JBJS Reviews最新文献

{"title":"Balancing Risk and Reward in Hip Resurfacing for Developmental Dysplasia of the Hip: A Systematic Review and Meta-Analysis.","authors":"Jean Shanaa, Ethan Bernstein, Natalie Shanaa, Maani Bahador, Theodor Di Pauli von Treuheim, Scott Marwin","doi":"10.2106/JBJS.RVW.25.00091","DOIUrl":"10.2106/JBJS.RVW.25.00091","url":null,"abstract":"<p><strong>Background: </strong>As interest in hip resurfacing arthroplasty (HRA) expands to complex pathologies, developmental dysplasia of the hip (DDH) has emerged as a challenging but increasingly considered indication. Although severe DDH often precludes resurfacing because of distorted anatomy, mild cases (Crowe I and II) may provide favorable conditions. This review evaluates outcomes of HRA in mild DDH, compares them with outcomes of total hip arthroplasty (THA) in DDH and HRA in primary osteoarthritis (OA) and assesses the potential of HRA to improve long-term function in this population.</p><p><strong>Methods: </strong>A systematic search of PubMed, Embase, and Scopus identified studies reporting outcomes of HRA in DDH. Titles and abstracts were screened, followed by full-text review. Data on demographics, outcomes, and radiographic findings were extracted. Pooled complication and survivorship rates were calculated. A random-effects meta-analysis compared revision risk in HRA-treated patients with DDH vs. OA, and in patients with DDH treated with HRA vs. THA. Statistical significance was defined as a 95% confidence interval (CI) excluding 1. A separate meta-analysis compared mean postoperative flexion in patients with DDH treated with HRA vs. THA, with significance defined as a 95% CI excluding 0.</p><p><strong>Results: </strong>From 65 screened articles, 11 met inclusion criteria, totaling 895 patients and 1,006 hips with DDH. The mean age was 45.26 years, with an average follow-up of 7.06 years. The pooled survivorship was 93%, and the complication rate was 13%. No significant difference in revision risk was found between DDH and OA HRA cohorts, or between HRA and THA in DDH, although both trends favored OA and THA. Patients with HRA-treated DDH had significantly greater postoperative flexion (standardized mean difference -1.21, 95% CI -1.54 to -0.87).</p><p><strong>Conclusion: </strong>Despite anatomical challenges and a potential for higher revision or complication rates in patients with DDH, mid-term outcomes, including patient-reported outcome, were comparable with those in primary osteoarthritis and THA cohorts. This review supports the selective use of HRA in patients with Crowe I and II DDH, particularly when modern surgical techniques and DDH-specific implants are used.</p><p><strong>Level of evidence: </strong>Level III, systematic review of Level I, III, and IV studies. See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"13 7","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144664028","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":"A 10-Year Systematic Review of Brucella Periprosthetic Joint Infections Following Total Knee Arthroplasty.","authors":"Klaudia Greer, Jonathan Brutti, Zachary Grand, Janae Rasmussen, Mikaela Rockwell, Taylor Davis, Joseph Song, Jaspreet Sidhu","doi":"10.2106/JBJS.RVW.25.00079","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.25.00079","url":null,"abstract":"<p><strong>Background: </strong>Brucella species are zoonotic pathogens responsible for brucellosis, a systemic bacterial infection primarily transmitted through direct contact with infected animals or consumption of unpasteurized dairy products. While Brucella infections following total knee arthroplasty (TKA) are rare, they pose significant diagnostic and therapeutic challenges with limited reported cases.</p><p><strong>Methods: </strong>A systematic review, following the Preferred Reporting in Systematic Reviews and Meta-Analyses guidelines, was performed on February 22, 2025, using the databases PubMed and Google Scholar for Brucella TKA periprosthetic joint infections (PJIs) in patients older than 18 years. The search was further narrowed by excluding articles before 2015 to reflect the most current trends and practices. Our eligibility criteria were guided by the Population, Intervention, Comparison, and Outcome framework. We considered outcomes including, but not limited to, successful eradication of infection, complications, and functional outcomes following intervention.</p><p><strong>Results: </strong>Fifteen studies met inclusion criteria. Brucella PJIs in a TKA typically present late with nonspecific symptoms, often mimicking aseptic loosening or culture-negative PJIs. Most patients had identifiable risk factors, including travel to endemic regions, animal exposure, or consumption of unpasteurized dairy. Two-stage revision was used in 11 of 15 cases. Conservative management with implant retention was successful when no loosening was present in 3 out of the 15 cases. The most common antibiotic treatment was doxycycline plus rifampicin with duration ranging from 3 to 12 months, most commonly for a total of 6 months. Successful outcomes are possible with prolonged combination antibiotics and often require 2-stage revision arthroplasty, though diagnostic and treatment approaches vary widely.</p><p><strong>Conclusion: </strong>This is an updated systematic review of Brucella infections following TKA within the last 10 years. Given the insidious onset and potential for chronic infection, orthopaedic surgeons and infectious disease specialists must be aware of the possibility of Brucella PJIs in patients with the appropriate history and clinical examination.</p><p><strong>Level of evidence: </strong>Level III. See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"13 7","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144664027","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":"Wearable Technology in Orthopaedic Surgery: Applications and Future Directions.","authors":"Alexander W Iwasyk, Sia S Gaur, Alyssa Federico, John R Holash, Fred Nicholls, Michael J Monument, Joseph K Kendal","doi":"10.2106/JBJS.RVW.25.00067","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.25.00067","url":null,"abstract":"<p><p>» Wearable technologies (wearables), including smartphones, smartwatches, and sensors, such as accelerometers and inertial measurement units, enable continuous, real-time, and objective data collection on physical function, health behaviors, and patient perceptions.» Wearables can track mobility metrics such as step count, activity duration, and joint range of motion, providing valuable longitudinal insights into recovery trajectories.» In orthopaedic surgery, wearables support timely, personalized patient education and improve communication between patients and surgical teams, contributing to better functional outcomes and patient satisfaction.» Smart implants and virtual/augmented reality systems are emerging as innovative approaches to enhancing engagement and adherence during postoperative rehabilitation.» Key challenges to implementation include concerns about data privacy, accessibility, and integration into clinical workflows.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"13 7","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144664080","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":"Metal-Backed Tibial Components Offer Comparable Patient-Reported Outcome Measures With Lower Revision Rates Compared With All-Polyethylene Tibial Components in Medial Fixed-Bearing Unicompartmental Knee Arthroplasty: A Systematic Review and Meta-Analysis.","authors":"Sina Hajiaghajani, Sadra Mohebbi, Keivan Asadi, Mohammad Poursalehian, Negin Ashoori, Amir Mehrvar","doi":"10.2106/JBJS.RVW.25.00061","DOIUrl":"10.2106/JBJS.RVW.25.00061","url":null,"abstract":"<p><strong>Background: </strong>Two tibial component designs are mainly used in fixed-bearing unicompartmental knee arthroplasty (UKA): metal-backed (MtB) and all-polyethylene (AP). While AP components allow for increased polyethylene thickness with minimal bone resection, MtB implants offer modularity for isolated bearing exchange and potentially superior stress distribution. However, controversy remains regarding their respective revision rates and patient-reported outcome measures (PROMs).</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and registered our protocol on International Prospective Register of Systematic Reviews (CRD42024604110). A comprehensive search was performed in PubMed, Web of Science, Embase, and Scopus up to December 10, 2024, without language restrictions. Studies comparing MtB and AP tibial components in medial fixed-bearing UKA were included, assessing revision rates, PROMs, and range of motion (ROM). Data were extracted independently by 2 reviewers, and statistical analysis was performed using a random-effect model. Odds ratios (ORs) were calculated for all-cause revision and aseptic tibial loosening rates, whereas mean differences were calculated for PROMs and ROM.</p><p><strong>Results: </strong>Sixteen studies involving 34,738 participants (34,998 knees) were included, with 21,097 knees receiving MtB prostheses and 13,836 receiving AP prostheses. The overall all-cause revision and aseptic tibial loosening rates were significantly lower in the MtB group: OR, 0.49; 95% confidence interval (CI), 0.31-0.79; p = 0.003 and OR, 0.29; 95% CI, 0.09-0.99; p = 0.048, respectively. However, PROMs-including Knee Society Score, Knee Society Function Score, Oxford Knee Score, Knee Injury and Osteoarthritis Outcome Score, Short Form-36, and ROM-were comparable between groups.</p><p><strong>Conclusion: </strong>MtB tibial components in medial fixed-bearing UKA offer comparable PROMs and ROM with significantly lower rates of both all-cause revision and revision because of aseptic tibial component loosening relative to AP designs.</p><p><strong>Level of evidence: </strong>Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"13 7","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144664029","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":"Proximal Humerus Bone Loss in the Setting of Reverse Total Shoulder Arthroplasty.","authors":"Jonathan E Koa, Daniel E Goltz, Mohamad Y Fares, Peter Boufadel, Mohammad Daher, Logan Kolakowski, Eddie Y Lo, Sumant G Krishnan, Mark A Frankle, Joseph A Abboud","doi":"10.2106/JBJS.RVW.25.00006","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.25.00006","url":null,"abstract":"<p><p>» Proximal humerus bone loss (PHBL) is a challenging issue in the setting of reverse total shoulder arthroplasty, particularly during revision surgeries.</p><p><p>» PHBL can compromise the deltoid moment arm, soft tissue attachments, and stability of the humeral and glenoid components.</p><p><p>» Causes of PHBL are multifactorial, and the degree of bone loss can vary widely among patients.</p><p><p>» Treatment options include long-stem reconstruction prostheses, cementoplasty, reverse total shoulder allograft prosthesis composite reconstruction, proximal humerus replacement/endoprosthesis, and custom 3D-printed reconstruction.</p><p><p>» Each treatment option has unique advantages and limitations, emphasizing the importance of individualized management plans tailored to patient needs.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"13 7","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601885","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":"Preoperative Patient Optimization for Lower Extremity Total Joint Arthroplasty Surgery.","authors":"Kristen Barton, Jason M Jennings, Douglas A Dennis, Antonia F Chen","doi":"10.2106/JBJS.RVW.25.00037","DOIUrl":"10.2106/JBJS.RVW.25.00037","url":null,"abstract":"<p><p>» Identifying medical comorbidities and optimizing modifiable risk factors (biological, social, and psychological) have been suggested as a strategy to improve the value of total joint arthroplasty (TJA) care, while reducing the risk of intraoperative and postoperative complications. Modifiable biological factors include weight management to reduce obesity, optimizing diabetic control, improving malnutrition, optimizing bone health, improving anemia, managing anticoagulants and bleeding risk, controlling inflammatory conditions, reducing methicillin-sensitive Staphylococcus aureus/methicillin-resistant S. aureus colonization, and reducing frailty. Modifiable social and psychological factors include tobacco and smoking cessation, reducing alcohol use, ceasing drug use/misuse, optimizing mental health (i.e., depression, anxiety), patient TJA education and managing expectations, and evaluating discharge determination and living status. This review comprehensively evaluates and summarizes preoperative patient optimization strategies for lower extremity TJA surgery, both in the primary and revision settings.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"13 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337151","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":"Split Posterior Tibialis Tendon Transfer and the Recurrence Rate of Equinovarus Deformity in Patients With Cerebral Palsy: A Systematic Review and Meta-Analysis.","authors":"Marc Daniel Bouchard, Cameron Pow, Mark Polemidiotis, David Slawaska-Eng, Mousa Saeed Alahmari, Waleed Kishta","doi":"10.2106/JBJS.RVW.25.00064","DOIUrl":"10.2106/JBJS.RVW.25.00064","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Cerebral palsy (CP) is the most common motor disability of childhood, predominantly characterized by spasticity. A frequent complication of spastic CP is equinovarus deformity, resulting in pain, instability, and altered gait, significantly affecting ambulation. Surgical intervention, particularly the split posterior tibialis tendon transfer (SPOTT), is often required to correct deformity when conservative management fails. However, the variability in outcomes and recurrence rates across different patient subtypes and surgical techniques remains unclear. This systematic review aimed to evaluate the recurrence rate of equinovarus deformity in children with CP after SPOTT, with a focus on factors such as age, CP subtype, and functional status.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A systematic search of MEDLINE, Embase, and Emcare databases was performed to identify observational studies reporting recurrence rates after SPOTT in pediatric patients with CP (aged ≤18 years). Studies with short follow-up periods (&lt;12 months), non-English articles, conference abstracts, and those involving concomitant bony procedures were excluded. Statistical analyses used random-effects meta-analysis models to calculate pooled recurrence rates. All statistical analyses were performed, and forest plots were generated using R (version 4.3.2).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Nine studies (325 patients, 366 feet) met the inclusion criteria. The mean age at surgery was 10.35 years, with a mean follow-up duration of 76.18 months. The overall pooled recurrence rate of equinovarus deformity after SPOTT was 11.4% (95% confidence interval 5.0-17.8), with substantial heterogeneity (I2 = 71.9%). Subgroup analysis revealed higher failure rates among nonambulatory patients with quadriplegic CP (47.6%) compared with ambulatory hemiplegic patients (6.6%). The optimal age window for SPOTT seemed to be between 6 and 10 years as younger patients demonstrated increased risks of valgus deformity, whereas older patients had higher recurrence rates. Variations in surgical techniques, including interosseous membrane versus circumtibial routing, were identified as potential sources of heterogeneity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;SPOTT seems to be an effective intervention for correcting equinovarus deformity in ambulatory patients with CP, particularly those with hemiplegia or diplegia. However, nonambulatory and quadriplegic patients are at higher risk of recurrence, warranting careful patient selection. These conclusions should be interpreted with caution because of substantial study heterogeneity and the variability in surgical techniques reported. Further high-quality studies with standardized reporting and direct comparisons between surgical techniques are necessary to optimize outcomes and inform clinical practice.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Level of evidence: &lt;/strong&gt;Therapeutic Level IV, systematic review. See Instructions for Authors for a complete description of ","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"13 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337152","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":"Assessment and Management of Residual Acetabular Dysplasia from Age 1 to 5 Years: Defining Normal Acetabular Index Values and Indications for Treatment.","authors":"Taylor R Johnson, Stephanie Y Pun, William Z Morris, Eduardo N Novais, Steven L Frick","doi":"10.2106/JBJS.RVW.25.00062","DOIUrl":"10.2106/JBJS.RVW.25.00062","url":null,"abstract":"<p><p>» Persistent abnormal acetabular index values (>25-30° at 4-5 years or > 35° at 2 years of postreduction) may predict poor outcomes and indicate the need for pelvic osteotomy.» Assessment of the acetabular cartilaginous morphology and cartilaginous coverage of the femoral head by magnetic resonance imaging may assist in guiding surgical decisions.» Earlier pelvic osteotomy leverages remodeling potential, but observation until 4 to 5 years may be preferred to minimize risks and allow spontaneous correction.» Routine monitoring is crucial for stable, dysplastic hips, focusing on acetabular index trends over time.» Shared decision-making with families is essential to balance the risks of residual dysplasia and the likelihood of secondary procedures.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"13 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337149","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 Abductor Tendon Injuries: Diagnosis and Management Strategies.","authors":"Karolina A Serhan, Thomas J Berault, Kyle Wieschhaus, Aaron A Olsen, George C Balazs","doi":"10.2106/JBJS.RVW.25.00031","DOIUrl":"10.2106/JBJS.RVW.25.00031","url":null,"abstract":"<p><p>» Abductor tendon tears of the hip are debilitating injuries that disproportionately affect older women, with presentations ranging from incidental findings on imaging to chronic atraumatic degeneration. They can also occur as an iatrogenic injury during primary hip arthroplasty. Diagnosis includes radiographs and magnetic resonance imaging. Management of these injuries remains difficult and controversial. Contemporary nonoperative modalities have variable results. A myriad of surgical techniques exists for recalcitrant cases with overall positive outcomes. For irreparable tears, salvage procedures including allograft reconstruction or tendon transfers have been described with variable results.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"13 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337150","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":"Diagnosis and Management of Osteonecrosis of the Femoral Head in Young Patients.","authors":"Angel Xiao, Lisa Bonsignore-Opp, Victoria Koffi, Sarah Coufal, Ishaan Swarup","doi":"10.2106/JBJS.RVW.25.00046","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.25.00046","url":null,"abstract":"<p><p>» Osteonecrosis of the femoral head (ONFH) in pediatric patients is a rare but significant cause of disability because of the risk of early-onset osteoarthritis. The pathophysiology is believed to be vascular in origin, stemming from the friable nature of the epiphyseal blood supply across an open physis. Etiologies of pediatric ONFH include idiopathic, traumatic, and atraumatic. The goal of treatment is to slow disease progression and prevent the sequelae after femoral head collapse. Early diagnosis is key using a combination of physical examination and imaging findings. The management of pediatric ONFH, however, is complicated by a limited body of evidence and a lack of consensus on prevention or treatment. Treatment consideration depends on the age of the patient, extent of femoral head involvement, and presence of femoral head collapse.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"13 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276259","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}