p><strong>Conclusions: </strong>1. Peri-incisional numbness is common after TKA but shows significant spontaneous improvement over 12 months. 2. Persistent numbness does not significantly impact clinical or satisfaction outcomes for the majority of patients. 3. Patients should be informed preoperatively about this expected, generally minor, and self-limiting symptom.</p>","PeriodicalId":19622,"journal":{"name":"Ortopedia, traumatologia, rehabilitacja","volume":"27 4","pages":"167-171"},"PeriodicalIF":0.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147271680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Coronavirus Infection with Higher Mortality Rate and Longer Hospital Stay in Patients with Major Extremity Fractures.","authors":"Ashwin Chawla, Chayanin Angthong, Khanatchet Ratta-Apha","doi":"10.5604/01.3001.0055.2409","DOIUrl":"10.5604/01.3001.0055.2409","url":null,"abstract":"<p><strong>Background: </strong>The Coronavirus disease 2019 (COVID-19) pandemic has significantly affected healthcare systems, raising concerns about patient outcomes, particularly for those with coexisting conditions. Despite various studies on orthopedic injuries during the COVID-19 pandemic, differences in treatment outcomes remain insufficiently known. This retrospective cohort study investigated the effects of SARS-CoV-2 infection on patients with major extremity fractures requiring surgery. We hypothesized that patients with COVID-19 would experience longer hospital stays (LOS) and higher mortality rates.</p><p><strong>Material and methods: </strong>Data from 500 patients (mean age 47.1 years; 69.8% male) admitted to our hospital between March 2020 and July 2022 were analyzed. We collected demographic data, COVID-19 test results, fracture-related data, LOS, and mortality-related data.</p><p><strong>Results: </strong>Of the patients, 23 (4.6%) had COVID-19. While overall LOS showed no significant prolongation in patients with COVID-19, a significantly longer LOS was observed for patients with COVID-19 and lower extremity fractures (14.62 vs. 11.39 days, p&lt;0.00001) and upper extremity fractures (11.90 vs. 5.73 days, p=0.0271).</p><p><strong>Conclusions: </strong>1. Patients with COVID-19 exhibited a markedly longer LOS than those without COVID-19, with this effect being more pronounced in patients with lower extremity fractures. 2. When all patients had major extremity fractures, patients with COVID-19 had a significantly higher mortality rate than those with out COVID-19.</p>","PeriodicalId":19622,"journal":{"name":"Ortopedia, traumatologia, rehabilitacja","volume":"27 2","pages":"65-71"},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144874408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}