Journal of Hip Preservation Surgery最新文献

{"title":"Anteroinferior iliac spine osteoplasty at the time of periacetabular osteotomy helps preserve preoperative range of motion.","authors":"Wasim Shihab, Connor Luck, Jennifer Oakley, Michael McClincy","doi":"10.1093/jhps/hnaf007","DOIUrl":"10.1093/jhps/hnaf007","url":null,"abstract":"<p><p>Iatrogenic femoroacetabular impingement following periacetabular osteotomy (PAO) is a well-documented cause of postoperative complications. The anterior inferior iliac spine (AIIS) is an increasingly recognized source of impingement, and previous studies have documented high rates of abnormal AIIS subtypes in dysplastic hips undergoing PAO. This study evaluates the effects of PAO with concomitant AIIS osteoplasty on a range of motion and function. We performed a retrospective study of 63 hips that underwent PAO with concomitant open AIIS osteoplasty. AIIS was classified using 3D-reconstruction Computed tomography (CT) and femoral version was measured on axial-CT. Pre- and post.-operative lateral center-edge angle, Tönnis-angle, and anterior center-edge angle were calculated using X-ray imaging. Hip internal rotation (IR) at 90° flexion was recorded preoperatively, intraoperatively following PAO (pre- and postosteoplasty), and 6 months postoperatively. Pre- and postoperative Merle-d'Aubigné (MDA) scores were compared using pairwise <i>t</i>-test. IR motion changes were compared using repeated measures analysis of variance. Regression analyses evaluated the impact of femoral version on IR before and after osteoplasty. MDA significantly improved postoperatively. Intraoperative IR prior to AIIS osteoplasty was significantly reduced compared to other timepoints, but addition of the osteoplasty improved IR intraoperatively and 6 months postoperatively. No differences were noted in IR between pre- and postoperative examination. The impact of IR restoration with AIIS osteoplasty correlated significantly with femoral version, with greater motion improvement noted in patients with lower version. When planning PAO, careful appreciation of motion parameters is critical. Regardless of AIIS morphology, consideration of an intraoperative AIIS osteoplasty should occur when IR is decreased following acetabular reorientation.</p>","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"12 2","pages":"139-143"},"PeriodicalIF":1.1,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12318923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of interobserver and Intraobserver reliability of alpha angle measurements using different types of circles for femoroacetabular impingement syndrome.","authors":"Özgür Aydin, Onur Hapa, Emre Acar, Mustafa Celtik, Selahattin Agca, Cihangir Turemis, Raif C Yarol, Selahaddin Aydemir","doi":"10.1093/jhps/hnaf006","DOIUrl":"10.1093/jhps/hnaf006","url":null,"abstract":"<p><p>The alpha angle is a radiological measurement that has been proposed for the detection of cam morphology in patients suspected of femoroacetabular impingement syndrome (FAIS). After analysing published articles on FAIS, it is apparent that different types of circles are used in the measurement of alpha angles. To determine the interobserver and intraobserver reliability of alpha angle values measured using different types of circles on a 45° Dunn lateral radiograph in patients with symptomatic FAIS. The 45° Dunn lateral radiographs of the operated hips of patients who underwent hip preservation surgery in Dokuz Eylül University Hospital between 2014 and 2017 were evaluated retrospectively. Alpha angles were measured manually with transparent goniometers using three different circle types: thin full circle, thin-dashed circle, and thick full circle, and eye estimation without circle insertion. Measurements were made separately by an orthopaedist and a radiologist. A second measurement was made by the radiologist 1 month later for intraobserver reliability. Interobserver reliability for the thin full circle, thin-dashed circle, thick circle, and eye estimation (ICC = 0.645, 0.525, 0.494, and 0.588, respectively). Intraobserver reliability for the thin, thin-dashed, thick line, and eye estimation (ICC= 0.626, 0.681, 0.681, and 0.462 respectively). Interobserver difference of mean values of alpha angles for thin full, thin-dashed, thick full, and eye estimation were 2.7°, 0.9°, 1.1°, and 2.3°, respectively. Intraobserver differences between measurements were 1.5°, 0.9°, 0°, and 1.6°, respectively. Our study demonstrated that interobserver reliability is highest when measurements are made using a thin full circle.</p>","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"12 2","pages":"134-138"},"PeriodicalIF":1.1,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12318922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time required to achieve the minimal clinically important difference after open proximal hamstring repair.","authors":"Alexander E White, Nathan H Varady, Thun Itthipanichpong, Samarth V Menta, Anil S Ranawat","doi":"10.1093/jhps/hnae045","DOIUrl":"10.1093/jhps/hnae045","url":null,"abstract":"<p><p>Understanding the minimal clinically important difference (MCID) for a given procedure and its associated patient-reported outcome measures (PROMs) are critical for evaluating success in orthopedic surgery. The MCIDs for the International Hip Outcome Tool (iHOT-33) and Modified Harris Hip Score (mHHS) have been defined for open proximal hamstring repair (OPHR); however, the speed and reliability at which patients achieve these are unknown. A retrospective review of prospectively collected data from our institution's hip preservation registry was performed, examining pre-operative and 6-, 12-, and 24 months post-operative mHHS and iHOT-33 scores. The percentage of patients achieving MCID at each time point was determined, and factors associated with achieving MCID were assessed. A total of 37 patients were included in this analysis (<i>n</i> = 36 for iHOT-33 and <i>n</i> = 32 for mHHS). At 6 months, 83% and 78% of patients achieved MCID for iHOT-33 and mHHS, respectively. Patients with chronic symptoms (pain >6 months) were significantly less likely to achieve at least one of the MCIDs at 6 months (60% vs. 12.5%, <i>P</i> = .04), while patients with more severe preoperative pain were significantly more likely to achieve at least one of the MCIDs at 6 months (<i>P</i> = .004). Most patients who achieve the MCID for iHOT-33 and mHHS following OPHR do so by 6 months postoperatively. Chronic symptoms were associated with failure to achieve either one of the MCIDs at 6 months post-operatively. Patients with more severe preoperative pain were more likely to successfully achieve one of the MCIDs at 6 months.</p>","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"12 2","pages":"87-92"},"PeriodicalIF":1.1,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12318921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in physical impairments in femoroacetabular impingement syndrome following arthroscopic surgery: a systematic review and meta-analysis.","authors":"Charlotte J Marshall, Charlotte Ganderton, Adrian Pranata, Oren Tirosh, Ky Wynne, John O'Donnell, Phong Tran, Doa El-Ansary","doi":"10.1093/jhps/hnaf002","DOIUrl":"10.1093/jhps/hnaf002","url":null,"abstract":"<p><p>Femoroacetabular impingement syndrome (FAIS) is a motion-related condition causing hip pain in young active adults. Physical impairment measures of body function include objective and reproducible measures of hip mobility, muscle power, and movement coordination. Limited data on physical impairments and the effects of arthroscopic surgery exist. The aim of this systematic review was to investigate changes in physical impairments in those with FAIS, pre- and post-arthroscopic surgery. Six databases were searched for English-language studies reporting on pre- and postoperative physical impairments using physical outcome measures. Reporting quality was assessed using the Grading of Recommendations Assessment, Development and Evaluations (GRADE) framework, the Cochrane Risk of Bias tools and Methodological Index for Non-Randomized Studies (MINORS); for pooled data [standardized mean difference (SMD), and 95% confidence intervals (CI)]. Seventeen studies were included (two randomized controlled trials; fifteen pre/postintervention studies), varying from low-critical risk of bias, low-moderate on the MINORS, and very low reporting quality using the GRADE tool. Postoperatively, participants with FAIS walked with a higher peak hip flexion moment [SMD 0.5, 95% CI (0.12-0.88); heterogeneity <i>I</i> ² = 0%, <i>P</i> = .82] and reduced external rotation range [SMD -0.68, 95% CI (-1.34 to -0.01); heterogeneity <i>I</i> ² = 61%, <i>P</i> = .05]. Surgery increased participant hip flexion moment and impulse, hip strength and faster gluteus maximus contraction time. Patients demonstrated reduced hip extension, abduction and adduction angles during walking gait, and peak hip extension moments during gait and squatting. While this review found some physical impairments changed postoperatively, further research into specific subgroups of FAIS would enhance understanding and inform rehabilitation programs and optimize patient outcomes. Level of Evidence: IV (systematic review of III and IV evidence).</p>","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"12 2","pages":"105-117"},"PeriodicalIF":1.1,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12318927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Weight-bearing CT as an approach to assess femoral-acetabular displacement during external rotation stress in the hip.","authors":"Dominic J L Rivas, Joshua M Gassmann, Jessica E Goetz, Holly D Aitken, John C Davison, Aspen Miller, Michael C Willey","doi":"10.1093/jhps/hnaf001","DOIUrl":"10.1093/jhps/hnaf001","url":null,"abstract":"<p><p>Hip dysplasia causes pathologic joint mechanics and can produce hip instability, leading to progressive joint degeneration and osteoarthritis. Weight-bearing computed tomography (WBCT) is an emerging technology that may enable quantification of femoral-acetabular displacement as an objective indicator of instability. To evaluate this potential, 10 patients indicated for periacetabular osteotomy to treat hip dysplasia and 10 healthy controls underwent two WBCT protocols. Participants were scanned in a neutral stance [weight-bearing (WB)] and again with the hip stressed in maximal external rotation (WB-stress), a position hypothesized to reproduce anterior instability. Clinical, nonweight-bearing computed tomography (CT) scans were available for patients with hip dysplasia. Congruency of the femoroacetabular joint space and position of the femoral head in the acetabulum were quantified via multiple 2D manual measurements and automated 3D measurements. There were no 2D measurements found to differ between the WB and WB-stress scans in either dysplastic (<i>P </i>= .742-1.000) or control (<i>P </i>= .203-1.000) hips. 3D translation of the femoral head center from WB to WB-stress averaged 1.3 ± 0.6 mm in the control hips, compared to 0.9 ± 0.4 mm in the dysplastic hips (<i>P </i>= .096). 3D joint space width (JSW) was determined for both the control and dysplastic hips, with greater JSW found in control hips for both the WB (<i>P </i>= .049) and WB-stress (<i>P </i>= .003) scans. WBCT has the potential to better capture subtle femoral-acetabular displacement derived from both automated 3D and manual 2D measurements in static instability-prone joint orientations.</p>","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"12 2","pages":"93-104"},"PeriodicalIF":1.1,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12318925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What the papers say.","authors":"Ali Bajwa","doi":"10.1093/jhps/hnae049","DOIUrl":"10.1093/jhps/hnae049","url":null,"abstract":"<p><p>The <i>Journal of Hip Preservation Surgery</i> (<i>JHPS</i>) is not the only place where work in the field of hip preservation can be published. Although our aim is to offer the best of the best, we are continually fascinated by work, which finds its way into journals other than our own. There is much to learn from it, and so <i>JHPS</i> has selected six recent and topical subjects for those who seek a summary of what is taking place in our ever-fascinating world of hip preservation. What you see here are the mildly edited abstracts of the original articles, to give them what <i>JHPS</i> hopes is a more readable feel. If you are pushed for time, what follows should take you no more than 10 min to read. So here goes ….</p>","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"11 4","pages":"323-325"},"PeriodicalIF":1.4,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Levels of evidence.","authors":"Richard E Field","doi":"10.1093/jhps/hnae047","DOIUrl":"10.1093/jhps/hnae047","url":null,"abstract":"","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"11 4","pages":"241-242"},"PeriodicalIF":1.6,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The ability of plain radiography to accurately describe the bone surface at the head-neck junction of the femur: a study using human bone models.","authors":"Tomohiro Mimura, Yuki Furuya, Kosuke Kumagai, Yasutaka Amano, Shunichi Miyahara, Ryota Uemura, Sadafumi Horikawa, Hideki Saito, Kohei Umeda, Fumitaka Ushiyama, Yugen Ogata, Takafumi Yayama, Kanji Mori, Shinji Imai","doi":"10.1093/jhps/hnae048","DOIUrl":"https://doi.org/10.1093/jhps/hnae048","url":null,"abstract":"<p><p>In evaluations of a cam deformity on femoroacetabular impingement, the head-neck junction (HNJ) must be accurately assessed. We conducted this study to determine the ability of plain radiography to visualize the end-to-end bone surface of the HNJ. We used six human bone models. Ten examiners evaluated the degree to which attached stainless wire marker at the 1:00, 1:30, and 2:00 radial plane defined in reconstructed computed tomography can be accurately detected on the bone surface on plain radiographies. We employed 13 plain radiographies: the cross-table lateral view, frog-leg lateral view, Espié frog-leg lateral view, false-profile view, modified false-profile view, 30° Dunn view (DV), 45° DV, 60° DV, 90° DV, 30° modified Dunn view (MDV), 45° MDV, 60° MDV, and 90° MDV. Examiners scored the degree to which the radiographic images accurately detected the stainless wire marker on the bone surface of the HNJ on a scale of 1 point (0% match) to 5 points (almost 100% match). The highest score for the 1:00 plane was 4.98 points on the 45° DV. Similarly, the highest scores of the 1:30 and 2:00 planes were 4.98 points for the 45° MDV and 4.68 points for the 90° MDV, respectively. On these bone model studies, the most suitable plain radiography for describing the HNJ at the 1:00, 1:30, and 2:00 planes were both the 45° DV, the 45° MDV, and the 90° MDV, respectively.</p>","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"12 1","pages":"65-73"},"PeriodicalIF":1.4,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12051853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bleeding disorders, longer operative time, and nongeneral anesthesia increase are associated with overnight admission after hip arthroscopy.","authors":"Jack Zhong, Connor R Crutchfield, Nathan J Lee, John Mueller, Christopher Ahmad, David Trofa, Thomas Sean Lynch","doi":"10.1093/jhps/hnae038","DOIUrl":"https://doi.org/10.1093/jhps/hnae038","url":null,"abstract":"<p><p>Overnight admission is a rare but major complication after hip arthroscopy (HA), and the paucity of data surrounding its causes limits patient education and quality of care. The purpose of this study was to identify risk factors for an unanticipated overnight admission after HA and assess for associated complications. This analysis queried the American College of Surgeons National Surgical Quality Improvement Program database using Current Procedural Terminology codes to identify hip arthroscopies from 2005 to 2017. Patient demographics, perioperative variables, and comorbidities were compared between ambulatory and nonambulatory patients [length of stay (LOS) ≥ 1] using bivariate analysis. Multivariate stepwise logistic regression then identified independent risk factors of adverse outcomes. Linear regression analyzed correlation of LOS with age, operative time, modified fragility index (mFI-5), and year of operation. A total of 2420 cases were included in this study with 400 (16.5%) overnight admissions. The mean subject age was 40 ± 13.9 years old (58.1% female). Admitted patients generally had higher American Society of Anesthesiologists (ASA) scores and a higher mFI-5 index. Multivariate logistic regression showed that mFI-5 > 0, bleeding disorders, operative time >1.5 h, and nongeneral anesthesia were independent risk factors for prolonged hospital stay. Patients aged 31-40 years had decreased risk of LOS ≥1. Nonambulatory surgery was associated with significantly increased risk for any complication, readmission, wound complication, and venous thromboembolism. This analysis demonstrates that operations >1.5 h and increased medical comorbidities predispose patients to greater risk of being admitted to the hospital after HA. Surgeons should consider these data to optimize controllable factors and patient selection to reduce the risk of postoperative admission.</p>","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"12 1","pages":"54-64"},"PeriodicalIF":1.4,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12051857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Six-month rehabilitation following surgical hip dislocation for femoroacetabular impingement restores the preoperative strength of most hip muscles, except for external rotators.","authors":"Guillaume Servant, Hugo Bothorel, Anthony Pernoud, Susan Mayes, François Fourchet, Panayiotis Christofilopoulos","doi":"10.1093/jhps/hnae042","DOIUrl":"https://doi.org/10.1093/jhps/hnae042","url":null,"abstract":"<p><p>The aim of this study was to evaluate the bilateral changes in hip muscle strength after a 6-month rehabilitation period for patients undergoing surgical hip dislocation (SHD) to treat femoroacetabular impingement syndrome (FAIS). We conducted a retrospective analysis on a cohort of 22 patients (mean ± SD age: 26 ± 7, 68% male) who underwent SHD for FAIS between March 2020 and January 2023 at La Tour Hospital. Bilateral isometric strength of eight hip muscle groups (abductors, adductors, hamstrings, quadriceps, extensors, flexors, internal, and external rotators) was assessed using a handheld dynamometer before surgery, and at 3 and 6 months postoperatively. After 6 months of rehabilitation, only the external rotators were weaker compared to preoperative levels (-13% ± 23%, <i>P</i> = .021). Strength levels were similar to preoperative levelsfor adductors (-2% ± 21%, <i>P</i> = .309), internal rotators (0% ± 25%, <i>P</i> = .444), quadriceps (0%± 23%, <i>P</i> = .501), hamstrings (7%± 20%, <i>P</i> = .232), extensors (7%± 19%, <i>P</i> = .336), flexors (8%± 34%, <i>P</i> = .781), and abductors (8% ± 25%, <i>P</i> = .266). At 6 months, 59% (abductors) to 82% (adductors) of patients did not achieve a clinically relevant strength improvement (>15%) compared to their preoperative status for aforementioned muscles. Additionally, 50% of the cohort experienced a clinically relevant loss of strength in the external rotators at 6 months post-surgery. To conclude, after SHD, most FAIS patients regained their preoperative strength for all muscle groups except the external rotators with a 6-month rehabilitation program. However, the effectiveness of the rehabilitation protocol varies on an individual level.</p>","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"12 1","pages":"46-53"},"PeriodicalIF":1.4,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12051858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}