Acta Orthopaedica最新文献

{"title":"Long-term use of opioids and neuropathic medication after diaphyseal humerus fractures with or without nerve injury: a nationwide register-based cohort study of 4,185 patients.","authors":"Erika Nyman, Simone Andersson, Raquel Perez, Malin Zimmerman, Juan Merlo, Lars B Dahlin","doi":"10.2340/17453674.2026.46808","DOIUrl":"10.2340/17453674.2026.46808","url":null,"abstract":"<p><strong>Background and purpose: </strong> Diaphyseal humerus fractures may lead to prolonged pain medication use. We aimed to study pain medication use after such fractures, focusing on nerve injury.</p><p><strong>Methods: </strong> Using Swedish register data (2007-2015), we identified individuals with diaphyseal humerus fractures. High use of opioids and neuropathic pain medication (≥ 60% of days covered/year; 2-month post-fracture washout) was evaluated in 5 groups: the general population (reference) and fractures treated nonoperatively or surgically, with and without nerve injury. Relative risks (RRs; 95% confidence intervals [CIs]; crude and adjusted [aRR] models; adjusted for age, sex, country of birth, income, and cohabitation status; and for previous high use of pain medication during the first year when analyzing the second year) were estimated in Cox proportional hazards regression models.</p><p><strong>Results: </strong> We identified 4,185 individuals with diaphyseal humerus fractures (3.7% with nerve injury; 23% surgically treated). In the first year, opioid use was higher among surgically treated fractures with nerve injury (aRR 17.6, CI 11.0-28.3) and without nerve injury (aRR 9.5, CI 8.2-10.9) than in the general population. In the second year, opioid use declined across most groups but remained elevated among nonoperatively treated fractures with nerve injury (aRR 8.3, CI 2.6-26.1). Neuropathic pain medication use increased in the first year, with no elevated use in the second. Adjustment did not change overall patterns. Women, older adults, lower-income individuals, and those living alone showed higher medication risk use.</p><p><strong>Conclusion: </strong> Patients with a diaphyseal humerus fracture were associated with a substantial burden of pain medication use, particularly for opioids during the first year post-injury in surgically treated fractures with nerve injury (RR 17.6) and a persistent risk in the second year among nonoperatively treated fractures with nerve injury (RR 8.3). Demographics and socioeconomic factors strongly relate to medication use, highlighting the need for careful early pain management and monitoring for prolonged medication use in exposed groups.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"97 ","pages":"790-798"},"PeriodicalIF":3.4,"publicationDate":"2026-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13721846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149293788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between cemented and uncemented cups and risk of revision in patients aged 65 years or older following primary total hip arthroplasty: a study of 310,515 patients from the Nordic Arthroplasty Register Association.","authors":"Roshan Latifi, Simon Kornvig, Maziar Mohaddes, Muhanned Ali, Torbjørn Berge Kristensen, Geir Hallan, Antti Eskelinen, Keijo Mäkelä, Claus Varnum, Søren Overgaard","doi":"10.2340/17453674.2026.46937","DOIUrl":"10.2340/17453674.2026.46937","url":null,"abstract":"<p><strong>Background and purpose: </strong> Cemented stem fixation in total hip arthroplasty (THA) reduces early femoral fracture risk in elderly patients, but the optimal method of cup fixation remains controversial. We aimed to compare cup revision risk between cemented and uncemented acetabular cups in patients aged 65 years or older undergoing primary THA.</p><p><strong>Methods: </strong> This registry-based cohort study used data from the Nordic Arthroplasty Register Association (NARA). We included patients aged 65 years or older who underwent primary THA for primary osteoarthritis or sequelae of childhood hip disorders between 1995 and 2018. The primary outcome was all-cause cup revision, with prespecified analyses stratified by age and sex. Cox regression adjusted for age, sex, femoral head size, time period, and nation was used. Follow-up was divided into 3 periods: 0-1, 1-6, and 6-26 years.</p><p><strong>Results: </strong> Among 310,515 patients, cemented cups were associated with a lower risk of all-cause cup revision during the first year (adjusted hazard ratio [aHR] 0.47, 95% confidence interval [CI] 0.41-0.53) and a higher risk at 6-26 years (aHR 1.91, CI 1.72-2.13). In patients aged 80 years or older, the sex-specific adjusted hazard ratios after the first year were close to 1, with wide confidence intervals.</p><p><strong>Conclusion: </strong> Cemented cups were associated with a lower risk of cup revision during the first year across all age groups and a higher risk at 6-26 years in the overall cohort. Among patients aged 80 years or older, we found no evidence of an association between fixation method and cup revision after the first year.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"97 ","pages":"781"},"PeriodicalIF":3.4,"publicationDate":"2026-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13714679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149284674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporary percutaneous trans-tibiofibular K-wire stabilization of selected unstable ankle fractures.","authors":"Anders F Overgaard, Thomas Bloch, Chris H Dreyer","doi":"10.2340/17453674.2026.46960","DOIUrl":"10.2340/17453674.2026.46960","url":null,"abstract":"","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"97 ","pages":"776-778"},"PeriodicalIF":3.4,"publicationDate":"2026-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13714678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149284651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stable 2-year migration on radiostereometric analysis and improved gait speed and function after bicruciate-retaining TKA: a prospective cohort of 25 patients.","authors":"Kelly Mills, Simon N Van Laarhoven, Koen C Defoort, Saskia Susan, Petra J C Heesterbeek","doi":"10.2340/17453674.2026.46950","DOIUrl":"10.2340/17453674.2026.46950","url":null,"abstract":"<p><strong>Background and purpose: </strong> In bicruciate-retaining total knee arthroplasty (BCR TKA) the preservation of both cruciate ligaments necessitates a different tibial tray design with reduced bone-implant interface. These ligaments also influence knee joint force dynamics and may thereby affect component migration. The primary aim of our study was to assess the fixation of BCR TKA up to 2 years postoperatively. Secondary aims included the evaluation of clinical and functional outcomes.</p><p><strong>Methods: </strong> This prospective study (https://osf.io/zqt8d) included 25 BCR TKA patients. Migration of both components was assessed at different follow-up time points by model-based radiostereometric analysis (RSA) using bone markers. Primary outcome was total translation (TT) and total rotation (TR) at the 2-year follow-up. Secondary outcomes included at-home gait parameters (gait speed, stride length, stride time) assessed with wearable sensors, patient-reported outcome measures (PROMs), and adverse events (AEs).</p><p><strong>Results: </strong> At the 2-year follow-up, least-squares mean tibial TT was 0.22 mm (95% confidence interval [CI] 0.16-0.28) (tibia) and femoral TT 0.43 mm (CI 0.30-0.57). The least-squares mean tibial TR was 0.53° (CI 0.43-0.63) and femoral TR 0.64° (CI 0.46-0.82). PROMs improved significantly after surgery, with improvements exceeding the predefined minimal clinically important difference (MCID). Gait outcomes revealed a significant gait speed improvement, which remained below MCID, and no significant difference from healthy controls 1 year postoperatively. AEs included 2 intraoperative tibial eminence fractures, 4 cases of persistent postoperative pain, and 2 cases of postoperative oedema with temporary knee stiffness.</p><p><strong>Conclusion: </strong> RSA analysis of this BCR TKA demonstrated a stabilizing migration pattern that remained below established TKA benchmark values (for different designs), indicating good fixation at 2-year follow-up. The findings were accompanied by an improved PROM, whereas gait speed improvement was below MCID.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"97 ","pages":"767-775"},"PeriodicalIF":3.4,"publicationDate":"2026-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13697300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149260326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arthroplasty versus internal fixation for displaced femoral neck fractures in older patients with dementia: a target trial emulation study.","authors":"Simon Storgaard Jensen, Per Hviid Gundtoft, Rob G H H Nelissen, Jan-Erik Gjertsen, Alma B Pedersen","doi":"10.2340/17453674.2026.46936","DOIUrl":"10.2340/17453674.2026.46936","url":null,"abstract":"<p><strong>Background and purpose: </strong> Target trial emulation can improve design transparency in observational comparative-effectiveness studies. We applied the framework to compare the outcome after arthroplasty with that of internal fixation (IF) in patients with dementia and displaced femoral neck fracture regarding recorded reoperation, mortality, length of stay, and postoperative mobility.</p><p><strong>Methods: </strong> Using nationwide Danish registries, we emulated a target trial among patients aged ≥ 70 years. Patients were classified by index treatment (arthroplasty or IF) and analyzed according to the intention-to-treat estimand. Recorded reoperation in the Danish National Patient Registry within 365 days was the primary outcome. Secondary outcomes included major reoperation, mortality, length of stay, early mobilization, and mobility decline. Stabilized inverse probability of treatment weighting balanced measured covariates. We estimated weighted cumulative incidences accounting for competing death and weighted cause-specific hazard ratios (HRs) with 95% confidence intervals (CIs).</p><p><strong>Results: </strong> The emulated target trial included 3,161 patients, of whom 2,231 received arthroplasty and 930 IF. At 365 days, recorded reoperation occurred in 298/2,231 vs 68/930 patients receiving arthroplasty or IF, respectively; weighted incidences were 13% (CI 13-14) vs 7.6% (CI 7.0-8.3) (HR 0.52, CI 0.39-0.69). Major reoperation occurred in 191/2,231 vs 68/930; weighted incidences were 8.6% (CI 8.2-8.9) vs 7.6% (CI 7.1-8.2) (HR 0.84, CI 0.63-1.10). Death occurred in 1,040/2,231 vs 421/930; weighted estimates were 47% (CI 46-48) vs 43% (CI 42-44) (HR 0.86, CI 0.77-0.98). Length of stay was modestly longer after arthroplasty, whereas early mobilization and postoperative mobility were similar.</p><p><strong>Conclusion: </strong>IF was associated with fewer recorded reoperations and lower mortality than arthroplasty in routine care. Active-comparator target trial emulation enabled a transparent comparison of the treatment strategies, but residual confounding and differential outcome ascertainment limited causal and clinical interpretation.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"97 ","pages":"758-766"},"PeriodicalIF":3.4,"publicationDate":"2026-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13697299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149260281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alcohol use is common in older patients with fall-related fractures: a secondary analysis from a prospective cohort study using PEth as an objective assessment of consumption.","authors":"Cecilia Rogmark, Linnea Malmgren, Anna Holmgren, Åsa Magnusson, Helmi-Sisko Pyrhönen","doi":"10.2340/17453674.2026.46961","DOIUrl":"10.2340/17453674.2026.46961","url":null,"abstract":"<p><strong>Background and purpose: </strong> Alcohol increases the risk of falls and complications, but data on alcohol intake among trauma patients is unreliable. Excessive alcohol use can contribute to excess frailty and confusion in frail individuals and increase fall risk in otherwise robust older people. Phosphatidylethanol (PEth) is a biomarker accumulating through repeated alcohol intake, i.e., suitable for screening long-term consumption. Our primary aim was to describe alcohol consumption in older individuals admitted after a fall-related fracture. Our secondary, exploratory aims were to investigate the association between alcohol, frailty, and short-term clinical outcomes in these individuals.</p><p><strong>Methods: </strong> This prospective observational cohort study included those ≥ 65 years admitted due to acute fall-related fracture February 1, 2023-August 31, 2024. PEth was taken at admission. Predefined norm values classified low/no consumption as < 0.05, intermediate 0.05-0.30 and hazardous consumption > 0.30 µmol/L. Frailty status was assessed by the Clinical Frailty Scale (CFS). Our secondary aim was addressed using multivariable logistic regression on a propensity score-matched cohort.</p><p><strong>Results: </strong> Of the 505 patients included, 13% had PEth indicating hazardous consumption, 8.9% intermediate consumption, and 78% had low/no consumption. Of the non-frail patients, 18% had hazardous and 11% intermediate consumption. 19% of all women and 29% of all men had continuous alcohol consumption (defined as PEth ≥ 0.05 µmol/L). In the matched cohort, alcohol consumption was associated with a higher odds ratio (OR) of hyponatremia (OR 2.3, 95% confidence interval [CI] 1.1-4.5, P = 0.02). A trend towards lower odds of 90-day mortality (OR 0.2, CI 0.1-1.0, P = 0.05) was seen.</p><p><strong>Conclusion: </strong> A minimum of 1/5 older patients with fall-related fractures have continuous alcohol consumption. Non-frail patients had a higher intake than frail individuals. Alcohol consumption was associated with higher odds of hyponatremia. Otherwise, no apparent negative effects were identified in the short term.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"97 ","pages":"743-750"},"PeriodicalIF":3.4,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13678457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to the Letter: Re-rupture is not the only failure: tendon elongation and the 6-week nonoperative protocol for Achilles tendon rupture.","authors":"Ville Happonen, Heikki Kröger","doi":"10.2340/17453674.2026.46976","DOIUrl":"10.2340/17453674.2026.46976","url":null,"abstract":"","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"97 ","pages":"742"},"PeriodicalIF":3.4,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13678455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasma calprotectin as infection biomarker in hip fracture patients: a prospective cohort study.","authors":"Helmi-Sisko Pyrhönen, Johan Tham, Anna Stefánsdóttir, Alicia Persson, Linnea Malmgren, Cecilia Rogmark","doi":"10.2340/17453674.2026.46719","DOIUrl":"10.2340/17453674.2026.46719","url":null,"abstract":"<p><strong>Background and purpose: </strong>We aimed to compare the diagnostic performance of plasma calprotectin in detecting infections following hip fracture surgery with 3 other biomarkers: procalcitonin (PCT), C-reactive protein (CRP), and white blood cell (WBC) count.</p><p><strong>Methods: </strong>This prospective cohort study included surgically treated hip fracture patients aged ≥ 65 years, admitted to our department from April 2023 to August 2024. Plasma calprotectin, PCT, CRP, and WBC count were measured on postoperative day 3. The outcome was any infection within 30 days (primary) and 7 days (secondary). Biomarker performance was evaluated using receiver operating characteristic analyses in a comparative framework.</p><p><strong>Results: </strong>166/550 individuals were analyzed (median age 85 years, 68% women). 19% (n = 31) and 12% (n = 20) had infection within 30 and respectively 7 days. For 30-day infections, calprotectin showed highest area under the curve (AUC) of 0.66 (95% confidence interval [CI] 0.54-0.77), followed by WBC count 0.60 (CCI 0.48-0.72), CRP 0.53 (CI 0.42-0.63), and PCT 0.51 (CI 0.40-0.63). Difference in AUC was largest between calprotectin and PCT (0.14, CI 0.00-0.29), followed by CRP (0.12, CI -0.01 to 0.26), while similar to WBC count (0.06, CI -0.05 to 0.16). For 7-day infections, AUCs were as following: calprotectin 0.70 (CI 0.58-0.82), WBC count 0.69 (CI 0.56-0.81), CRP 0.56 (CI 0.42-0.69), and PCT 0.48 (CI 0.33-0.63). Difference in AUC was largest between calprotectin and PCT (0.22, CI 0.05-0.39), followed by CRP (0.15, CI -0.02 to 0.31), while WBC count was similar (0.01, CI -0.09 to 0.12).</p><p><strong>Conclusion: </strong>Calprotectin demonstrated a trend towards superior discriminatory ability for infections compared with PCT and CRP, particularly for infections within 7 days. Calprotectin provided moderate diagnostic accuracy, likewise WBC count.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"97 ","pages":"751-757"},"PeriodicalIF":3.4,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13678456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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 the Editor: Re-rupture is not the only failure: tendon elongation and the 6-week nonoperative protocol for Achilles tendon rupture.","authors":"Filippo Spiezia, Francesco Oliva, Nicola Maffulli","doi":"10.2340/17453674.2026.46973","DOIUrl":"10.2340/17453674.2026.46973","url":null,"abstract":"","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"97 ","pages":"740-741"},"PeriodicalIF":3.4,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13678454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound- and fluoroscopy-guided hip aspiration before revision total hip arthroplasty: procedural outcomes and diagnostic accuracy in sequential cohorts.","authors":"Thomas J A Van Schaik, Kevin May, Gerjon Hannink, Job L C Van Susante, Jon H M Goosen, H W Bart Schreuder, Wim H C Rijnen","doi":"10.2340/17453674.2026.46931","DOIUrl":"10.2340/17453674.2026.46931","url":null,"abstract":"<p><strong>Background and purpose: </strong> Hip aspiration remains essential in the diagnostic work-up of a painful total hip arthroplasty (THA) to assess for periprosthetic joint infection (PJI). In 2020, our institution transitioned from fluoroscopy-guided to ultrasound-guided aspiration. Our study aimed to describe dry-tap proportions, aspirated volumes, and complications, and explore diagnostic accuracy in sequential cohorts.</p><p><strong>Methods: </strong> This retrospective single-center study included 117 fluoroscopy-guided aspirations (December 2013-June 2020) and 90 ultrasound-guided aspirations (April 2020-March 2024) before revision THA. Procedural outcomes defined as dry taps, aspirated volumes, and complications within 14 days were assessed in the full cohorts, and diagnostic accuracy in procedures with a successful aspiration. Ultrasound-guided biopsy was performed in 39 patients.</p><p><strong>Results: </strong> The prevalence of PJI was 54/117 (46%) in the fluoroscopy cohort and 25/90 (28%) in the ultrasound cohort (difference -18 percentage points, 95% confidence interval [CI] -31 to -5). Dry taps occurred in 38/117 (32%) and 31/90 (34%) procedures, corresponding to an absolute difference of 2 percentage points (CI -11 to 16). Median aspirated volumes were 5 mL in the fluoroscopy cohort and 4 mL in the ultrasound cohort. No complications were recorded in the fluoroscopy cohort; 2 occurred in the ultrasound cohort, both among patients who underwent biopsy. Sensitivity was 16/34 (47%, CI 30-65) for fluoroscopy and 8/13 (62%, CI 32-86) for ultrasound; specificity was 41/44 (93%, CI 81-99) and 37/40 (93%, CI 80-98).</p><p><strong>Conclusion: </strong> Dry-tap proportions were similar in these sequential cohorts. 2 complications were recorded, both in patients who underwent biopsy. Specificity was high, whereas sensitivity could be assessed only in patients with a successful aspiration and available culture results, resulting in less precise estimates. The findings do not establish equivalence or superiority.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"97 ","pages":"734-739"},"PeriodicalIF":3.4,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}