Archives of Orthopaedic and Trauma Surgery最新文献

{"title":"Correction: Total blood loss and early clinical outcomes under different Tranexamic acid regimes in total knee arthroplasty","authors":"Mona-Lisa Eckhof, Sebastian von Hertzberg-Bölch, Annette Eidmann, Martin Lüdemann, Maximilian Rudert, Axel Jakuscheit","doi":"10.1007/s00402-025-05970-1","DOIUrl":"10.1007/s00402-025-05970-1","url":null,"abstract":"","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145011963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Percutaneous versus open cannulated screws fixation for displaced isolated medial malleolar fractures in adults: a randomized controlled clinical trial","authors":"Khalaf fathy elsayed Ahmed","doi":"10.1007/s00402-025-06055-9","DOIUrl":"10.1007/s00402-025-06055-9","url":null,"abstract":"","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00402-025-06055-9.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145011836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimation of cup orientation on intraoperative fluoroscopy in total hip arthroplasty: how safe is the safe zone—an experimental study","authors":"Roman Maduz,&nbsp;Michel Schläppi,&nbsp;Peter Wahl,&nbsp;Emanuel Benninger,&nbsp;Christoph Meier","doi":"10.1007/s00402-025-06025-1","DOIUrl":"10.1007/s00402-025-06025-1","url":null,"abstract":"<div><h3>Background</h3><p>Accurate acetabular cup orientation in total hip arthroplasty (THA) is crucial for successful outcomes. Intraoperative fluoroscopy may be used to evaluate acetabular cup placement. This study aimed to evaluate the accuracy of purely visual estimation of cup inclination and anteversion using intraoperative fluoroscopy, considering different surgeon experience levels and cup designs.</p><h3>Methods</h3><p>Thirty-five surgeons with varying levels of experience participated in the study. Standardized fluoroscopic images depicting two different cementless acetabular cup designs placed in a bone model were used. Inclination values ranged from 20 to 60°, while anteversion values ranged from 0 to 40°, both in 5° increments, resulting in 162 combinations of cup orientation. Each participant received a randomly compiled sequence of all images and was provided with instructions for estimating inclination and anteversion angles, and was asked additionally to categorize cup orientations into predefined safe zones, utilizing two definitions: (a) an institutional safe zone (inclination 35 to 45°, anteversion 10 to 20°), and (b) the safe zone according to Lewinnek et al. (inclination 30 to 50°, anteversion 5 to 25°). Participants had no time limit and were not allowed to use measuring tools during the estimation process.</p><h3>Results</h3><p>No significant difference in the precise estimation of inclination and anteversion was found among surgeons of varying experience levels. However, the ability to correctly identify whether cup orientation fell within predefined safe zones improved with surgical experience and seniority. Cup design influenced estimation of inclination, with one design showing superior accuracy. Estimation of anteversion remained consistent across designs. The influence of anteversion on inclination estimation and vice versa was minimal. Safe zone definitions did not significantly affect classification accuracy between cup designs.</p><h3>Conclusion</h3><p>While surgical experience did not improve angle estimation accuracy in degrees, it was associated with more accurate identifications of positions within clinically relevant safe zones. Cup design influenced inclination estimation. Our findings emphasize the importance of precise cup positioning in THA and highlight areas for potential improvement in surgical practice and training.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00402-025-06025-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145011815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the clinical results of arthroscopic release and open release in the surgical treatment of lateral epicondylitis","authors":"Mert Kahraman Marasli,&nbsp;Ali Cavit,&nbsp;Birkan Kibar,&nbsp;Ismail Emre Ketenci,&nbsp;Hakan Serhat Yanik","doi":"10.1007/s00402-025-06052-y","DOIUrl":"10.1007/s00402-025-06052-y","url":null,"abstract":"","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144998600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tibial tunnel widening in patients undergoing primary anterior cruciate ligament reconstruction: hydroxyapatite-coated vs. uncoated interference screws","authors":"Ufuk Arzu,&nbsp;İsmail Tarık Atasoy,&nbsp;Taha Kızılkurt,&nbsp;Demir Can Pata,&nbsp;Mehmet Erdil,&nbsp;Gökhan Polat","doi":"10.1007/s00402-025-06056-8","DOIUrl":"10.1007/s00402-025-06056-8","url":null,"abstract":"<div><h3>Introduction</h3><p>Tunnel widening following anterior cruciate ligament (ACL) reconstruction remains a significant clinical concern. Polyether ether ketone (PEEK) screws offer favorable biomechanical properties and MRI compatibility; however, they lack osteoconductivity, which may contribute to tunnel widening. This study investigated whether hydroxyapatite (HA)-coated polyether ether ketone (PEEK) screws reduce tibial tunnel widening compared to uncoated PEEK screws, considering the osteoconductive properties of HA. We hypothesized that HA-coated PEEK screws would demonstrate significantly less tibial tunnel widening at one year postoperatively than uncoated PEEK screws.</p><h3>Materials and methods</h3><p>A retrospective cohort study was conducted on patients who underwent primary ACL reconstruction using hamstring autografts. The patients were divided into two groups: Group 1 received HA-coated PEEK interference screws, and Group 2 received uncoated PEEK screws. Tibial tunnel diameters were measured on standardized anteroposterior and lateral radiographs immediately postoperatively (baseline) and at the first-year follow-up. Tunnel width was assessed perpendicular to the tunnel axis at consistent locations, and the percentage tunnel widening was calculated from the baseline. Two independent observers measured the tunnel dimensions separately.</p><h3>Results</h3><p>A total of 65 patients were analyzed, of whom 31 received HA-coated PEEK screws and 34 received standard uncoated PEEK screws. At the first-year follow-up, tunnel widening was significantly lower in the HA-coated group across all measurement sites. In the AP view, the proximal, middle, and distal regions showed significantly reduced tunnel widening in the HA-coated group (<i>p</i> &lt; 0.05). A similar outcome was observed in all three regions of the lateral view, with significantly less widening with HA-coated screws than with uncoated screws (<i>p</i> &lt; 0.05).</p><h3>Conclusion</h3><p>Compared with standard uncoated PEEK screws, HA-coated PEEK screws significantly reduced tibial tunnel widening at the one-year follow-up after primary ACL reconstruction. The added osteoconductive properties of HA may be the underlying mechanism. These findings suggest that HA-coated screws may offer improved biological fixation and better long-term graft stability compared to uncoated screws.</p><h3>Level of evidence</h3><p>Level III, retrospective cohort study.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144990461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes following primary total hip arthroplasty with ceramic-on-metal and metal-on-metal bearings","authors":"Ignacio Miranda,&nbsp;Caterina Chiappe,&nbsp;Rocío Valverde-Vázquez,&nbsp;Francisco J. Miranda,&nbsp;Julio Doménech","doi":"10.1007/s00402-025-06053-x","DOIUrl":"10.1007/s00402-025-06053-x","url":null,"abstract":"<div><h3>Introduction</h3><p>There is concern in the scientific community that patients implanted years ago with metal-on-metal (M-M) bearings for total hip arthroplasty (THA) may still have persistent and potentially toxic levels of chromium (Cr) and cobalt (Co). Studies suggest that blood metal levels may be elevated in both ceramic-on-metal (C-M) and M-M bearings. The objective of this study was to establish whether patients with THA and C-M bearing surfaces require the same follow-up as those with M-M THA and to evaluate the long-term survival of THAs with M-M and C-M bearing surfaces, blood Cr and Co levels and complications (especially metallosis).</p><h3>Materials and Methods</h3><p>A retrospective, observational, analytical, descriptive cohort study was conducted on the patients who underwent THA at a single centre with the use of M-M (64) and C-M (76) bearings and a control group (44 THA: 23 ceramic-on-ceramic, 8 metal-on-polyethylene, 13 ceramic-on-polyethylene) between 2005 and 2009 (an additional 12 THAs performed with the same implants between 2010 and 2012 were also included). The median follow-up period was 14.41 (interquartile range 11.6–15.7) years. The primary outcomes were blood levels of Cr and Co, complications, implant survival and patient survival (Kaplan Meier analysis). Multivariate binary logistic regression was performed to examine the risk of metallosis, prosthesis replacement and death between groups, adjusting for potential confounders.</p><h3>Results</h3><p>THA with M-M bearings produce more metallosis (47%, <i>p</i> &lt; 0.001) than C-M bearings (16%). Thirty-one THA revisions were performed (17%), with significantly more revisions in the M-M group (33%) compared to both the C-M group (11%, <i>p</i> = 0.002) and the control group (4%, <i>p</i> = 0.003). There were no significant differences in 15-year patient survival between the groups.</p><h3>Conclusions</h3><p>Routine monitoring of C-M bearings should be recommended, similar to the protocols for M-M. In the long term, both metallosis and revision rates are unacceptably high for both types of bearings, with M-M bearings performing worse. Therefore, neither implant type is recommended for THA.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144929340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient self-reported outcomes 10 years after surgical correction in AIS patients. A systematic review and meta-analysis","authors":"Eduardo Hevia,&nbsp;Jesús Burgos,&nbsp;Ignacio Sanpera,&nbsp;Vicente García,&nbsp;María Teresa de Santos Moreno,&nbsp;María Benlloch,&nbsp;Gonzalo Mariscal,&nbsp;Carlos Barrios","doi":"10.1007/s00402-025-06051-z","DOIUrl":"10.1007/s00402-025-06051-z","url":null,"abstract":"<div><h3>Introduction</h3><p>the aim of this report is to evaluate the long-term (≥ 10 years) functional outcomes and quality of life after surgery in AIS patients.</p><h3>Methods</h3><p>PROSPERO (CRD42023439331). Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Systematic Review (PRISMA) guidelines were followed. The PubMed, EMBASE, Scopus, and Cochrane Collaboration Library databases were used. Comparative studies assessing outcomes ≥ 10 years after surgery in AIS patients and controls were included. Study quality was assessed using the MINORS criteria. The outcomes of interest were SRS-22/24 scores for pain, self-image, function, mental health, total score, and the Oswestry Disability Index (ODI). Comparisons were performed using mean difference (MD) with 95% confidence interval (CI). Heterogeneity was assessed using the I2 statistic. A fixed effects model was used if there was no evidence of heterogeneity.</p><h3>Results</h3><p>Four comparative cohort studies and four case series were analyzed (<i>n</i> = 586). At long-term follow-up, pain (MD -0.47, 95%CI -0.64 to -0.30), self-image (MD -0.45, 95%CI -0.62 to -0.28), function (MD -0.45, 95%CI -0.83 to -0.07), and mental health (MD -0.53,95%CI -0.84 to -0.23) SRS-22 domains were significantly lower in surgically treated AIS patients than in controls. The total SRS score (MD -0.38, 95%CI -0.58 to -0.17) and ODI scores (MD 3.12, 95%CI 0.51 to 5.73) were lower in surgically treated patients. No significant differences were noted pre- and postoperatively ≥ 10 years after surgery in pain (MD -0.05,95%CI -0.32 to 0.23) and function (MD -0.05,95%CI -0.30 to 0.21), while self-image (MD -0.68,95%CI -1.02 to -0.34) and mental health (MD -0.37,95%CI -0.99 to 0.25) improved.</p><h3>Conclusion</h3><p>Ten years or more after surgery, patients with AIS had a significantly lower quality of life and higher disability than their healthy peers, based on lower SRS scores in multiple domains and higher ODI, except for self-image and mental health that improved.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144926963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alignment and early clinical outcomes following total knee arthroplasty using a handheld navigation system compared to conventional instruments","authors":"Cameron Nishida,&nbsp;Brent Shimoda,&nbsp;Rosana H Weldon,&nbsp;Jeanae M Kaneshiro,&nbsp;Cass K Nakasone","doi":"10.1007/s00402-025-05998-3","DOIUrl":"10.1007/s00402-025-05998-3","url":null,"abstract":"<div><h3>Introduction</h3><p>Proper lower extremity alignment is important for success and longevity of total knee arthroplasty (TKA). Conventional instrumentation has demonstrated higher rates of mechanical axis (MA) malalignment compared to robotic or computer navigated surgery. The purpose of this study is to compare the alignment and early clinical outcomes between a handheld implant agnostic navigation system and conventional instrumentation.</p><h3>Methods</h3><p>117 patients who underwent single-stage bilateral TKA were prospectively studied. The distal femoral and proximal tibial resections were performed using a handheld navigation system (HHNS) on one knee and conventional instrumentation on the other knee. Implant positioning and lower extremity alignment were compared. Knee society knee score (KSKS), knee injury and osteoarthritis outcome score for joint replacement (KOOS JR), patient-reported outcomes measurement information system (PROMIS) global physical health (GPH), and patient satisfaction were compared up to one year postoperatively.</p><h3>Results</h3><p>There were statistically significant differences in the mean values between knees performed using HHNS compared to conventional instruments for MA (0.71° vs. − 0.32°, <i>p</i> = 0.0086), tibial slope (1.17° vs. 0.61°, <i>p</i> = 0.0165), and AP tibial component angle (0.52° vs 0.03°, <i>p</i> = 0.0149). No significant difference in AP femoral component position (5.65° vs. 5.60°, <i>p</i> = 0.87) was found. The HHNS resulted in a higher proportion of knees achieving targeted alignment for each measurement reviewed by 3–9%. Tourniquet time was approximately 6 min longer for the HHNS compared to conventional instruments (<i>p</i> &lt; 0.0005). No significant difference was found for KSKS, KOOS JR, PROMIS GPH, and patient satisfaction at 1 year following surgery.</p><h3>Conclusion</h3><p>TKA performed with a HHNS did not result in any clinical or statistically meaningful differences regarding alignment or patient reported outcomes when compared to conventional instruments. However, a larger proportion of patients achieved surgical alignment targets for all measurements considered with use of the HHNS.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144926962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacologic pain management strategies for reducing postoperative pain in total knee arthroplasty: a systematic review from molecular mechanisms to clinical efficiency","authors":"Anca Maria Pop,&nbsp;Michael T. Hirschmann","doi":"10.1007/s00402-025-06049-7","DOIUrl":"10.1007/s00402-025-06049-7","url":null,"abstract":"<div><h3>Introduction</h3><p>The aim of this systematic review was to evaluate the efficiency of different analgetic regimes used in clinical practice in reducing postoperative pain and cumulative opioid consumption following total knee arthroplasty (TKA).</p><h3>Materials and methods</h3><p>A systematic search was conducted on PubMed, Embase and Scopus according to PRISMA guidelines in order to identify appropriate studies published between 2010 and 2025, which investigated different oral or intravenous analgesic strategies (duloxetine, acetaminophen, corticosteroids, opioids, nonsteroidal anti-inflammatory drugs (NSAIDs) and gabapentinoids) in populations of patients receiving TKA by having as primary outcome the quantification of postoperative pain scores or opioid consumption.</p><h3>Results</h3><p>Out of the 1069 identified articles, 63 met the inclusion criteria. Duloxetine improved pain scores following TKA and reduced opioid consumption, however without reaching clinical relevance. Acetaminophen, despite moderate evidence for its efficiency, remains one of the most commonly used analgesics following TKA. Gabapentinoids are useful in reducing chronic neuropathic pain, but lack efficiency in the acute clinical setting. Opioids, although highly prescribed, fail to demonstrate a clinical benefit. Intravenous corticosteroids can also provide significant pain relief due to extensive anti-inflammatory properties, while NSAIDs remain one of the mainstays of treatment due to the relevant opioid-sparing effect and acceptable safety profile.</p><h3>Conclusions</h3><p>The appropriate management of postoperative pain following TKA relies on a multimodal approach, which emphasizes the predominant use of non-opioid analgesics. NSAIDs and acetaminophen remain validated treatments, while the applicability of other alternative agents requires further exploration in large studies.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00402-025-06049-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144923049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the Aarhus periacetabular osteotomy database","authors":"Lisa Tønning,&nbsp;Frederik Foldager,&nbsp;Josefine Larsen,&nbsp;Pia Kristensen,&nbsp;Inger Mechlenburg,&nbsp;Kjeld Søballe,&nbsp;Stig Jakobsen","doi":"10.1007/s00402-025-05978-7","DOIUrl":"10.1007/s00402-025-05978-7","url":null,"abstract":"<div><h3>Background</h3><p>Periacetabular osteotomy (PAO) is the preferred surgical treatment for hip dysplasia. In Denmark, patients undergoing PAO at two orthopaedic departments are registered in a disease registry, the Aarhus PAO-database. This study aimed to validate the Aarhus PAO-database by assessing the registration completeness compared to the Danish National Patient Registry (DNPR).</p><h3>Materials and methods</h3><p>Patients registered in the Aarhus PAO-database were compared to patients identified in DNPR as having undergone PAO for hip dysplasia. Further, a random selection of 20 PAO procedures from each registry per year (2014–2021) was validated by comparing the information from the registries to the hospital’s electronic medical records.</p><h3>Results</h3><p>Between 2014 and 2021, 1144 PAO procedures were registered in the Aarhus PAO-database and 1150 in DNPR. The overall registration completeness was 94.7% (95% CI: 93.3;95.9) with 1116 PAO proceduresincluded in both datasets. The diagnosis and surgery procedure were verified as hip dysplasia and PAO for all randomly selected patients, and almost all discrepancies were resolved (&gt; 95%), using the medical records.</p><h3>Conclusion</h3><p>The Aarhus PAO-database has effectively captured all patients who underwent PAO for hip dysplasia from 2014 to 2021. It appears to be a valid resource for future research as well as for ensuring and improving the quality of hip dysplasia treatment.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00402-025-05978-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144914811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}