Journal of Knee Surgery最新文献

{"title":"Leveraging the American Joint Replacement Registry (AJRR) for Knee Arthroplasty Research.","authors":"Jeffrey B Stambough","doi":"10.1055/s-0044-1801309","DOIUrl":"https://doi.org/10.1055/s-0044-1801309","url":null,"abstract":"","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":"38 3","pages":"109"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multidimensional Analysis of Preoperative Patient-Reported Outcomes Identifies Distinct Phenotypes in Total Knee Arthroplasty: Secondary Analysis of the SHARKS Registry in a Public Hospital Department.","authors":"Raquel McGill, Corey Scholes, Stephen Torbey, Lorenzo Calabro","doi":"10.1055/s-0044-1801750","DOIUrl":"https://doi.org/10.1055/s-0044-1801750","url":null,"abstract":"<p><p>Traditional research on total knee arthroplasty (TKA) relies on preoperative patient-reported outcome measures (PROMs) to predict postoperative satisfaction. We aim to identify distinct patient phenotypes among TKA candidates, and investigate their correlations with patient characteristics. Between 2017 and 2021, patients with primary knee cases at a metropolitan public hospital were enrolled in a clinical quality registry. Demographics, clinical data, and the Veterans Rand 12 and Oxford Knee Score were collected. Imputed data were utilized for the primary analysis, employing <i>k</i>-means clustering to identify four phenotypes. Analysis of variance assessed differences in scores between clusters, and nominal logistic regression determined relationships between phenotypes and patient age, sex, body mass index (BMI), and laterality. The sample comprised 389 patients with 450 primary knees. Phenotype 4 (mild symptoms with good mental health) exhibited superior physical function and overall health. In contrast, patients in phenotype 2 (severe symptoms with poor mental health) experienced the most knee pain and health issues. Phenotype 1 (moderate symptoms with good mental health) reported high mental health scores despite knee pain and physical impairment. Patient characteristics significantly correlated with phenotypes; those in the severe symptoms with poor mental health phenotype were more likely to be younger, female, have a higher BMI, and bilateral osteoarthritis (<i>p</i> < 0.05). This multidimensional analysis identified TKA patient phenotypes based on common PROMs, revealing associations with patient demographics. This approach has the potential to inform prognostic models, enhancing clinical decision-making and patient outcomes in joint replacement.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contemporary Cementless Patellar Implant Survivorship: A Systematic Review and Meta-Analysis of 3,005 Patellae.","authors":"Khaled A Elmenawi, Adrian E Gonzalez-Bravo, Larry J Prokop, Charles P Hannon, Matthew P Abdel, Nicholas A Bedard","doi":"10.1055/a-2509-3442","DOIUrl":"https://doi.org/10.1055/a-2509-3442","url":null,"abstract":"<p><p>Historically, cementless patellar implants were fraught with issues of fixation and polyethylene wear. However, contemporary cementless patellar implants incorporate modern technologies for implant design and offer the potential for improved biological fixation and longevity. As such, an evaluation of the performance of modern cementless patellae is needed. The purpose of this study was to perform a systematic review and meta-analysis of contemporary cementless patellar implants used during primary total knee arthroplasty (TKA), with a particular focus on aseptic loosening of the patellar component.A systematic review of the literature was performed from January 2000 to February 22, 2024. We included all peer-reviewed studies that reported the number of revisions in patients who had cementless patellae placed in 2000 or later during primary TKA. Reviews and case reports were excluded. Out of 639 studies, 13 were included with a total of 3,005 cementless patellae analyzed. The mean patient age was 64 years and the mean body mass index (BMI) was 31 kg/m². Meta-analyses were performed to calculate the pooled revision rate per person-year of revision for aseptic loosening of the patellar component and revision for any patellar failure.Upon analysis of 13 studies involving a total of 3,005 cementless patellae, the revision rate for aseptic loosening of the patella was 0.2 per 1,000 person-years and the revision rate for any patellar failure was 1 per 1,000 person-years.Contemporary cementless patellar implants showed an overall revision rate of 1 per 1,000 person-years, demonstrating excellent longevity. The high survivorship, together with a low rate of loosening, show the utility and effectiveness of these implants. Given the nature of biologic fixation, these results are promising for long-term implant stability but additional follow-up is warranted.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143056133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients Undergoing Manipulation under Anesthesia following Primary Total Knee Arthroplasty: Are Their Patient-Reported Outcome Measures Inferior?","authors":"Michael N Sirignano, Robert S Rowe, James C Gainer, Brett W Royster, Langan S Smith, Kyle M Altman, Madhusudhan R Yakkanti, Arthur L Malkani","doi":"10.1055/a-2509-3109","DOIUrl":"https://doi.org/10.1055/a-2509-3109","url":null,"abstract":"<p><p>Stiffness after total knee arthroplasty (TKA) can lead to decreased function and patient dissatisfaction. Manipulation under anesthesia (MUA) is often performed to improve range of motion (ROM); however, there is no consensus on indications or timing. The purpose of this study was to compare clinical results and patient-reported outcome measures (PROMs) between patients who underwent MUA versus those with an uncomplicated postoperative course following primary TKA. This was an institutional review board-approved retrospective review of 116 consecutive patients who underwent MUA from 2013 to 2019 following primary TKA due to stiffness. Indication for MUA was failure to achieve 105 degrees of knee flexion at 6 weeks following surgery. Five patients underwent revision surgery and 15 patients from the MUA group were excluded: 12 lost to follow-up and 3 deaths. The remaining 96 MUA patients were matched to 288 TKAs who did not require MUA or revision, all with a minimum 2-year follow-up. Patients who underwent MUA were younger (60.7 vs. 66.3 years, <i>p</i> < 0.001) and had less preoperative knee flexion (105.4 vs. 110.7 degrees, <i>p</i> < 0.001). There were five (4.9%) revisions in the MUA group: two instability, two chronic pain, and one arthrofibrosis. There were no differences between the groups with respect to postoperative Knee Society Knee Score, Western Ontario and McMaster Universities Osteoarthritis, Knee Injury and Osteoarthritis Outcome Score for Joint Replacement, Forgotten Joint Score-12, satisfaction, or complications. Satisfaction rates were 88.5% among MUA patients and 89.6% among non-MUA patients (<i>p</i> = 1.0). Patients undergoing MUA following TKA, using the criteria of failure to achieve 105 degrees of flexion by 6 weeks postoperatively, were able to achieve similar PROMs and satisfaction compared with a control group with a low incidence of revision due to persistent arthrofibrosis.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraoperative Patellar Tendon Injuries during Total Knee Arthroplasty: A Comprehensive Review of Incidence, Risk Factors, and Management Strategies.","authors":"Evan Offord, Innocent Njoku, Nickelas Huffman, Ignacio Pasqualini, Viktor E Krebs, Nicolas S Piuzzi, Matthew E Deren","doi":"10.1055/a-2509-3559","DOIUrl":"10.1055/a-2509-3559","url":null,"abstract":"<p><p>Patellar tendon rupture (PTR) is a rare and severe postoperative complication of total knee arthroplasty (TKA). Even rarer is the intraoperative occurrence of PTR during TKA. PTR is a major complication as it can lead to chronic disability, functional limitations, and postoperative morbidity. Therefore, surgical repair of the intraoperative PTR is typically pursued through one of the following three methods: (i) primary repair with direct suturing; (ii) direct suturing with cerclage augmentation, and (iii) direct suturing with either autograft or synthetic graft augmentation. In the case of an incomplete tear, direct repair with suture anchors for distal tears, and end-to-end repair with/without synthetic graft augmentation for mid-substance and proximal tears, is recommended. In the case of complete tears, if adequate tissue is present, direct repair with extensor mechanism reconstruction should be performed, regardless of the location of the tear. Furthermore, for complete tears with defective tissue, extensor mechanism reconstruction should be performed using mesh or allograft augmentation, regardless of the location of the tear. This review aims to provide a comprehensive and thorough overview of the prevention, diagnosis, management, and outcomes of intraoperative extensor mechanism injuries during TKA.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of the Serial Alignment Change after Opening-Wedge High Tibial Osteotomy Based on Coronal Plane Alignment of the Knee Using Machine Learning Algorithm.","authors":"Joon Hee Cho, Hee Seung Nam, Seong Yun Park, Jade Pei Yuik Ho, Yong Seuk Lee","doi":"10.1055/a-2525-4622","DOIUrl":"https://doi.org/10.1055/a-2525-4622","url":null,"abstract":"<p><p>Categorization of alignment into phenotypes can be useful for predicting and analyzing postoperative alignment changes after opening-wedge high tibial osteotomy (OWHTO). The purposes of this study were (1) to develop a machine learning model for the predicting the Coronal Plane Alignment of the Knee (CPAK) phenotypes of final alignment after OWHTO, and (2) to analyze predictive factors for final alignment phenotypes. Data were retrospectively collected from 163 knees that underwent OWHTO between March 2014 and December 2019. Each data was assessed at three time points: preoperatively, at 3 months postoperatively, and the final follow-up. Constitutional alignment was also evaluated. Machine learning models were developed using two independent feature sets consisting of serial radiologic parameters and CPAK phenotypes. The area under the curve (AUC) was used as a primary metric to determine the best model. To evaluate the feature importance, Shapley additive explanation (SHAP) analysis was also performed on the best model. Multi-layer perceptron (MLP) was the best prediction model, with the highest AUC of 0.867 based on radiologic parameters and 0.783 based on CPAK phenotypes. Joint line obliquity (JLO) at 3 months postoperatively was the most important factor among the radiologic parameters for predicting the final CPAK phenotypes. The features of constitutional and preoperative alignments also contributed, although the features of alignments at 3 months postoperatively were the highest contributing predictors. In conclusion, the developed machine learning models of the MLP showed excellent performance in predicting the final CPAK phenotypes after OWHTO. Postoperative JLO was the most important radiologic parameter for predicting the final alignment. The combination of features of the constitutional, preoperative, and postoperative periods enabled high accuracy and performance in predicting the final alignment. Level of evidence: Retrospective cohort study; Level III Key words: Knee, High tibial osteotomy, CPAK classification, Machine learning, Prediction.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiological characteristics of the knee in young patients with medial meniscus horizontal tears.","authors":"Takuya Naraoka, Hikaru Soneda, Runa Hori, So Morioka, Yukihiro Matsuyama","doi":"10.1055/a-2525-4711","DOIUrl":"https://doi.org/10.1055/a-2525-4711","url":null,"abstract":"<p><strong>Introduction: </strong>We aimed to assess medial meniscal (MM) healing and horizontal tear (HT) repair in the knees of young patients.</p><p><strong>Materials and methods: </strong>We enrolled 37 knees of 35 patients (mean age: 28.0 ± 10.2 years) with isolated meniscal repair that were divided into three groups: MM HT group (HT group, n = 15), MM tear except for HT group (MM group, n = 11), and lateral meniscus (LM) tear except for discoid meniscus group (LM group, n = 11). The anatomical lateral distal femoral angle (aLDFA), medial proximal tibial angle (MPTA), and posterior tibial slope were measured on preoperative radiographs. Magnetic resonance imaging was performed at 3, 6, and 12 months post-surgery. Clinical outcomes were evaluated using Lysholm and Knee Injury and Osteoarthritis Outcome Score (KOOS) at 24 months post-surgery.</p><p><strong>Results: </strong>aLDFA values were significantly lower in the HT and MM groups than in the LM group (P = .007). The MPTA was significantly lower in the HT group than in the MM and LM groups (P = .000). There were no differences in meniscal healing among the three groups at any time point after surgery (P = .376, .830, and .523, respectively). The KOOS subscale scores, symptom, pain, sports and recreation, and quality of life in the HT group were significantly lower than those in the LM group (P = .021, .033, .035, and .041, respectively).</p><p><strong>Conclusion: </strong>Young patients with MM HT have small aLDFA and MPTA values. Although the healing rate of HT post-repair was comparable to other types of MM or LM tears up to 1 year post-repair, clinical outcomes (KOOS) of repaired HTs were inferior to those of LM tears 2 years post-repair.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patellar Instability after Total Knee Arthroplasty.","authors":"Gabrielle Swartz, Zuhdi E Abdo, Sandeep S Bains, Jeremy A Dubin, Daniel Hameed, Sumon Nandi, Michael A Mont, Ronald E Delanois, Giles R Scuderi","doi":"10.1055/a-2509-3388","DOIUrl":"10.1055/a-2509-3388","url":null,"abstract":"<p><p>Patellar instability following total knee arthroplasty (TKA) is a rare, yet serious complication, potentially requiring revision surgery or resulting in chronic dysfunction. When encountered, it is paramount to understand the etiologies, diagnostic approaches, treatment options, and outcomes of the selected treatment. The most common cause of patella instability is improper positioning of components, leading to lateral maltracking of the patella. Factors such as internal rotation and/or medialization of femoral or tibial components and lateralization of the patellar button have been identified as factors that contribute to instability. Additionally, a longstanding valgus deformity of the knee may exacerbate patella maltracking. Patients typically present with anterior knee pain, worsened by activities like stair climbing, and may report sensations of giving way. Radiographs and computed tomography scans aid in evaluating component positioning and rotation. Operative intervention is often necessary, with options ranging from soft tissue realignment to component revision. Lateral retinacular release is a common approach, although it is associated with complications such as osteonecrosis of the patella. Proximal or distal realignment procedures may be required if instability persists. Some recent case reports have also described medial patellofemoral ligament reconstruction as a treatment modality, but more investigation on the topic is still pending. It is important that the treatment strategy address the underlying cause, as failure to do so may result in recurrent instability. The best way to avoid patella instability is to pay attention to all the details of component position and soft tissue balance during the index procedure.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilization of smartphone technology and wearable technology following TKA.","authors":"Adam Gordon, Awais Hussain, Michael A Mont","doi":"10.1055/a-2525-4672","DOIUrl":"https://doi.org/10.1055/a-2525-4672","url":null,"abstract":"<p><strong>Introduction: </strong>The widespread adoption of smartphones and wearable technology has introduced innovative approaches in healthcare, particularly in postoperative rehabilitation. These technologies hold significant promise for improving recovery following lower extremity arthroplasty, especially total knee arthroplasty (TKA). Despite growing interest, the evidence on their effectiveness and long-term impact remains variable.</p><p><strong>Methods: </strong>This narrative review evaluates the utilization of smartphone applications, wearable devices, and their combined use in postoperative recovery after TKA. Key studies assessing adherence, functional outcomes, patient satisfaction, and healthcare utilization were analyzed to synthesize insights into their effectiveness compared to traditional rehabilitation approaches.</p><p><strong>Results: </strong>Smartphone applications have demonstrated improvements in adherence to rehabilitation plans, pain management, and functional outcomes. For instance, interventions using text-based prompts or interactive platforms enhanced physical activity, reduced narcotic use, and improved patient-reported outcomes such as PROM adherence and range of motion (ROM). Similarly, wearable devices provided accurate feedback on activity levels and step counts, promoting early mobility and strength recovery. Combined approaches leveraging both technologies further enhanced adherence, functional recovery, and patient engagement while reducing healthcare utilization.</p><p><strong>Discussion: </strong>The integration of smartphone and wearable technologies in TKA rehabilitation shows potential for improving recovery outcomes. While findings generally indicate noninferiority or superiority to conventional methods, limitations exist in standardization, data accuracy, and long-term benefits. Future research should focus on refining these technologies, establishing standardized guidelines, and evaluating their cost-effectiveness in diverse populations. Smartphone and wearable technologies represent safe and effective tools for enhancing postoperative outcomes in TKA patients. Their integration into clinical practice could optimize rehabilitation protocols, improve patient engagement, and potentially reduce healthcare costs.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Bedside-to-Bench-to-Bedside Journey to Advance Osteochondral Allograft Transplantation towards Biologic Joint Restoration.","authors":"James L Cook, James P Stannard, Aaron M Stoker, Kylee Rucinski, Brett D Crist, Cristi R Cook, Cory Crecelius, Chantelle C Bozynski, Keiichi Kuroki, Lisa A Royse, Renee Stucky, Clark T Hung, Matthew J Smith, Kyle M Schweser, Clayton W Nuelle, Steven DeFroda","doi":"10.1055/a-2506-2675","DOIUrl":"10.1055/a-2506-2675","url":null,"abstract":"<p><p>More than 70 million adults in the United States are impacted by osteoarthritis (OA). Symptomatic articular cartilage loss that progresses to debilitating OA is being diagnosed more frequently and earlier in life, such that a growing number of active patients are faced with life-altering health care decisions at increasingly younger ages. Joint replacement surgeries, in the form of various artificial arthroplasties, are reliable operations, especially for older (≥65 years), more sedentary patients with end-stage OA, but have major limitations for younger, more active patients. For younger adults and those who wish to remain highly active, artificial arthroplasties are associated with significantly higher levels of pain, complications, morbidity, dysfunction, and likelihood of revision. Unfortunately, non-surgical management strategies and surgical treatment options other than joint replacement are often not indicated and have not proven to be consistently successful for this large and growing population of patients. As such, these patients are often relegated to postpone surgery, take medications including opioids, profoundly alter their lifestyle, and live with pain and disability until artificial arthroplasty is more likely to meet their functional demands without high risk for early revision. As such, our research team set out to develop, test, and validate biologic joint restoration strategies that could provide consistently successful options for young and active patients with joint disorders who were not considered ideal candidates for artificial arthroplasty. In pursuit of this goal, we implemented a targeted bedside-to-bench-to-bedside translational approach to hypothesis-driven studies designed to address this major unmet need in orthopaedics by identifying and overcoming key clinical limitations and obstacles faced by health care teams and patients in realizing optimal outcomes after biologic joint restoration. The objective of this article is to condense more than two decades of rigorous patient-centered research aimed at optimizing osteochondral and meniscus allograft transplantation toward more consistently successful management of complex joint problems in young and active patients.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}