Knee最新文献

{"title":"Three-dimensional models demonstrate differences in correction depending on femoral derotational osteotomy site and may enhance the planning and precision in femoral derotational osteotomy – An observational study in eight femora and two surgeons","authors":"Caterina Chiappe ,&nbsp;Alejandro Roselló-Añón ,&nbsp;Vicente Sanchis-Alfonso ,&nbsp;Joan Carles Monllau ,&nbsp;Julio Domenech-Fernández","doi":"10.1016/j.knee.2024.10.023","DOIUrl":"10.1016/j.knee.2024.10.023","url":null,"abstract":"<div><h3>Background</h3><div>Increased femoral anteversion (FAV) is crucial in the genesis of anterior knee pain (AKP) and a femoral derotational osteotomy (FDO) has demonstrated good clinical results. It remains unclear at what level of the femur the osteotomy should be performed. Resulting degrees of FAV measured by Murphy’s method do not always correspond to the degrees that had been planned after an FDO. The hypothesis of this study is that the femur rotation axis and the osteotomy rotation axis do not coincide. Three-dimensional (3D) technology is used to objectify the discrepancy between these two axes and to find solutions so that the two axes can coincide. The objective is to demonstrate the reliability and reproducibility of the 3D technique for osteotomy adjustment through an intraobserver and interobserver study.</div></div><div><h3>Methods</h3><div>Images of eight computed tomography scans of the femur, corresponding to seven patients with a diagnosis of AKP and increased FAV, were selected. Two surgeons performed the FAV measurement and simulation of FDO on 3D biomodels. The femoral osteotomies were defined at three levels, at 10°, 20°, 30°. To determine interobserver agreement, measurements were performed independently by two surgeons. To evaluate intraobserver differences each surgeon repeated all measurements after 15 days.</div></div><div><h3>Results</h3><div>Interobserver and intraobserver agreement: intraclass correlation coefficient 0.930 (95% confidence interval (CI) 0.799–0.975) and 0.986 (95% CI 0.959–0.995). Significant differences between the resulting values were observed when the osteotomy was performed at the intertrochanteric level.</div></div><div><h3>Conclusions</h3><div>The misalignment of the axes results in hypocorrection when the osteotomy is intertrochanteric. This phenomenon is not observed when the osteotomy is diaphyseal or supracondylar.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"52 ","pages":"Pages 131-138"},"PeriodicalIF":1.6,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693891","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":"Biomechanical differences of Asian knee osteoarthritis patients during standing and walking using statistical parametric mapping: A cross-sectional study","authors":"Yi Hu ,&nbsp;Phillis Teng ,&nbsp;Tsung-Lin Wu ,&nbsp;Ross Clark ,&nbsp;Yong-Hao Pua ,&nbsp;Oliver Roberts ,&nbsp;Jia Wei Yong ,&nbsp;Amr Alhossary ,&nbsp;Lek Syn Lim ,&nbsp;Desmond Y.R. Chong ,&nbsp;Wei Tech Ang ,&nbsp;Bryan Yijia Tan","doi":"10.1016/j.knee.2024.10.022","DOIUrl":"10.1016/j.knee.2024.10.022","url":null,"abstract":"<div><h3>Background</h3><div>Biomechanics of knee osteoarthritis (KOA) patients have been extensively studied using motion capture systems, but less have explored standing knee joint angles with the walking parameters, particularly in Asians. We aim to determine gait biomechanical differences between healthy and KOA participants in an Asian population using One-dimensional Statistical Parametric Mapping (SPM1D) and explore if they are associated with standing joint angles.</div></div><div><h3>Methods</h3><div>A total of 20 KOA and 24 healthy stood upright and walked 10 m at self-selected speeds. The standing angles, walking kinematic and kinetic parameters of the ankle, knee, hip and trunk were analysed. Lower limb muscle excitation was measured via electromyography. SPM1D was used to compare the healthy group with the KOA group, and for further subgroup analysis.</div></div><div><h3>Results</h3><div>The all KOA group had significantly greater standing knee flexion angles (KFA) (<em>p</em> &lt; 0.001), standing ankle dorsiflexion angles (ADA) (<em>p</em> &lt; 0.001), walking KFA during terminal stance (<em>p</em> = 0.001) and terminal swing (<em>p</em> = 0.02) and walking ADA during terminal stance (<em>p</em> = 0.02) and mid-swing to terminal swing (<em>p</em> = 0.001). Knee adduction moment (<em>p</em> = 0.04) and knee flexion moment (<em>p</em> = 0.03) were higher in severe KOA. A positive correlation was found between standing KFA and initial KFA (<em>R</em>² = 0.579), and mean walking KFA (<em>R</em>² = 0.801) in the KOA group.</div></div><div><h3>Conclusion</h3><div>The increase in standing KFA was associated with an increase in walking KFA in the KOA group. Static joint angles remain as an essential parameter, although further studies need to be carried out to determine if the increase in standing joint angles can be recommended as an adjunctive measure during gait analysis of KOA using motion capture.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"52 ","pages":"Pages 155-163"},"PeriodicalIF":1.6,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693778","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 submitted to re-revision ACL reconstruction present more knee laxity, more complications, and a higher failure rate than patients submitted to the first revision ACL reconstruction","authors":"Camilo Partezani Helito ,&nbsp;Andre Giardino Moreira da Silva ,&nbsp;Riccardo Cristiani ,&nbsp;Anders Stålman ,&nbsp;Vitor Barion Castro de Pádua ,&nbsp;Riccardo Gomes Gobbi ,&nbsp;José Ricardo Pécora","doi":"10.1016/j.knee.2024.11.004","DOIUrl":"10.1016/j.knee.2024.11.004","url":null,"abstract":"<div><h3>Background</h3><div>Few comparative studies have evaluated patients who underwent two revision anterior cruciate ligament reconstruction (ACLR) and patients who underwent one revision ACLR, and many of them have a short postoperative follow-up and a relatively small number of patients. The objective of this study is to evaluate the functional results, complications, and failure rates of patients who underwent one revision ACLR and patients who underwent two revision ACLRs.</div></div><div><h3>Methods</h3><div>This is a retrospective study comparing patients who underwent one revision ACLR (Group 1) with patients who underwent a re-revision ACLR (Group 2). Baseline demographic variables, operative data and post-operative data were evaluated.</div></div><div><h3>Results</h3><div>Among the 266 patients included, 226 were from Group 1 and 40 from Group 2. Patients in Group 2 had greater rotatory laxity and were more often subjected to associated osteotomy at the time of revision surgery. Postoperatively, patients from Group 2 reported poorer subjective IKDC score and showed greater knee laxity measured with the KT-1000 arthrometer, although both probably not clinically relevant. The complication rate was high in both groups, with a higher incidence in Group 2. Reconstruction failures were also higher in Group 2 (20% vs. 8.8%, <em>p</em> = 0.03).</div></div><div><h3>Conclusion</h3><div>Patients from Group 2 underwent a higher rate of associated osteotomy procedures, present higher complication rates and a higher failure rate compared with patients from Group 1. However, the functional scores (Lysholm and IKDC score) and the physical examination (KT-1000 and pivot-shift) did not show clinically relevant differences between the groups.</div></div><div><h3>Level of Evidence</h3><div>III, retrospective comparative therapeutic trial.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"52 ","pages":"Pages 147-154"},"PeriodicalIF":1.6,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693811","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 tendon–Hoffa fat pad interface: From anatomy to high-resolution ultrasound imaging","authors":"Vincenzo Ricci ,&nbsp;Giulio Cocco ,&nbsp;Kamal Mezian ,&nbsp;Ke-Vin Chang ,&nbsp;Jorge Barbosa ,&nbsp;Ondřej Naňka ,&nbsp;Levent Özçakar","doi":"10.1016/j.knee.2024.10.024","DOIUrl":"10.1016/j.knee.2024.10.024","url":null,"abstract":"<div><h3>Aim</h3><div>To propose a standardized, high-resolution ultrasound (US) protocol to assess the patellar tendon–Hoffa fat pad interface (PTHFPI) in patients with (proximal) patellar tendinopathy (PPT).</div></div><div><h3>Methods</h3><div>Using a high-frequency transducer and a high-level machine, we matched the cadaveric and histological microarchitecture of the PTHFPI with multiple sonographic patterns of patients with PPT. Likewise, high-sensitive color/power Doppler assessments were also performed to evaluate the microcirculation of the soft tissues beneath the patellar tendon.</div></div><div><h3>Results</h3><div>Modern US equipment allows for detailed assessment of the potential pain generators located inside the PTHFPI in patients with PPT. They include anterosuperior portion of the Hoffa body and the loose connective tissue of the deep paratenon with its microvascular plexus.</div></div><div><h3>Conclusions</h3><div>In patients with PPT, accurate sonographic assessment of the PTHFPI can be performed using adequate technological equipment. Accordingly, tailored ultrasound-guided interventions can also be planned if/when clinically indicated.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"52 ","pages":"Pages 139-146"},"PeriodicalIF":1.6,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693807","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":"The effect of frontal plane osteotomy angle on lateral cortex fracture in medial open wedge high tibial osteotomy procedure","authors":"Alper Kirilmaz ,&nbsp;Mustafa Özkaya ,&nbsp;Turgut Emre Erdem ,&nbsp;Faik Türkmen","doi":"10.1016/j.knee.2024.10.007","DOIUrl":"10.1016/j.knee.2024.10.007","url":null,"abstract":"<div><h3>Background</h3><div>Precise high tibial osteotomy is crucial, especially for middle-aged individuals with medial compartment arthritis, aiming to prevent complications like lateral cortex fractures. This study explores how frontal plane osteotomy inclination impacts lateral cortex fractures during medial open-wedge high tibial osteotomy.</div></div><div><h3>Methods</h3><div>Using finite element analysis, tibia models underwent osteotomies at angles of 10°, 13°, 16°, 19°, and 22°, forming five models. Forces from 5 N to 75 N were applied incrementally, recording bone stresses (MPa) at the lateral hinge, angle changes (°) along the osteotomy line, and gap distances (mm).</div></div><div><h3>Results</h3><div>Models with higher frontal inclination showed increased gap distances under identical forces. For instance, at 5 N force, the 10° inclination model displayed a correction angle of 0.28° and a 1.43 mm gap, while the 22° model had a correction angle of 0.35° and a 1.37 mm gap. Under 75 N force, the 10° model had a correction angle of 10.81° and a 14.02 mm gap, while the 22° model had a correction angle of 16.86° and a 19.31 mm gap.</div></div><div><h3>Conclusion</h3><div>The osteotomy starting point’s distance from the joint doesn’t significantly impact final stress on the lateral cortex when the same gap distance is achieved. However, in cases requiring a higher degree of correction, we can say that the surgeon can achieve the result with less resistance by keeping the osteotomy starting point more distal to the joint line.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"52 ","pages":"Pages 108-120"},"PeriodicalIF":1.6,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649581","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":"The impact of different types of physical activity on the risk of knee osteoarthritis: A Mendelian randomization study","authors":"Guiguan Wang ,&nbsp;Long Chen ,&nbsp;Yancheng Chen ,&nbsp;Jie Xu","doi":"10.1016/j.knee.2024.10.019","DOIUrl":"10.1016/j.knee.2024.10.019","url":null,"abstract":"<div><h3>Background</h3><div>We aim to evaluate the causal relationship between different types of physical activity and the risk of knee osteoarthritis (KOA) through a two-sample Mendelian randomization study.</div></div><div><h3>Methods</h3><div>We performed a two-sample Mendelian randomization analysis using publicly available Genome-wide association study associated with physical activity (460 376 individuals) and KOA (403 124 individuals). Two-sample Mendelian randomization analyses were performed to investigate the effects of exposure traits on KOA risk.</div></div><div><h3>Results</h3><div>In this Mendelian randomization analysis, we investigated the impact of different types of physical activity on the risk of KOA. Light do-it-yourself and walking for pleasure demonstrated a protective effect on the risk of KOA (P = 8.19 × 10−4 and P = 4.24 × 10−6, respectively). No statistically significant differences were observed for heavy do-it-yourself, strenuous sports, other exercises or physical inactivity.</div></div><div><h3>Conclusion</h3><div>This study has revealed that engaging in light do-it-yourself activities and walking may serve as potential protective factors against KOA. These findings underscore the significance of introducing such activities into public health strategies designed for the prevention and management of KOA. Additional research is warranted to reveal the underlying mechanisms further.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"52 ","pages":"Pages 90-98"},"PeriodicalIF":1.6,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142645184","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":"In vivo kinematics during step ascent: Changes to the knee associated with osteoarthritis","authors":"Owen J. Rabak ,&nbsp;Jacob A Devenish ,&nbsp;Diana M Perriman ,&nbsp;Jennie M Scarvell ,&nbsp;Catherine R Galvin ,&nbsp;Paul N Smith ,&nbsp;Mark R Pickering ,&nbsp;Joseph T Lynch","doi":"10.1016/j.knee.2024.10.018","DOIUrl":"10.1016/j.knee.2024.10.018","url":null,"abstract":"<div><h3>Background</h3><div>Stair climbing is a kinematically demanding activity, essential for maintaining independence and quality of life, yet is often impaired in patients with knee osteoarthritis (OA). The purpose of this study was to examine differences in kinematics of a step-up movement between participants with osteoarthritis and asymptomatic controls.</div></div><div><h3>Methods</h3><div>Thirty participants with end-stage OA awaiting total knee arthroplasty (TKA) and twenty-eight sex and age-similar asymptomatic participants were recruited. Participants performed a step-up task which was imaged via single-plane fluoroscopy. 3-dimensional prosthesis computer-aided design models were registered to the fluoroscopy, yielding in-vivo kinematic data. Kinematic variables of position, displacement, and rate-of-change in six degrees of freedom were compared between the two groups.</div></div><div><h3>Results</h3><div>OA knees exhibited significantly different kinematics to asymptomatic knees during step-up. Knees with OA demonstrated a reduced terminal extension angle, inferior translation and increased internal rotation throughout the movement compared to asymptomatic. OA participants exhibited more variability in kinematic parameters compared to asymptomatic controls, reflecting the heterogeneity within OA pathology.</div></div><div><h3>Conclusion</h3><div>The findings of this study indicate that knee kinematics, particularly rotation, differ significantly between OA and asymptomatic knees during step-up. Optimising rotational profiles in OA knee management could help optimise patient function and inform rehabilitation and surgical protocols.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"52 ","pages":"Pages 69-77"},"PeriodicalIF":1.6,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142645183","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":"An anatomical artificial bone implant can improve three-dimensional correction accuracy in open-wedge high tibial osteotomy","authors":"Yugo Morita ,&nbsp;Shinichi Kuriyama ,&nbsp;Yusuke Yamawaki ,&nbsp;Shinichiro Nakamura ,&nbsp;Kohei Nishitani ,&nbsp;Hiromu Ito ,&nbsp;Shuichi Matsuda","doi":"10.1016/j.knee.2024.10.017","DOIUrl":"10.1016/j.knee.2024.10.017","url":null,"abstract":"<div><h3>Background</h3><div>An anatomical artificial bone implant inserted into the osteotomy gap might be useful for accurate alignment correction during open-wedge high tibial osteotomy (OWHTO). The aims of this study were to evaluate morphological variation in the osteotomy surface, identify an anatomical implant’s shape, and verify its usefulness for accurate three-dimensional (3D) correction.</div></div><div><h3>Methods</h3><div>Virtual OWHTO was performed with preoperative 3D computed tomography data from 100 knees. The tibial contour in the osteotomy plane was analyzed using principal component analysis to determine implant shape. An anatomical artificial bone implant with a 10° correction angle was made with a synthetic bone substitute. Coronal correction accuracy and changes in posterior tibial slope (PTS) and rotation were evaluated on eight cadaver knees that received the anatomical artificial bone implant and clinically on 85 in vivo knees that received conventional wedge-shaped spacers.</div></div><div><h3>Results</h3><div>The single-shape anatomical artificial bone implant was designed to occupy a posteromedial 30 × 25 mm region and had high contour congruency (mean mismatch, 0.73 mm; mean contact area coverage, 97.5%). Gap opening angle with the anatomical artificial bone implant was precise, avoiding excessive PTS change (mean, 0.6°) and rotational change (mean, 0.5°). In contrast, both PTS and rotational change with conventional spacers increased by a mean of 2.9°.</div></div><div><h3>Conclusions</h3><div>An anatomical artificial bone implant derived from the mean shape of 100 knees had high and consistent contour congruency. The anatomical artificial bone implant inserted with 3D surgical guidance provided accurate gap opening, reducing PTS change to less than 1° during OWHTO.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"52 ","pages":"Pages 78-89"},"PeriodicalIF":1.6,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649578","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":"Association between intra and inter-limb strength asymmetry with sprint kinematics and force-velocity profile in youth team athletes","authors":"İzzet İnce ,&nbsp;Erkan Tortu","doi":"10.1016/j.knee.2024.10.020","DOIUrl":"10.1016/j.knee.2024.10.020","url":null,"abstract":"<div><h3>Background</h3><div>Maximal force plays a pivotal role in enhancing performance across various dynamic sports, particularly in sprinting biomechanics. However, muscle strength asymmetry among major muscle groups like the hamstrings and quadriceps may hinder sprint performance and raise injury risks. This study examines how intra- and inter-limb strength asymmetry relates to sprint kinematics and the power-force–velocity profile in youth athletes.</div></div><div><h3>Methods</h3><div>Seventy-four youth athletes from football, volleyball, and handball completed two testing sessions, 48 h apart. Assessments included anthropometric measurements, sprint tests, and isokinetic dynamometer strength evaluations at 60°.s⁻1 and 180°.s⁻1. Sprint kinematics were analyzed using the Optojump Next system, and force–velocity profile variables were determined via Samozino’s method. Asymmetry analysis used a standard percentage difference equation.</div></div><div><h3>Results</h3><div>Weak to moderate correlations (r = −0.46 to 0.45) were found between strength asymmetry and sprint parameters, suggesting limited impact of asymmetry on sprint kinematics and kinetics. Although most participants showed asymmetry levels below the 15% threshold deemed functionally significant, outliers had asymmetry values up to 42%, indicating considerable variability.</div></div><div><h3>Conclusions</h3><div>Lower extremity strength asymmetry moderately affects sprint kinematics and force–velocity profiles in young team athletes, challenging traditional views. Further research is needed to explore the mechanisms between strength asymmetry and sprint performance, aiming to inform targeted training interventions that optimize performance and reduce injury risks in youth athletes.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"52 ","pages":"Pages 99-107"},"PeriodicalIF":1.6,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142645182","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":"Letter to the Editor regarding \"The value of sequential application of hydrogen peroxide, povidone-iodine and physiological saline in reducing postoperative infections after total knee arthroplasty: A prospective, randomized, controlled study\".","authors":"Xinjie Wang, Hui Ma","doi":"10.1016/j.knee.2024.10.015","DOIUrl":"https://doi.org/10.1016/j.knee.2024.10.015","url":null,"abstract":"","PeriodicalId":56110,"journal":{"name":"Knee","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142645181","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}