Knee最新文献

{"title":"Sex-based differences in physical and psychological recovery, and return to sport, following anterior cruciate ligament reconstruction","authors":"Liza Kneebone ,&nbsp;Peter Edwards ,&nbsp;Nic Blackah ,&nbsp;Ross Radic ,&nbsp;Peter D’Alessandro ,&nbsp;Jay R. Ebert","doi":"10.1016/j.knee.2024.10.013","DOIUrl":"10.1016/j.knee.2024.10.013","url":null,"abstract":"<div><h3>Background</h3><div>A robust comparison of the recovery pathway between sexes after anterior cruciate ligament reconstruction (ACLR) is lacking. This study investigated sex-based differences in physical and psychological recovery, and return to sport (RTS), after ACLR.</div></div><div><h3>Methods</h3><div>104 community-level patients underwent ACLR. Patients were evaluated at 6-, 12- and 24-months with the Anterior Cruciate Ligament Return to Sport after Injury Scale (ACL-RSI), International Knee Documentation Committee (IKDC) form and Tegner Activity Scale (TAS), a 4-hop test battery including the 6-meter timed hop (6MTH) and the single (SHD), triple (THD) and triple crossover (TCHD) hop tests for distance, and peak isokinetic knee extensor and flexor torque. Sex-based differences were assessed, while regression analysis modelled the relationship between patient characteristics and outcomes, with 24-month psychological readiness to RTS.</div></div><div><h3>Results</h3><div>All PROMS improved (p &lt; 0.05), with males reporting higher 24-month ACL-RSI (p = 0.002), IKDC (p = 0.007) and TAS (p = 0.005) scores. A greater percentage of males returned to pivoting sports at 24 months (p = 0.030, males 60.0%, females 40.8%). Males demonstrated higher knee extensor strength LSIs at 6 (p = 0.037) and 24 (p = 0.047) months, and higher knee flexor strength LSIs at 6 (p = 0.007) and 12 (p = 0.002) months. IKDC knee scores (β = 24.9; 95% CI, 10.8 to 35.0), male sex (β = 12.2; 95% CI, 3.9 to 20.4) and the 6MTH LSI (β = 1.31; 95% CI, 0.6 to 2.1) were associated with the ACL-RSI.</div></div><div><h3>Conclusions</h3><div>In community-level ACLR patients, females demonstrated lower physical performance recovery, subjective function and psychological readiness, as well as a lower rate of RTS.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"52 ","pages":"Pages 22-31"},"PeriodicalIF":1.6,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604323","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":"Soft tissue flap reconstruction in infected or exposed total knee arthroplasty: A systematic review and network meta-analysis","authors":"Mario Alessandri-Bonetti ,&nbsp;Riccardo Giorgino ,&nbsp;Andrea Costantino ,&nbsp;Francesco Amendola ,&nbsp;Armando De Virgilio ,&nbsp;Laura Mangiavini ,&nbsp;Giuseppe M. Peretti ,&nbsp;Luca Vaienti ,&nbsp;Saïd C. Azoury ,&nbsp;Francesco M. Egro","doi":"10.1016/j.knee.2024.10.014","DOIUrl":"10.1016/j.knee.2024.10.014","url":null,"abstract":"<div><h3>Background</h3><div>Total knee arthroplasty (TKA) infection or exposure associated with soft tissue deficiency represents a challenging scenario for the reconstructive surgeon. The aim of the study is to determine the most successful reconstructive option for infected or exposed TKA comparing local muscle flaps (LMF), local fasciocutaneous flaps (LFF), and free muscle flaps (FMF).</div></div><div><h3>Methods</h3><div>A systematic review and single-arm network <em>meta</em>-analysis (PRISMA) was conducted to compare outcomes of complicated TKA requiring soft tissue coverage with either LMF, LFF and FMF. The protocol was registered on PROSPERO (CRD42023388731). PubMed, Embase, Web of Science and Cochrane Library were queried. MINORS criteria were employed for bias assessment. Outcomes included infection recurrence, TKA failure, above-knee amputation, and arthrodesis.</div></div><div><h3>Results</h3><div>A total of 30 studies and 555 flaps were included. Pooled prevalence was 0.18 (95% CI: 0.11–0.26) for infection recurrence, 0.18 (95% CI: 0.11–0.28) for arthroplasty failure, 0.10 (95% CI: 0.08–0.13) for above-knee amputation and 0.10 (95% CI: 0.08–0.13) for arthrodesis. Local fasciocutaneous flaps demonstrated the lowest risk of infection recurrence (LFF = 0.04 ± 0.037, LMF = 0.27 ± 0.043, FMF = 0.26 ± 0.092<em>)</em>, arthroplasty failure (LFF = 0.11 ± 0.068, LMF = 0.28 ± 0.045, FMF = 0.22 ± 0.094) and knee arthrodesis (LFF = 0.03 ± 0.027, LMF = 0.14 ± 0.03, FMF = 0.08 ± 0.06) after flap coverage of infected TKA. Free muscle flaps were associated with the lowest risk of above knee amputation (FMF = 0.08 ± 0.07, LFF = 0.10 ± 0.07, LMF = 0.11 ± 0.03). The mean MINORS score was 11.1 (95% CI: 11–12) with major weakness being the lack of prospective enrollment of the patients.</div></div><div><h3>Conclusion</h3><div>Based on the available literature, when appropriate, LFF appear to be the best reconstructive choice for soft tissue reconstruction in complicated TKA.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"52 ","pages":"Pages 9-21"},"PeriodicalIF":1.6,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604325","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":"Hip and knee joints mechanics and asymmetries in individuals with a history of anterior cruciate ligament reconstruction during overground running","authors":"Mostafa Shahbazi ,&nbsp;Hamed Esmaeili ,&nbsp;Fatemeh Salari-Esker ,&nbsp;Behzad Bashiri ,&nbsp;Davood Khezri","doi":"10.1016/j.knee.2024.10.010","DOIUrl":"10.1016/j.knee.2024.10.010","url":null,"abstract":"<div><h3>Background</h3><div>Individuals with a history of anterior cruciate ligament reconstruction (ACLR) represent altered knee joint mechanics in running. Hip joint can make subtle compensations in response to ACLR. Effects of ACLR on hip joint compensatory mechanisms is not well known. The aim of this study was to evaluate the hip join mechanics and asymmetry in individuals with ACLR history. We hypothesized that ACLR individuals’ hip exhibit altered mechanics which can increase the risk of hip overuse or osteoarthritis.</div></div><div><h3>Methods</h3><div>Kinetic and kinematic data of 20 males with ACLR history and 20 healthy males were collected bilaterally while running at 3.3 m·s⁻¹. Hip and knee joints peak angles, peak moments, peak negative and positive power and negative and positive work in the sagittal plane were calculated. Also, asymmetry of the outcomes was calculated. A mixed design MANOVA was used to detect between-group and within-group (side-by-group interaction) effects of ACLR on outcomes.</div></div><div><h3>Results</h3><div>Involved knee showed smaller flexion angle and negative work compared to uninvolved and control knee. In the hip joint, involved leg showed a higher flexion angle, extension moment, and peak positive and negative power as well as negative and positive work compared to uninvolved and control leg. ACLR group showed greater asymmetries in knee flexion angle, knee flexion moment, hip flexion angle, hip extension angle and hip negative power compared to healthy group.</div></div><div><h3>Conclusion</h3><div>Hip and knee joints mechanics of involved and uninvolved sides of the ACLR individuals are different. These results show that ACLR affects hip joint as well as knee joint. When returning to activity and sport, mechanics of the hip joint as well as knee joint, must be considered in ACLR individuals.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"52 ","pages":"Pages 1-8"},"PeriodicalIF":1.6,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142593390","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":"Intrawound vancomycin powder in primary total knee arthroplasty: Does it reduce early postoperative infection?","authors":"Stephen A. Doxey ,&nbsp;Torben H. Urdahl ,&nbsp;Rafat H. Solaiman ,&nbsp;Mariah N. Wegner ,&nbsp;Harsh Parikh ,&nbsp;Brian P. Cunningham ,&nbsp;Patrick K. Horst","doi":"10.1016/j.knee.2024.10.008","DOIUrl":"10.1016/j.knee.2024.10.008","url":null,"abstract":"<div><h3>Background</h3><div>The purpose of this retrospective analysis of a prospective quality control project was to determine whether the use of intrawound vancomycin powder (IVP) decreases the rate prosthetic joint infection (PJI) within 90-days following primary total knee arthroplasty (TKA).</div></div><div><h3>Methods</h3><div>From October 2021-September 2022, a prospective quality control project was undertaken in which 10 high-volume arthroplasty surgeons alternated between using IVP and not using IVP each month. Patients who received IVP were compared to those who did not. The primary outcome was culture positive PJI within 90-days following primary total knee arthroplasty. Secondary outcomes included overall reoperation rate, wound complications, and readmission within 90-days post-operatively.</div></div><div><h3>Results</h3><div>A total of 1,317 primary TKA patients were identified for analysis. Fifty-six and seven tenths percent (<em>n</em> = 747) of patients were included in the IVP group and 43.3% (<em>n</em> = 570) patients were included in the non-IVP group. The overall PJI rate was 0.5%. There was no difference in 90-day culture positive PJI rates between the groups (0.7% vs. 0.2%, <em>p</em> = 0.24). The overall reoperation rate did not differ between the IVP and non-IVP group (6.4% vs. 4.6%, <em>p</em> = 0.15). Reoperation for suspected infection was not statistically different by IVP administration (1.2% vs. 0.5%, <em>p</em> = 0.25). Additionally, there were no differences in the incidence of wound complications (<em>p</em> = 0.80) or readmissions (<em>p</em> = 0.15).</div></div><div><h3>Conclusions</h3><div>The overall infection rate for this cohort was low. IVP was not associated with decreased culture positive PJI, wound complications, reoperation or readmission rates. Further analysis of IVP use in TKA should be undertaken to fully determine its efficacy and safety profile.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"51 ","pages":"Pages 312-319"},"PeriodicalIF":1.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549191","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: Aseptic loosening of the option stemmed tibial tray in the Zimmer NexGen LPS total knee arthroplasty system. Knee. 2024 Mar;47:1-12.","authors":"","doi":"10.1016/j.knee.2024.10.004","DOIUrl":"https://doi.org/10.1016/j.knee.2024.10.004","url":null,"abstract":"","PeriodicalId":56110,"journal":{"name":"Knee","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513601","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":"Response to : Letter to the editor on \"Aseptic loosening of the option stemmed tibial tray in the Zimmer NexGen LPS total knee arthroplasty system\".","authors":"","doi":"10.1016/j.knee.2024.10.005","DOIUrl":"https://doi.org/10.1016/j.knee.2024.10.005","url":null,"abstract":"","PeriodicalId":56110,"journal":{"name":"Knee","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513602","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":"Long term outcomes following tibial plateau fracture fixation and risk factors for progression to total knee arthroplasty","authors":"Matthew Howell ,&nbsp;Alisa Khalid ,&nbsp;Callum Nelson ,&nbsp;James Doonan ,&nbsp;Bryn Jones ,&nbsp;Mark Blyth","doi":"10.1016/j.knee.2024.10.003","DOIUrl":"10.1016/j.knee.2024.10.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Tibial plateau fractures are complex, <em>peri</em>-articular fractures that can have poor outcomes resulting in conversion to total knee arthroplasty (TKA). This study evaluates the 10-year survival of tibial plateau fractures treated with open reduction and internal fixation and identifies risk factors associated with conversion to TKA.</div></div><div><h3>Methods</h3><div>This retrospective cohort study evaluates the outcomes of 126 patients undergoing tibial plateau ORIF from January 2011 to December 2012 at Glasgow Royal Infirmary. As well as patient factors, radiographic assessments were analysed including the degree of articular depression, medial proximal tibial angle, and femoral width ratio pre-operatively, <em>peri</em>-operatively and at the time of union. Patients requiring further surgical intervention, including TKA, were evaluated further.</div></div><div><h3>Results</h3><div>A bell-shaped distribution of patient age was observed. Schatzker II fractures were most prevalent (48%). Pre-operative articular depression averaged 6.9 mm ranging from 0.0 – 36.0 mm. Operative reduction was generally satisfactory (mean articular depression 1.3 mm, femoral width 0.96, mPTA 89.6⁰), with 82% achieving an anatomical reduction. 12 patients (9.3%) required TKA during follow-up with Kaplan-Meier calculated as 91.9% at 5 years and 87.4% at 10 years. Articular depression &gt; 4 mm (HR = 16.2), femoral width ratio &gt; 1.05 (HR = 14.7) and age &gt; 50 years (HR = 4.2) at time for fracture union were independently associated with progression to TKA.</div></div><div><h3>Conclusion</h3><div>9.3% of patients required TKA within 10 years of tibial plateau ORIF, Kaplan Meier 10-year survivorship was 87.4%. Joint depression and increased tibial width at time of union and age were independent risk factors associated with need for TKA. Particular care must be taken during operative intervention to ensure adequate reduction to lower this risk.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"51 ","pages":"Pages 303-311"},"PeriodicalIF":1.6,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513604","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":"Influence of varus-producing distal femur osteotomy correction and hinge width in relation to hinge fractures: Biomechanical study on porcine femora","authors":"Michel Meisterhans ,&nbsp;Anna-Katharina Calek ,&nbsp;Christoph Zindel ,&nbsp;Esteban Ongini ,&nbsp;Mario Somm ,&nbsp;Lazaros Vlachopoulos ,&nbsp;Sandro F. Fucentese","doi":"10.1016/j.knee.2024.10.002","DOIUrl":"10.1016/j.knee.2024.10.002","url":null,"abstract":"<div><h3>Background</h3><div>Hinge fractures in varus-producing distal femoral osteotomies (DFOs) lead to decreased axial and torsional stability. The purpose of this study was to assess (1) which hinge width has a high risk of hinge fracture in DFO for lateral opening wedge (LOW) and medial closing wedge (MCW) osteotomies, (2) which osteotomies allow for greater correction before risking a fracture, (3) whether patient-specific instrumentation (PSI) allows accurate hinge width planning.</div></div><div><h3>Methods</h3><div>Thirty porcine femoral bones were divided into two groups: LOW, MCW with hinge widths of 5 mm, 7.5 mm, and 10 mm as subgroups. Osteotomies were performed in a PSI-navigated fashion. A force parallel to the longitudinal bone axis was applied in a uniaxial testing machine until a fracture occurred.</div></div><div><h3>Results</h3><div>The maximum correction was 6.7 ± 1.1° for LOW and 13.4 ± 1.9° for MCW (β₀ &lt; 0.001_, β₁ = 0.002, β₂ = 0.02_, β₃ = 0.005). The relative error of the planned hinge width compared with the actual hinge width was −3.7 ± 12.3% for LOW (<em>P</em> = 0.25) and 12.3 ± 13.1% for MCW (<em>P</em> = 0.003).</div></div><div><h3>Conclusions</h3><div>Increasing the hinge width allows for greater correction in MCW osteotomies. For LOW osteotomies, a smaller hinge width seems to be advantageous because it allows a greater correction without the risk of hinge fracture. With PSI-guided LOW osteotomies, the planned hinge width could be achieved intraoperatively with greater accuracy than with MCW osteotomies. However, the MCW osteotomy appears to be the preferred option when larger corrections are desired because a larger correction angle can be achieved without the risk of intraoperative hinge fracture.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"51 ","pages":"Pages 282-291"},"PeriodicalIF":1.6,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513603","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":"Surgical treatment of progressive melorheostosis worsening over 19 years: A case report","authors":"Ziyang Dong ,&nbsp;Yang Li ,&nbsp;Feng Li ,&nbsp;Hua Tian","doi":"10.1016/j.knee.2024.10.001","DOIUrl":"10.1016/j.knee.2024.10.001","url":null,"abstract":"<div><h3>Background</h3><div>Melorheostosis is a relatively rare disease, which may cause chronic pain, soft tissue mass and restricted range of motion. Diagnosis and treatment of melorheostosis remains challenging.</div></div><div><h3>Case report</h3><div>We describe a patient with sclerotic bone involving the left acetabulum, femur, tibia, and talus. Over 19 years this patient showed slow progression of disease. The bone mass in the right popliteal region resulted in limitation of knee motion. Comprehensive management including physical therapy, medications and surgeries were adopted to obtain a full range of motion and no recurrence for 2 years.</div></div><div><h3>Discussion</h3><div>Accurate diagnosis and adequate treatments are critical to melorheostosis patients. Resection of redundant calcified mass is an effective method to treat severe limitation of range of motion associated with knee melorheostosis.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"51 ","pages":"Pages 276-281"},"PeriodicalIF":1.6,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513605","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":"Validity of wearable sensors for total knee arthroplasty (TKA) rehabilitation: A study in younger and older healthy participants","authors":"L. Forsyth ,&nbsp;A. Ligeti ,&nbsp;M. Blyth ,&nbsp;J.V. Clarke ,&nbsp;P.E. Riches","doi":"10.1016/j.knee.2024.10.006","DOIUrl":"10.1016/j.knee.2024.10.006","url":null,"abstract":"<div><h3>Background</h3><div>With 100,000 total knee arthroplasty (TKA) procedures taking place in the United Kingdom annually, the demand on rehabilitation services is high. Most regimes are home-based. Without clinician-patient interaction, detection of rehabilitation concerns can be delayed, reducing the chance of successful early intervention. Wearable technologies, such as MotionSense^TM (Stryker, US), may offer a solution to this problem by remotely supporting post-operative TKA rehabilitation through the provision of personalised rehabilitation and tracking of home exercises, enabling healthcare professionals to continuously monitor rehabilitation progress remotely. Validation of such devices against a known kinematic model in activities of daily living is important for confident interpretation of resulting clinical data. The aim of this study therefore was to validate the accuracy of MotionSense^TM against a clinical motion capture standard.</div></div><div><h3>Methods</h3><div>Twenty younger and 14 older healthy, able-bodied adults attended one testing session (Younger: 24 ± 4 years old; Older: 71 ± 5 years old). Movement was tracked using Vicon motion analysis and a Plug-In-Gait lower body model was applied to all participants. Three activities were performed – walking, stair ascent, stair descent. The knee flexion angle root mean square error (RMSE) between the technologies was determined.</div></div><div><h3>Results</h3><div>For both groups the knee flexion RMSE remained below 3° for all activities. The combined RMSE for all adults was 2.4° for walking, 2.7° for stair ascent, and 2.6° for stair descent. The signed error increased during the swing phase of gait.</div></div><div><h3>Conclusion</h3><div>MotionSense^TM was found to accurately estimate knee flexion angles during several common activities compared to Vicon motion capture.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"51 ","pages":"Pages 292-302"},"PeriodicalIF":1.6,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513606","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}