Knee最新文献

{"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}

{"title":"Indications for lateral unicompartmental knee arthroplasty – A systematic review","authors":"Kristine Ifigenia Bunyoz ,&nbsp;Anders Troelsen ,&nbsp;Kirill Gromov ,&nbsp;Abtin Alvand ,&nbsp;Nicholas Bottomley ,&nbsp;Will Jackson ,&nbsp;Andrew Price","doi":"10.1016/j.knee.2024.10.012","DOIUrl":"10.1016/j.knee.2024.10.012","url":null,"abstract":"<div><h3>Background</h3><div>While evidence-based indications are established for medial UKA, the optimal indications for lateral UKA have not received as much attention. There exists significant anatomical, osteoarthritis phenotype, kinematic, and surgical technique differences between medial and lateral UKA. The indications for the two procedures may therefore not be identical. Hence, this review aims to access the indications and contraindications in published cohort studies on lateral UKA, to assess if consensus exists.</div></div><div><h3>Methods</h3><div>In May 2024, a systematic review was carried out following the Preferred Reporting Item for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Cohort studies on lateral UKA with a clear report of indications were included. Data on indications and contraindications were extracted to evaluate consensus. Furthermore, outcomes related to expanding or testing indications for lateral UKA were obtained.</div></div><div><h3>Results</h3><div>38 studies were included. Lateral UKA was mostly performed for primary lateral osteoarthritis. The most reported indications were moderate to severe lateral osteoarthritis, with full-thickness cartilage in the medial compartment, intact ligaments, a correctable valgus deformity, and a flexion contracture &lt; 10–15 degrees. The most reported contraindications were inflammatory arthritis and severe patellofemoral involvement. Eight studies investigated different indications on outcomes after lateral UKA; suggesting better outcomes for primary lateral osteoarthritis, no significant impact from the state of the patellofemoral joint, and conflicting results regarding age and weight.</div></div><div><h3>Conclusion</h3><div>While the literature suggests that some agreement does exist regarding indications for lateral UKA, a strong consensus was not found, indicating that well-defined and consensus-based indications for lateral UKA do not yet exist.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"52 ","pages":"Pages 58-68"},"PeriodicalIF":1.6,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633531","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":"Evaluating the impact of robotic-assisted total knee arthroplasty on quality of care through patient-reported outcome measures in a third-level hospital in Italy: A prospective cohort study","authors":"Davide Golinelli ,&nbsp;Federico Polidoro ,&nbsp;Simona Rosa ,&nbsp;Agnese Puzzo ,&nbsp;Giovanni Guerra ,&nbsp;Stefano Raimondi ,&nbsp;Antonio Chiaravalloti ,&nbsp;Valentina Sisti ,&nbsp;Francesco Sanmarchi ,&nbsp;Francesca Bravi ,&nbsp;Roberto Grilli ,&nbsp;Maria Pia Fantini ,&nbsp;Alberto Belluati","doi":"10.1016/j.knee.2024.10.009","DOIUrl":"10.1016/j.knee.2024.10.009","url":null,"abstract":"<div><h3>Background</h3><div>With the shift towards personalized medicine, understanding the impact of robotic-assisted total knee arthroplasty (TKA) on patient-reported outcome measures (PROMs) is essential for evaluating its effectiveness and patient satisfaction. The QUAROB (Quality-assessment-of-ROBotic-orthopedic-surgery) study aims at assessing the impact of robotic surgery on quality of care and joint functionality at 6 months post-surgery among patients undergoing robotic-assisted TKA.</div></div><div><h3>Methods</h3><div>This observational, prospective cohort study included patients from Ravenna Hospital, Italy, who underwent elective robotic TKA (2022–2023), and a historical cohort who underwent traditional TKA (2019). PROMs questionnaires (EuropeanQualityofLife-Visual AnalogScale, EQ-VAS, EuropeanQualityofLife-5Dimensions-3Likert, EQ-5D-3L, and KneeinjuryOsteoarthritisOutcomeScore-PatientSatisfaction, KOOS-PS) were administered within 30 days before surgery and 6 months post-surgery. Statistical analysis involved comparing baseline and follow-up PROMs, focusing on patients achieving at least a 10% improvement (Minimal Clinically Important Difference, MCID).</div></div><div><h3>Results</h3><div>The study enrolled 214 robotic surgery patients, with 208 completing baseline and 103 completing 6-month follow-up questionnaires. Patients undergoing robotic-assisted TKA demonstrated significant improvements in EQ-VAS, EQ-5D-3L, and KOOS-PS scores at 6 months. A significant proportion of patients achieved improvements exceeding the MCID threshold (68.9% for EQ-VAS, 58.3% for EQ-5D-3L, and 68.9% for KOOS-PS). Robotic TKA patients experienced shorter hospital stays (7 vs. 9 days, p &lt; 0.001) and higher engagement in rehabilitation compared to traditional TKA patients.</div></div><div><h3>Conclusions</h3><div>The QUAROB study provides evidence of the impact and benefits of robotic-assisted TKA, highlighting significant enhancements in PROMs, reduced hospital stays, and increased rehabilitation engagement. These outcomes reinforce the role of robotic technology in improving surgical precision and patient satisfaction in orthopedic surgery.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"52 ","pages":"Pages 32-42"},"PeriodicalIF":1.6,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633529","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":"Comparison of the treatment of patellar inferior pole fractures with combined vertical wire and mini steel plate fixation versus independent vertical wire fixation","authors":"Yan Dong,&nbsp;Weichun Huang,&nbsp;Lihong Wei,&nbsp;Yingxun Du,&nbsp;Bingmin Lin","doi":"10.1016/j.knee.2024.09.015","DOIUrl":"10.1016/j.knee.2024.09.015","url":null,"abstract":"<div><h3>Background</h3><div>Patellar fractures, in particular inferior pole fractures, pose significant challenges due to the patella’s complex biomechanics and crucial role in knee extension and stability. This study aimed to compare the therapeutic effectiveness and long-term efficacy of two fixation methods: combined vertical wire and mini steel plate fixation versus independent vertical wire fixation. The comparison was based on clinical classification, addressing the ongoing debate regarding optimal management strategies for patellar inferior pole fractures.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted, analyzing 226 patients with patellar inferior pole fractures. Patients were divided into two groups: the independent vertical wire fixation group (n = 117) and the combined vertical wire and mini steel plate fixation group (n = 109). Demographic data, clinical characteristics, surgical outcomes, functional outcomes, pain levels, return to daily activities, quality of life, and both short-term and long-term complications were assessed and compared between the two groups.</div></div><div><h3>Results</h3><div>The combined fixation group demonstrated significantly superior surgical outcomes, including shorter operation times and lower infection rates, despite higher blood loss. Furthermore, this group exhibited enhanced functional outcomes, reduced pain levels, and lower rates of osteoarthritis and salvage procedures compared with the independent fixation group.</div></div><div><h3>Conclusions</h3><div>The findings of this study suggest potential advantages of combined vertical wire and mini steel plate fixation over independent vertical wire fixation in the treatment of patellar inferior pole fractures. The combined fixation method was associated with improved surgical outcomes, enhanced functional recovery, better pain management, and reduced long-term complication rates.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"52 ","pages":"Pages 43-57"},"PeriodicalIF":1.6,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633521","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}