Knee最新文献

{"title":"Medial meniscus extrusion is associated with acute cartilage deformation after mechanical loading during treadmill walking in older adults","authors":"Shogo Okada ,&nbsp;Masashi Taniguchi ,&nbsp;Masahide Yagi ,&nbsp;Yoshiki Motomura ,&nbsp;Sayaka Okada ,&nbsp;Kaede Nakazato ,&nbsp;Yoshihiro Fukumoto ,&nbsp;Kenta Iwane ,&nbsp;Masashi Kobayashi ,&nbsp;Kyoseki Kanemitsu ,&nbsp;Noriaki Ichihashi","doi":"10.1016/j.knee.2025.02.021","DOIUrl":"10.1016/j.knee.2025.02.021","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to investigate whether the worsening of meniscus function caused by medial meniscus extrusion (MME) was associated with acute cartilage deformation in the medial femur after mechanical loading, which changes depending on the contact force on the cartilage.</div></div><div><h3>Methods</h3><div>This was a secondary analysis of our previous study investigating acute cartilage deformation after mechanical loading in older women. Fifty-six women, aged ≥50 years, participated in the previous study, 48 of whom (age: 70.3 ± 7.6 years) participated in the meniscus assessment and were included in this analysis. MME was assessed using ultrasonographic B-mode images acquired in the standing position. Acute cartilage deformation was assessed based on the reduction in cartilage thickness after 15 min of treadmill walking. The mechanical cumulative loading was calculated by multiplying the time integrals of the positive values of the knee adduction moment, as assessed by motion analysis with the number of steps taken during treadmill walking. Paired <em>t</em>-tests were performed to compare cartilage thickness in pre- and post-walking. In addition, multiple linear regression analysis was performed to investigate whether MME was associated with acute cartilage deformation after walking.</div></div><div><h3>Results</h3><div>Significant cartilage deformation occurred after treadmill walking (pre-walking: 1.6 ± 0.3 mm, post-walking: 1.5 ± 0.3 mm, <em>P</em> &lt; 0.001, effect size (r) = 0.760). MME was associated with the amount of acute cartilage deformation after walking, independent of cumulative mechanical loading or cartilage condition (unstandardized regression coefficient B = 0.013, 95% confidence interval: 0.001–0.025, <em>P</em> = 0.033, effect size (R²) = 0.144).</div></div><div><h3>Conclusion</h3><div>Greater MME is associated with increased acute cartilage deformation after mechanical loading.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"54 ","pages":"Pages 192-198"},"PeriodicalIF":1.6,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143620550","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 tilt calculation utilizing artificial intelligence on CT knee imaging","authors":"Johannes Sieberer ,&nbsp;Albert Rancu ,&nbsp;Nancy Park ,&nbsp;Shelby Desroches ,&nbsp;Armita R. Manafzadeh ,&nbsp;Steven Tommasini ,&nbsp;Daniel H. Wiznia ,&nbsp;John Fulkerson","doi":"10.1016/j.knee.2025.02.019","DOIUrl":"10.1016/j.knee.2025.02.019","url":null,"abstract":"<div><h3>Background</h3><div>In the diagnosis of patellar instability, three-dimensional (3D) imaging enables measurement of a wide range of metrics. However, measuring these metrics can be time-consuming and prone to error due to conducting 2D measurements on 3D objects. This study aims to measure patellar tilt in 3D and automate it by utilizing a commercial AI algorithm for landmark placement.</div></div><div><h3>Methods</h3><div>CT-scans of 30 patients with at least two dislocation events and 30 controls without patellofemoral disease were acquired. Patellar tilt was measured using three different methods: the established method, and by calculating the angle between 3D-landmarks placed by either a human rater or an AI algorithm. Correlations between the three measurements were calculated using interclass correlation coefficients, and differences with a Kruskal-Wallis test. Significant differences of means between patients and controls were calculated using Mann-Whitney U tests. Significance was assumed at 0.05 adjusted with the Bonferroni method.</div></div><div><h3>Results</h3><div>No significant differences (overall: <em>p</em> = 0.10, patients: 0.51, controls: 0.79) between methods were found. Predicted ICC between the methods ranged from 0.86 to 0.90 with a 95% confidence interval of 0.77–0.94. Differences between patients and controls were significant (<em>p</em> &lt; 0.001) for all three methods.</div></div><div><h3>Conclusion</h3><div>The study offers an alternative 3D approach for calculating patellar tilt comparable to traditional, manual measurements. Furthermore, this analysis offers evidence that a commercially available software can identify the necessary anatomical landmarks for patellar tilt calculation, offering a potential pathway to increased automation of surgical decision-making metrics.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"54 ","pages":"Pages 217-221"},"PeriodicalIF":1.6,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143620571","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":"Structural equation model of knee pain in individuals with knee osteoarthritis-associated knee pain, based on functional capacity, kinesiophobia, muscle thickness, and joint position sense","authors":"Prasert Sakulsriprasert ,&nbsp;Tipwadee Bunprajun ,&nbsp;Ninwisan Hengsomboon ,&nbsp;Pichaya Hengsomboon ,&nbsp;Pavinee Harutaichun ,&nbsp;Chompunoot Suwanasri ,&nbsp;Pinyada Warathanagasame ,&nbsp;Chutiporn Thammajaree ,&nbsp;Akenarin Chocknakawaro ,&nbsp;Nattapa Ariyakitsakul","doi":"10.1016/j.knee.2025.02.024","DOIUrl":"10.1016/j.knee.2025.02.024","url":null,"abstract":"<div><h3>Background</h3><div>There are several clinical parameters that contribute to knee osteoarthritis (KOA)-associated knee pain and/or its progression such as kinesiophobia, functional capacity, muscle thickness, and joint position sense. The relationship between knee pain and those aforementioned clinical parameters is needed for clear understanding. Therefore, this study constructed the structural equation model of knee pain with the variables of kinesiophobia, functional capacity, muscle thickness, and joint position sense in individuals with KOA-associated knee pain.</div></div><div><h3>Methods</h3><div>We examined 200 individuals (74% female) with KOA-associated knee pain. Kinesiophobia, functional capacity test, quadriceps and hamstring muscle thickness, and knee joint position sense in flexion and extension were obtained and served as latent variables to investigate causal relationships with knee pain through structural equation modeling.</div></div><div><h3>Results</h3><div>All latent variables were fit for the structural model with excellent statistical parameters. The squared multiple correlations’ estimate for the model was 0.928. In particular, kinesiophobia, functional capacity test, and hamstring muscle thickness had significant associations with knee pain.</div></div><div><h3>Conclusion</h3><div>Knee pain was associated with kinesiophobia, functional capacity, quadriceps and hamstring muscle thickness, and knee joint position sense. Although this relationship does not establish causality, the findings underscore the importance of adopting an integrated approach when designing preventive interventions or therapeutic strategies for managing knee pain.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"54 ","pages":"Pages 199-208"},"PeriodicalIF":1.6,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143610781","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":"Letter to editor: Correction of injury rate calculation in anterior cruciate ligament ruptures in Spanish soccer first division: An epidemiological retrospective study","authors":"David Ortiz-Sánchez ,&nbsp;Alfredo Bravo-Sánchez ,&nbsp;Javier Abián-Vicén","doi":"10.1016/j.knee.2025.02.023","DOIUrl":"10.1016/j.knee.2025.02.023","url":null,"abstract":"","PeriodicalId":56110,"journal":{"name":"Knee","volume":"54 ","pages":"Pages 343-344"},"PeriodicalIF":1.6,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626836","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":"Commentary on “Bone Patella Bone allografts show superior outcomes in revision ACL reconstruction: A systematic review and meta-analysis”","authors":"Shubham Kumar,&nbsp;Ahmad Neyazi,&nbsp;Rachana Mehta,&nbsp;Ranjana Sah","doi":"10.1016/j.knee.2025.02.020","DOIUrl":"10.1016/j.knee.2025.02.020","url":null,"abstract":"","PeriodicalId":56110,"journal":{"name":"Knee","volume":"54 ","pages":"Pages 340-341"},"PeriodicalIF":1.6,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626851","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 machine learning approach using gait parameters to cluster TKA subjects into stable and unstable joints for discovery analysis","authors":"Erica M. Ramirez,&nbsp;Kathrin Ebinger ,&nbsp;Denis Nam,&nbsp;Christopher Ferrigno,&nbsp;Markus A. Wimmer","doi":"10.1016/j.knee.2025.02.018","DOIUrl":"10.1016/j.knee.2025.02.018","url":null,"abstract":"<div><h3>Background</h3><div>Patient-reported joint instability after total knee arthroplasty (TKA) is difficult to quantify objectively. Here, we apply machine learning to cluster TKA subjects using nine literature-proposed gait parameters as knee instability predictors and explore cluster reliability and consistency with self-organizing map (SOM) and k-means computation.</div></div><div><h3>Methods</h3><div>Subjects with TKA were retrieved from a data repository, supplemented by TKA patients with self-reported knee instability. Healthy elderly subjects, serving as control group for gait features, were added as well. All subjects have undergone identical gait analysis testing. Gait parameters (in singularity or combination) were used to cluster subjects using SOM and k-means and to identify the best split. Once clustered, comparisons between groups were performed.</div></div><div><h3>Results</h3><div>From all gait parameter combinations tried across the 91 TKA subjects, dynamic joint stiffness (DJS) was the single parameter that gave high reliability, was reasonably consistent, and singularly clustered all but one of the known unstable subjects. This TKA cluster, which contained 11 presumably unstable subjects, showed higher DJS (0.57) than the cluster containing the remaining TKA subjects (0.23). Interestingly, the latter had a DJS similar to that of the 34 healthy subjects (0.24). Additionally, during swing, the cluster with the presumably unstable subjects exhibited lower antero-posterior motion with a higher-than-normal biceps/rectus femoris activity ratio.</div></div><div><h3>Conclusion</h3><div>Using machine learning, DJS emerged as the most powerful variable to cluster TKA subjects into presumably stable and unstable groups based on gait. Future hypothesis driven, prospective research has to verify the observations made in this retrospective discovery work.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"54 ","pages":"Pages 167-177"},"PeriodicalIF":1.6,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593770","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":"Differences in functional recovery after unilateral versus bilateral total knee arthroplasty","authors":"Seung Jun Lee ,&nbsp;Jun Hwan Choi ,&nbsp;Bo Ryun Kim ,&nbsp;Yong-Geun Park ,&nbsp;So Young Lee ,&nbsp;Hyun Jung Lee ,&nbsp;Wooseong Jeong","doi":"10.1016/j.knee.2025.02.016","DOIUrl":"10.1016/j.knee.2025.02.016","url":null,"abstract":"<div><h3>Background</h3><div>Understanding functional changes between unilateral and simultaneous bilateral total knee arthroplasty (TKA) patients remains limited. The purpose of this study was to investigate the differences in recovery times between unilateral and bilateral TKA.</div></div><div><h3>Methods</h3><div>We retrospectively recruited patients who met the eligibility criteria. All patients engaged in a standard rehabilitation program and completed both self-reported questionnaires and performance-based physical function tests preoperatively, at 6 and 12 weeks postoperatively.</div></div><div><h3>Results</h3><div>A total of 838 patients were included in this study. Those who underwent bilateral TKA (<em>n</em> = 281) were younger than those opting for unilateral TKA (<em>n</em> = 557), with no significant differences in baseline health status observed between the two groups. Both groups showed continuous improvements in pain, function, and performance-based physical functions from preoperatively to 12 weeks postoperatively. Notably, stiffness did not significantly improve from the preoperative to 6 weeks postoperatively and the stair-climbing test (SCT) showed delayed recovery, with deterioration at 6 weeks but subsequent improvement at 12 weeks in bilateral TKA group. Similarly, the recovery rate in the 6-min walking test (6MWT) was initially slow for the bilateral TKA group during the first 6 weeks, but later accelerated. Significant interactions between time and group were observed in the timed-up-and-go test, 6MWT, and SCT.</div></div><div><h3>Conclusion</h3><div>Patients who underwent bilateral TKA showed distinct recovery patterns, suggesting the need for tailored rehabilitation approaches compared those who underwent unilateral surgery. These findings underscore the need to provide patients with information about potential differences in recovery patterns based on their chosen surgical approach prior to surgery.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"54 ","pages":"Pages 184-191"},"PeriodicalIF":1.6,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593771","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":"Detailed anatomy of the meniscotibial ligament and clock face position of meniscal attachments in the tibia","authors":"Keiichi Yoshida ,&nbsp;Mitsuaki Kubota ,&nbsp;Haruka Kaneko ,&nbsp;Jun Tomura ,&nbsp;Jun Shiozawa ,&nbsp;Youngji Kim ,&nbsp;Shinnosuke Hada ,&nbsp;Yoshitomo Saita ,&nbsp;Muneaki Ishijima","doi":"10.1016/j.knee.2025.02.022","DOIUrl":"10.1016/j.knee.2025.02.022","url":null,"abstract":"<div><h3>Background</h3><div>The meniscotibial ligament (MTL) is linked to meniscal extrusion that leads to knee osteoarthritis. There have been some reports on surgical treatment of MTL, however, the precise anatomy of the MTL attachment remains unclear. This study aimed to investigate the detailed anatomy of the attachment and to propose a method of clock face position.</div></div><div><h3>Methods</h3><div>Twenty knees of embalmed cadavers were included. Imaginary clock face positions were drawn on the tibial joint surface, with the anterior side defined as 12 o’clock, the posterior side as 6 o’clock, the medial side as 3 o’clock, and the lateral side as 9 o’clock. The MTL attachments to the tibial rim were then analyzed at 1-h intervals.</div></div><div><h3>Results</h3><div>All medial MTL and lateral MTL attachments at the 7 o’clock position were attached to the wall. MTL attachments on the articular surface were observed in certain cases at the 9 o’clock, 10 o’clock, and 11 o’clock positions. The medial MTL attachment was furthest from the articular surface at the 1 o’clock position and closest at the 4 o’clock position. The lateral MTL attachment was furthest at the 7 o’clock and closest at the 11 o’clock positions.</div></div><div><h3>Conclusions</h3><div>We revealed the detailed anatomy of the MTL and defined a novel method of clock face position. The medial MTL was not attached to the articular surface, whereas the lateral MTL was more anteriorly attached to the articular surface.<!--> <!-->These findings may facilitate the development of more accurate surgical techniques.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"54 ","pages":"Pages 178-183"},"PeriodicalIF":1.6,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143578773","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":"Is leukocyte scintigraphy recommended in periprosthetic knee infection diagnosis? A retrospective study of 92 total knee arthroplasties","authors":"Maria Pia Neri ,&nbsp;Mirco Lo Presti ,&nbsp;Davide Pellicanò ,&nbsp;Marco Minerba ,&nbsp;Monica Cosentino ,&nbsp;Cosimo Vasco ,&nbsp;Ludovica Solito ,&nbsp;Gabrio Goracci ,&nbsp;Stefano Zaffagnini","doi":"10.1016/j.knee.2025.02.005","DOIUrl":"10.1016/j.knee.2025.02.005","url":null,"abstract":"<div><h3>Purpose</h3><div>The aim of this study was to assess in vitro labelled leukocyte scintigraphy (LS) diagnostic accuracy in periprosthetic knee infection diagnosis.</div></div><div><h3>Methods</h3><div>This is a retrospective study that includes all patients with total knee arthroplasty (TKA) who performed LS before undergoing revision surgery for septic or aseptic loosening of the implant in our department from January of 2011 to March of 2023.</div><div>The 2018 International Consensus Meeting (ICM) and 2021 European Bone and Joint Infection Society (EBJS) periprosthetic joint infection (PJI) definitions were employed to define infected and not infected patients.</div></div><div><h3>Results</h3><div>92 TKAs were included in this study. This was the LS diagnostic performance according to the 2018 ICM PJI definition: sensitivity 89%, specificity 80%, positive predictive value (PPV) 80%, negative predictive value (NPV) 89%, positive likelihood ratio (LR + ) 4.46, negative likelihood ratio (LR-) 0.14. According to 2021 EBJS PJI definition: sensitivity 91%, specificity 80%, PPV 76%, NPV 92%, LR + 4.43, LR- 0.12.</div></div><div><h3>Conclusion</h3><div>Previously published studies on LS diagnostic performance report very variable results, probably due to the different and subjective PJI diagnostic criteria employed by each article. This is one of the first studies to employ the most recent PJI definitions and to demonstrate that LS may have a higher specificity and PPV than previously estimated. Therefore it represents a valid instrument in PJI diagnosis.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"54 ","pages":"Pages 154-166"},"PeriodicalIF":1.6,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143548652","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":"Posterior tibial slope after total knee arthroplasty is not reproducible or consistent","authors":"Ekin Barış Demir,&nbsp;Fatih Barça,&nbsp;Mert Uçak,&nbsp;Halis Atıl Atilla,&nbsp;Mutlu Akdoğan,&nbsp;Yalım Ateş","doi":"10.1016/j.knee.2025.01.006","DOIUrl":"10.1016/j.knee.2025.01.006","url":null,"abstract":"<div><h3>Background</h3><div>Our aim was to compare posterior tibial slope (PTS) values, distribution, deviation from manufacturer’s recommended value and restoration of this value in total knee arthroplasty (TKA) with tibial component placement using intramedullary (IM) and extramedullary (EM) methods, and to analyze factors affecting these values.</div></div><div><h3>Methods</h3><div>A total of 151 knees operated with Zimmer-Biomet NexGen® LPS Fixed Bearing Knee TKA between 2022 and 2024 were retrospectively investigated. Knees were grouped by method of tibial component placement (IM or EM). Pre-operative descriptive data, postoperative PTS, scatteredness of PTS, difference between pre-operative and postoperative PTS, deviation from 7° which was claimed by the manufacturer and rate of outliers were compared between groups. Factors that might affect postoperative PTS in the EM group were analyzed.</div></div><div><h3>Results</h3><div>Ninety-five knees (62.9%) in the EM group and 56 knees (37.1%) in the IM group were analyzed. Mean PTS decreased from 8.8 ± 3.5° to 6.7 ± 2.7° (<em>P</em> &lt; 0.001) in the EM group, and from 10 ± 4.1° to 4.9 ± 2.6° (<em>P</em> &lt; 0.001) in the IM group. Postoperative PTS was significantly lower in the IM group (<em>P</em> &lt; 0.001<u>)</u>. Mean deviation from 7° claimed by the manufacturer was 2.4 ± 1.4° for the EM group and 2.8 ± 1.8° for the IM group (<em>P</em> = 0.14). In 15 of 151 patients (9.9%), postoperative PTS was above 10°. Linear regression analysis revealed a moderate effect of pre-operative PTS and weight in the EM group.</div></div><div><h3>Conclusions</h3><div>Although not statistically significant, the EM method is closer to the manufacturer’s recommendation for sagittal alignment. However, both groups had a wide range of PTS and a large number of outliers. Both methods are not reliable in terms of PTS reproducibility and consistency.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"54 ","pages":"Pages 136-145"},"PeriodicalIF":1.6,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143548651","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}