Pub Date : 2026-01-12DOI: 10.1016/j.jor.2026.01.008
Fangfang Deng, Huali Guo, Li Song, Bo Chen
Background
This article aims to investigate the link between social determinants of health (SDoH) and the occurrence of hip fractures, and to analyze the potential underlying mechanisms of influence.
Methods
This paper conducted a deep analysis among the general sample population from the National Health and Nutrition Examination Survey (NHANES) 1999–2018. Within each survey period, self-reported data covering eight domains of SDoH were collected, including employment status, poverty-to-income ratio (PIR), food security, educational level, health insurance coverage, type of health insurance, homeownership, and marital status. Concurrently, a history of hip fractures among participants was learned through self-reporting. Correlation analysis, Lasso regression analysis, and the Boruta algorithm were employed to explore the link between SDoH and hip fractures.
Results
This study comprehensively analyzed 11,254 adult participants. The findings indicated a notable link between eight sub-items of SDoH and the risk of hip fracture. Specifically, the cumulative number of adverse SDoH was positively linked with the risk of hip fracture. Especially as 4-7 adverse factors were accumulated, the incidence of hip fractures climbed greatly.
Conclusion
This paper suggests a marked link between adverse SDoH and the occurrence of hip fractures, particularly when these adverse factors accumulate to a certain number (4–7). A profound probe into the interactions among these SDoH and their mechanisms of influence on fracture risk may offer crucial evidence for the prevention and intervention of hip fractures.
{"title":"Relationship between social determinants of health and hip fracture in the American population: a cross-sectional NHANES study","authors":"Fangfang Deng, Huali Guo, Li Song, Bo Chen","doi":"10.1016/j.jor.2026.01.008","DOIUrl":"10.1016/j.jor.2026.01.008","url":null,"abstract":"<div><h3>Background</h3><div>This article aims to investigate the link between social determinants of health (SDoH) and the occurrence of hip fractures, and to analyze the potential underlying mechanisms of influence.</div></div><div><h3>Methods</h3><div>This paper conducted a deep analysis among the general sample population from the National Health and Nutrition Examination Survey (NHANES) 1999–2018. Within each survey period, self-reported data covering eight domains of SDoH were collected, including employment status, poverty-to-income ratio (PIR), food security, educational level, health insurance coverage, type of health insurance, homeownership, and marital status. Concurrently, a history of hip fractures among participants was learned through self-reporting. Correlation analysis, Lasso regression analysis, and the Boruta algorithm were employed to explore the link between SDoH and hip fractures.</div></div><div><h3>Results</h3><div>This study comprehensively analyzed 11,254 adult participants. The findings indicated a notable link between eight sub-items of SDoH and the risk of hip fracture. Specifically, the cumulative number of adverse SDoH was positively linked with the risk of hip fracture. Especially as 4-7 adverse factors were accumulated, the incidence of hip fractures climbed greatly.</div></div><div><h3>Conclusion</h3><div>This paper suggests a marked link between adverse SDoH and the occurrence of hip fractures, particularly when these adverse factors accumulate to a certain number (4–7). A profound probe into the interactions among these SDoH and their mechanisms of influence on fracture risk may offer crucial evidence for the prevention and intervention of hip fractures.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"74 ","pages":"Pages 205-213"},"PeriodicalIF":1.5,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145978363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-08DOI: 10.1016/j.jor.2026.01.007
Sean Bae , Mark Ehioghae , Jonathan P. Japa , Ala Alshomali , Aaron Phung , Linus Lee , Justin Hyde , Jamie Lee , Kevin Yoon , Addisu Mesfin
Background
Sacral chordomas are rare malignant tumors arising from notochordal remnants that can be identified incidentally or present with sacral pain. Although surgical resection is the accepted standard treatment, some patients forgo surgery due to associated morbidity and complications. Nonoperative alternatives, including radiotherapies, have emerged, but literature on their outcomes remains scarce. The purpose of this study was to evaluate the outcomes of nonoperative management of sacral chordomas.
Methods
We conducted a systematic review of the literature utilizing PubMed. Search keywords included “nonoperative treatment,” “sacral chordomas,” “radiotherapy,” and “functional outcomes.” Studies involving sacral chordoma patients who underwent nonoperative treatment were included; patients with surgical treatment and hybrid therapies that included surgery were excluded from the analysis.
Results
Eleven clinical studies on nonoperative management of sacral chordomas with 52 patients aged between 35 and 85 years (mean = 62.8) were identified. Males were affected at higher rates than females (73.1 % vs 26.9 %). S1 (15.4 %) and S2 (25 %) were the most affected spinal segments. CT-guided biopsy was the most common method of tumor diagnosis (82.7 %). Carbon ion radiotherapy (CIRT) and proton beam therapy were the most common treatment methods, with 57.7 % of patients reporting recurrence-free survival at a mean follow-up of 24 months.
Conclusion
Nonoperative management of sacral chordomas shows promising outcomes for patients who are not candidates for surgery. Although recurrence remains a risk, nonoperative management may offer meaningful functional preservation and local disease control.
背景：骶脊索瘤是一种罕见的恶性肿瘤，起源于脊索残余，可偶然发现或伴有骶痛。虽然手术切除是公认的标准治疗方法，但由于相关的发病率和并发症，一些患者放弃手术。包括放射治疗在内的非手术替代疗法已经出现，但关于其结果的文献仍然很少。本研究的目的是评估非手术治疗骶脊索瘤的结果。方法利用PubMed对相关文献进行系统综述。搜索关键词包括“非手术治疗”、“骶脊索瘤”、“放疗”和“功能结果”。包括接受非手术治疗的骶脊索瘤患者的研究；手术治疗和混合治疗包括手术的患者被排除在分析之外。结果对52例35 ~ 85岁的骶脊索瘤患者进行非手术治疗的临床研究，平均62.8岁。男性受影响的比例高于女性（73.1% vs 26.9%）。S1（15.4%）和S2（25%）是受影响最大的脊柱节段。ct引导下活检是最常见的肿瘤诊断方法（82.7%）。碳离子放射治疗（CIRT）和质子束治疗是最常见的治疗方法，平均随访24个月，57.7%的患者报告无复发生存。结论非手术治疗骶脊索瘤对不需要手术治疗的患者有较好的疗效。虽然复发仍有风险，但非手术治疗可能提供有意义的功能保留和局部疾病控制。
{"title":"Nonoperative management of sacral chordomas: A systematic review of the literature","authors":"Sean Bae , Mark Ehioghae , Jonathan P. Japa , Ala Alshomali , Aaron Phung , Linus Lee , Justin Hyde , Jamie Lee , Kevin Yoon , Addisu Mesfin","doi":"10.1016/j.jor.2026.01.007","DOIUrl":"10.1016/j.jor.2026.01.007","url":null,"abstract":"<div><h3>Background</h3><div>Sacral chordomas are rare malignant tumors arising from notochordal remnants that can be identified incidentally or present with sacral pain. Although surgical resection is the accepted standard treatment, some patients forgo surgery due to associated morbidity and complications. Nonoperative alternatives, including radiotherapies, have emerged, but literature on their outcomes remains scarce. The purpose of this study was to evaluate the outcomes of nonoperative management of sacral chordomas.</div></div><div><h3>Methods</h3><div>We conducted a systematic review of the literature utilizing PubMed. Search keywords included “nonoperative treatment,” “sacral chordomas,” “radiotherapy,” and “functional outcomes.” Studies involving sacral chordoma patients who underwent nonoperative treatment were included; patients with surgical treatment and hybrid therapies that included surgery were excluded from the analysis.</div></div><div><h3>Results</h3><div>Eleven clinical studies on nonoperative management of sacral chordomas with 52 patients aged between 35 and 85 years (mean = 62.8) were identified. Males were affected at higher rates than females (73.1 % vs 26.9 %). S1 (15.4 %) and S2 (25 %) were the most affected spinal segments. CT-guided biopsy was the most common method of tumor diagnosis (82.7 %). Carbon ion radiotherapy (CIRT) and proton beam therapy were the most common treatment methods, with 57.7 % of patients reporting recurrence-free survival at a mean follow-up of 24 months.</div></div><div><h3>Conclusion</h3><div>Nonoperative management of sacral chordomas shows promising outcomes for patients who are not candidates for surgery. Although recurrence remains a risk, nonoperative management may offer meaningful functional preservation and local disease control.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"74 ","pages":"Pages 186-194"},"PeriodicalIF":1.5,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145978892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Footvolley, a fusion of football and volleyball, has gained considerable popularity worldwide. The dynamic nature of the sport exposes players to various risks of injury. This study investigates the prevalence of injuries among footvolley athletes. It examines practitioner profiles and associated injuries and identifies the anatomical regions most commonly affected.
Material and methods
The study sample comprised footvolley players from Brazil, encompassing individuals of both genders aged 18 and above, with no restrictions on practice duration, to provide a comprehensive overview of player profiles within the sport. Data was collected using a customised form created in Google Forms®, which was disseminated via email, WhatsApp®, and social media platforms and distributed in training centres and to individual practitioners. The study population predominantly consisted of male participants, with an average age of 30.
Results
182 injuries were reported, resulting in an overall injury incidence rate of 1.43 per 1000 h of exposure. Notably, 52.3 % of practitioners experienced some form of injury related to footvolley practice. The anatomical segments most commonly affected were the knees, lumbar spine, neck, and ankles. Furthermore, the recurrence rate for all injuries was 21.5 %. Several factors were associated with a higher prevalence of injuries, including older age, increased experience and practice in footvolley, participation in competitions, and not engaging in simultaneous training in another modality.
Conclusions
This study sheds light on the injury landscape in footvolley and underscores the importance of implementing targeted injury prevention strategies and promoting athlete well-being in this dynamic sport.
{"title":"Injury patterns in footvolley players: an epidemiological survey","authors":"Rodrigo Favarin Pozzobom , Tamiris Beppler Martins , Filippo Migliorini , Nicola Maffulli , Rodrigo Okubo","doi":"10.1016/j.jor.2025.12.066","DOIUrl":"10.1016/j.jor.2025.12.066","url":null,"abstract":"<div><h3>Background</h3><div>Footvolley, a fusion of football and volleyball, has gained considerable popularity worldwide. The dynamic nature of the sport exposes players to various risks of injury. This study investigates the prevalence of injuries among footvolley athletes. It examines practitioner profiles and associated injuries and identifies the anatomical regions most commonly affected.</div></div><div><h3>Material and methods</h3><div>The study sample comprised footvolley players from Brazil, encompassing individuals of both genders aged 18 and above, with no restrictions on practice duration, to provide a comprehensive overview of player profiles within the sport. Data was collected using a customised form created in Google Forms®, which was disseminated via email, WhatsApp®, and social media platforms and distributed in training centres and to individual practitioners. The study population predominantly consisted of male participants, with an average age of 30.</div></div><div><h3>Results</h3><div>182 injuries were reported, resulting in an overall injury incidence rate of 1.43 per 1000 h of exposure. Notably, 52.3 % of practitioners experienced some form of injury related to footvolley practice. The anatomical segments most commonly affected were the knees, lumbar spine, neck, and ankles. Furthermore, the recurrence rate for all injuries was 21.5 %. Several factors were associated with a higher prevalence of injuries, including older age, increased experience and practice in footvolley, participation in competitions, and not engaging in simultaneous training in another modality.</div></div><div><h3>Conclusions</h3><div>This study sheds light on the injury landscape in footvolley and underscores the importance of implementing targeted injury prevention strategies and promoting athlete well-being in this dynamic sport.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"74 ","pages":"Pages 174-178"},"PeriodicalIF":1.5,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-07DOI: 10.1016/j.jor.2026.01.005
Ryota Fujii , Hyunho Lee , Christopher Stickley , Kazuyoshi Nakanishi
Purpose
Single-radius (SR) and multi-radius (MR) femoral components are widely used in posterior-stabilized total knee arthroplasty (TKA). While previous studies have compared these designs primarily using clinical outcomes or basic kinematics, the relationship between quadriceps strength and dynamic sagittal-plane knee biomechanics remains insufficiently understood.
Methods
This prospective exploratory cohort study included 31 posterior-stabilized TKAs (SR: 16 knees; MR: 15 knees). Patients were evaluated at 6 months and 1 year postoperatively. Knee extension strength was measured using a handheld dynamometer. Sagittal-plane biomechanics during level walking, stair ascent, and stair descent were assessed using three-dimensional motion capture. External knee flexion moment (KFM) and KFM impulse were calculated. Associations between quadriceps strength and sagittal-plane biomechanical variables were analyzed using Spearman correlation coefficients.
Results
No significant between-group differences were observed in demographics or clinical activity levels. In the SR group, no significant associations were identified between quadriceps strength and sagittal-plane biomechanical variables at any postoperative time point. In contrast, the MR group demonstrated a moderate positive correlation between knee extensor strength and stair-descent knee flexion moment (KFM) impulse at 6 months postoperatively (r = 0.498, p < 0.05), which was not observed at 1 year postoperatively. During stair ascent, a significant positive correlation between knee extensor strength and the first peak KFM was observed in the MR group at 1 year (r = 0.606, p < 0.05).
Conclusions
This exploratory study demonstrated design-dependent associations between quadriceps strength and sagittal-plane knee biomechanics after posterior-stabilized TKA. While no significant between-group differences were observed in clinical or absolute biomechanical outcomes, task- and time-dependent strength–biomechanics associations were identified in the MR group, whereas no such associations were observed in the SR group, suggesting potential clinical relevance in patients with delayed quadriceps recovery.
目的单桡骨（SR）和多桡骨（MR）股骨假体广泛应用于后稳定全膝关节置换术（TKA）。虽然先前的研究主要通过临床结果或基本运动学来比较这些设计，但股四头肌力量和动态矢状面膝关节生物力学之间的关系仍然没有得到充分的了解。方法本前瞻性探索性队列研究纳入31例后稳定tka患者（SR: 16膝；MR: 15膝）。分别于术后6个月和1年对患者进行评估。使用手持式测力仪测量膝关节伸展强度。使用三维运动捕捉技术评估水平行走、楼梯上升和楼梯下降时的矢状面生物力学。计算膝关节外屈力矩（KFM）和KFM冲量。使用Spearman相关系数分析股四头肌力量与矢状面生物力学变量之间的关系。结果两组在人口统计学和临床活动水平上无显著差异。在SR组中，在任何术后时间点，股四头肌力量和矢状面生物力学变量之间没有明显的关联。相比之下，MR组在术后6个月时膝关节伸肌强度与下楼梯膝关节屈曲力矩（KFM）脉冲呈中度正相关（r = 0.498, p < 0.05），而在术后1年未观察到这种正相关。在爬楼梯过程中，MR组1年时膝关节伸肌强度与KFM第一次峰值呈显著正相关（r = 0.606, p < 0.05）。结论：本探索性研究证实了后稳定TKA后股四头肌力量与膝关节矢状面生物力学之间的设计依赖性关联。虽然在临床或绝对生物力学结果方面没有观察到组间的显著差异，但在MR组中发现了任务和时间依赖的力量-生物力学关联，而在SR组中没有观察到这种关联，这表明在股四头肌延迟恢复患者中存在潜在的临床相关性。
{"title":"Design-dependent associations between quadriceps strength and sagittal knee biomechanics after posterior-stabilized total knee arthroplasty: A 3D motion analysis study","authors":"Ryota Fujii , Hyunho Lee , Christopher Stickley , Kazuyoshi Nakanishi","doi":"10.1016/j.jor.2026.01.005","DOIUrl":"10.1016/j.jor.2026.01.005","url":null,"abstract":"<div><h3>Purpose</h3><div>Single-radius (SR) and multi-radius (MR) femoral components are widely used in posterior-stabilized total knee arthroplasty (TKA). While previous studies have compared these designs primarily using clinical outcomes or basic kinematics, the relationship between quadriceps strength and dynamic sagittal-plane knee biomechanics remains insufficiently understood.</div></div><div><h3>Methods</h3><div>This prospective exploratory cohort study included 31 posterior-stabilized TKAs (SR: 16 knees; MR: 15 knees). Patients were evaluated at 6 months and 1 year postoperatively. Knee extension strength was measured using a handheld dynamometer. Sagittal-plane biomechanics during level walking, stair ascent, and stair descent were assessed using three-dimensional motion capture. External knee flexion moment (KFM) and KFM impulse were calculated. Associations between quadriceps strength and sagittal-plane biomechanical variables were analyzed using Spearman correlation coefficients.</div></div><div><h3>Results</h3><div>No significant between-group differences were observed in demographics or clinical activity levels. In the SR group, no significant associations were identified between quadriceps strength and sagittal-plane biomechanical variables at any postoperative time point. In contrast, the MR group demonstrated a moderate positive correlation between knee extensor strength and stair-descent knee flexion moment (KFM) impulse at 6 months postoperatively (r = 0.498, p < 0.05), which was not observed at 1 year postoperatively. During stair ascent, a significant positive correlation between knee extensor strength and the first peak KFM was observed in the MR group at 1 year (r = 0.606, p < 0.05).</div></div><div><h3>Conclusions</h3><div>This exploratory study demonstrated design-dependent associations between quadriceps strength and sagittal-plane knee biomechanics after posterior-stabilized TKA. While no significant between-group differences were observed in clinical or absolute biomechanical outcomes, task- and time-dependent strength–biomechanics associations were identified in the MR group, whereas no such associations were observed in the SR group, suggesting potential clinical relevance in patients with delayed quadriceps recovery.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"74 ","pages":"Pages 179-185"},"PeriodicalIF":1.5,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145978365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study aims to explore the role of METTL14, a key m6A “writer” in regulating LRIG1 expression and its involvement in IVDD pathogenesis.
Methods
METTL14 expression was evaluated in nucleus pulposus (NP) tissues from IVDD patients at different degeneration stages using immunohistochemistry. In vitro experiments were conducted with METTL14 knockdown and TNF-α-induced cellular degeneration in NP cells. The effects on cellular senescence markers, ECM components, and m6A RNA methylation were examined. m6A RNA immunoprecipitation was employed to assess m6A modification levels. Bioinformatics tools predicted potential m6A sites on LRIG1 mRNA, which were further validated by luciferase reporter assays.
Results
METTL14 expression was significantly upregulated in NP tissues from patients with severe IVDD. METTL14 knockdown in NP cells led to reduced m6A enrichment on LRIG1 mRNA, destabilizing LRIG1 transcripts and increasing cellular senescence marker P21. TNF-α stimulation further induced METTL14 expression, exacerbated ECM degradation, and accelerated cellular senescence. Restoration of LRIG1 expression through overexpression mitigated the degenerative changes caused by METTL14 knockdown. Luciferase assays confirmed that METTL14 regulates LRIG1 mRNA stability via specific m6A sites, establishing a METTL14-LRIG1 axis in cellular senescence.
Conclusions
This study identifies METTL14 as a critical regulator of LRIG1-mediated ECM stability and cellular senescence in IVDD pathogenesis. The METTL14-LRIG1 axis, driven by m6A modifications, provides new mechanistic insights into the inflammatory and degenerative processes underlying IVDD. Targeting METTL14 or the associated m6A pathway may offer novel therapeutic strategies for IVDD.
{"title":"METTL14 regulate LRIG1 expression via m6A to affect nucleus pulposus cell senescence in intervertebral disc degeneration","authors":"Ruihai Xiao , Qunying Yang , Yingqun Yin , Shanshan Peng , Xigao Cheng","doi":"10.1016/j.jor.2026.01.004","DOIUrl":"10.1016/j.jor.2026.01.004","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aims to explore the role of METTL14, a key m6A “writer” in regulating LRIG1 expression and its involvement in IVDD pathogenesis.</div></div><div><h3>Methods</h3><div>METTL14 expression was evaluated in nucleus pulposus (NP) tissues from IVDD patients at different degeneration stages using immunohistochemistry. In vitro experiments were conducted with METTL14 knockdown and TNF-α-induced cellular degeneration in NP cells. The effects on cellular senescence markers, ECM components, and m6A RNA methylation were examined. m6A RNA immunoprecipitation was employed to assess m6A modification levels. Bioinformatics tools predicted potential m6A sites on LRIG1 mRNA, which were further validated by luciferase reporter assays.</div></div><div><h3>Results</h3><div>METTL14 expression was significantly upregulated in NP tissues from patients with severe IVDD. METTL14 knockdown in NP cells led to reduced m6A enrichment on LRIG1 mRNA, destabilizing LRIG1 transcripts and increasing cellular senescence marker P21. TNF-α stimulation further induced METTL14 expression, exacerbated ECM degradation, and accelerated cellular senescence. Restoration of LRIG1 expression through overexpression mitigated the degenerative changes caused by METTL14 knockdown. Luciferase assays confirmed that METTL14 regulates LRIG1 mRNA stability via specific m6A sites, establishing a METTL14-LRIG1 axis in cellular senescence.</div></div><div><h3>Conclusions</h3><div>This study identifies METTL14 as a critical regulator of LRIG1-mediated ECM stability and cellular senescence in IVDD pathogenesis. The METTL14-LRIG1 axis, driven by m6A modifications, provides new mechanistic insights into the inflammatory and degenerative processes underlying IVDD. Targeting METTL14 or the associated m6A pathway may offer novel therapeutic strategies for IVDD.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"74 ","pages":"Pages 195-204"},"PeriodicalIF":1.5,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145978364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-03DOI: 10.1016/j.jor.2026.01.001
Donald MacElroy , Jay B. Ayar , Samir Rao , Merritt D. Kinon
Introduction
Legally blind patients represent a vulnerable group who may face barriers to safe mobility, postoperative rehabilitation, and discharge planning. There is limited evidence describing perioperative course during spinal fusion surgery in this population. This study aimed to evaluate the association between legal blindness, operative complications and discharge disposition in patients undergoing cervical or lumbar spinal fusion.
Methods
The National Inpatient Sample was queried from 2016 to 2021, identifying adult hospitalizations for cervical or lumbar spinal fusion using ICD-10 procedure codes. The primary exposure was legal blindness (ICD-10-CM: H54.8). Outcomes included: major medical complications, non-home discharge and extended length of stay (>3 days). Survey-weighted logistic regression was used to evaluate associations between legal blindness and complications.
Results
Among 338,578 hospitalizations for cervical or lumbar spinal fusion that met our inclusion criteria, 315 involved legally blind patients. In multivariate analysis adjusting for demographics, comorbidities and hospital level covariates, legal blindness was independently associated with higher odds of major medical complications (aOR 1.58, 95 % CI 1.08–2.32), non-home discharge (aOR 2.57, 95 % CI 1.98–3.32), and extended length of stay (aOR 1.67, 95 % CI 1.31–2.12).
Conclusions
Legal blindness is independently associated with increased major medical complications, extended hospital stays and higher rates of non-home discharge following spinal fusion procedures. These findings highlight the importance of recognizing visual impairment as a marker of perioperative vulnerability in the context of spinal fusion surgery and highlight the need for targeted perioperative strategies to support this underrepresented population.
法定失明患者是一个弱势群体，他们可能面临安全行动、术后康复和出院计划方面的障碍。在这一人群中，描述脊柱融合术围手术期病程的证据有限。本研究旨在评估接受颈椎或腰椎融合术患者的法定失明、手术并发症和出院处置之间的关系。方法查询2016年至2021年全国住院患者样本，使用ICD-10程序代码确定颈椎或腰椎融合术的成人住院病例。主要暴露为法定失明（ICD-10-CM: H54.8）。结果包括：主要医疗并发症、非居家出院和延长住院时间（3天）。采用调查加权logistic回归来评估法律盲症与并发症之间的关系。结果在338,578例符合纳入标准的颈椎或腰椎融合术住院患者中，315例为法定盲患者。在调整人口统计学、合并症和医院水平协变量的多变量分析中，法定失明与较高的主要医疗并发症（aOR 1.58, 95% CI 1.08-2.32）、非居家出院（aOR 2.57, 95% CI 1.98-3.32）和延长住院时间（aOR 1.67, 95% CI 1.31-2.12）独立相关。结论：法定失明与脊柱融合术后主要并发症增加、住院时间延长和非家庭出院率升高独立相关。这些发现强调了在脊柱融合手术背景下，将视力障碍作为围手术期易损标志的重要性，并强调了有针对性的围手术期策略的必要性，以支持这一未被充分代表的人群。
{"title":"Legal blindness as a risk factor for complications and prolonged hospitalization after spinal fusion","authors":"Donald MacElroy , Jay B. Ayar , Samir Rao , Merritt D. Kinon","doi":"10.1016/j.jor.2026.01.001","DOIUrl":"10.1016/j.jor.2026.01.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Legally blind patients represent a vulnerable group who may face barriers to safe mobility, postoperative rehabilitation, and discharge planning. There is limited evidence describing perioperative course during spinal fusion surgery in this population. This study aimed to evaluate the association between legal blindness, operative complications and discharge disposition in patients undergoing cervical or lumbar spinal fusion.</div></div><div><h3>Methods</h3><div>The National Inpatient Sample was queried from 2016 to 2021, identifying adult hospitalizations for cervical or lumbar spinal fusion using ICD-10 procedure codes. The primary exposure was legal blindness (ICD-10-CM: H54.8). Outcomes included: major medical complications, non-home discharge and extended length of stay (>3 days). Survey-weighted logistic regression was used to evaluate associations between legal blindness and complications.</div></div><div><h3>Results</h3><div>Among 338,578 hospitalizations for cervical or lumbar spinal fusion that met our inclusion criteria, 315 involved legally blind patients. In multivariate analysis adjusting for demographics, comorbidities and hospital level covariates, legal blindness was independently associated with higher odds of major medical complications (aOR 1.58, 95 % CI 1.08–2.32), non-home discharge (aOR 2.57, 95 % CI 1.98–3.32), and extended length of stay (aOR 1.67, 95 % CI 1.31–2.12).</div></div><div><h3>Conclusions</h3><div>Legal blindness is independently associated with increased major medical complications, extended hospital stays and higher rates of non-home discharge following spinal fusion procedures. These findings highlight the importance of recognizing visual impairment as a marker of perioperative vulnerability in the context of spinal fusion surgery and highlight the need for targeted perioperative strategies to support this underrepresented population.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"74 ","pages":"Pages 152-156"},"PeriodicalIF":1.5,"publicationDate":"2026-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-31DOI: 10.1016/j.jor.2025.12.069
Yanping Liu, Xijie Yu
Despite extensive research on osteoporosis therapies, systematic analysis of knowledge evolution and translational bottlenecks remains unexplored. This study presents the multidimensional bibliometric analysis of 10,247 publications (2015–2024) to decode paradigm shifts in osteoporosis therapeutics. Using CiteSpace and VOSviewer for bibliometric and visualization analyses, we observed a notable increase in annual publications, peaking in 2022. China and the United States led in research output, while European countries demonstrated higher citation impact. Shanghai Jiao Tong University, Harvard Medical School, and Chinese Academy of Sciences were the top three contributing institutions. Cooper, Cyrus is the most influential author. In academic publishing, Osteoporosis International has been identified as the journal with the most research results in the field of osteoporosis treatment. Keyword emergence analysis revealed a transition in research focus from randomized controlled trial and ovariectomized rats to drug, discontinuation, osteogenesis, bisphosphonate related osteonecrosis, network pharmacology, molecular docking, reduction, fixation, damage, American association, osteoporotic fracture, gut microbiota in the last five years, and that this is being explored in detail for future work. In summary, this study offers a thorough bibliometric analysis of osteoporosis therapeutics worldwide, providing scholars conducting analogous research in this field with valuable insights.
{"title":"A decade of progress and paradigm shifts in osteoporosis therapeutics: A bibliometric analysis","authors":"Yanping Liu, Xijie Yu","doi":"10.1016/j.jor.2025.12.069","DOIUrl":"10.1016/j.jor.2025.12.069","url":null,"abstract":"<div><div>Despite extensive research on osteoporosis therapies, systematic analysis of knowledge evolution and translational bottlenecks remains unexplored. This study presents the multidimensional bibliometric analysis of 10,247 publications (2015–2024) to decode paradigm shifts in osteoporosis therapeutics. Using CiteSpace and VOSviewer for bibliometric and visualization analyses, we observed a notable increase in annual publications, peaking in 2022. China and the United States led in research output, while European countries demonstrated higher citation impact. Shanghai Jiao Tong University, Harvard Medical School, and Chinese Academy of Sciences were the top three contributing institutions. Cooper, Cyrus is the most influential author. In academic publishing, <em>Osteoporosis International</em> has been identified as the journal with the most research results in the field of osteoporosis treatment. Keyword emergence analysis revealed a transition in research focus from randomized controlled trial and ovariectomized rats to drug, discontinuation, osteogenesis, bisphosphonate related osteonecrosis, network pharmacology, molecular docking, reduction, fixation, damage, American association, osteoporotic fracture, gut microbiota in the last five years, and that this is being explored in detail for future work. In summary, this study offers a thorough bibliometric analysis of osteoporosis therapeutics worldwide, providing scholars conducting analogous research in this field with valuable insights.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"74 ","pages":"Pages 104-112"},"PeriodicalIF":1.5,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145882593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hip abductor weakness is common after proximal femoral fracture and may contribute to gait instability. The influence of postoperative hip alignment on early recovery of hip abductor strength during inpatient rehabilitation after surgery remains unclear.
Objective
To examine longitudinal changes in hip abductor strength and identify factors associated with the operated-to-non-operated hip abductor strength ratio at discharge, focusing on surgical procedure and radiographic alignment.
Methods
This retrospective observational cohort study enrolled 64 patients transferred to a rehabilitation hospital after proximal femoral fracture surgery (34 femoral neck fractures treated with hemiarthroplasty; 30 intertrochanteric fractures treated with cephalomedullary nailing). Hip abductor strength was measured using a handheld dynamometer at rehabilitation admission and discharge and normalized by body weight. Radiographic parameters were measured on supine anteroposterior pelvic radiographs; side-to-side differences (operated minus non-operated) were calculated for the neck–shaft angle, hip center of rotation, femoral offset, and trochanteric height. Multivariable linear regression (ANCOVA-type) was performed with the discharge strength ratio as the dependent variable and the admission strength ratio as an adjustment factor.
Results
Hip abductor strength improved on both sides (p < 0.001). The operated side increased from 1.04 ± 0.5 to 1.8 ± 0.7 N/kg and the non-operated side from 1.6 ± 0.6 to 2.3 ± 0.8 N/kg; the operated-to-non-operated ratio improved from 62.7 % to 72.9 %. In the adjusted model (R2 = 0.325), cephalomedullary nailing (vs hemiarthroplasty) was associated with a higher discharge strength ratio (B = 0.114, p = 0.027). A greater neck–shaft angle difference was also associated with a higher discharge strength ratio (B = 0.0073 per degree, p = 0.011). The admission strength ratio remained a significant predictor (B = 0.245, p = 0.002).
Conclusions
Early recovery of the hip abductor strength ratio after proximal femoral fracture was associated with surgical procedure and postoperative neck–shaft angle asymmetry, independent of baseline strength ratio. Postoperative radiographic alignment may aid in stratifying recovery and tailoring rehabilitation, although causal inference is limited.
{"title":"Association of surgical procedure and radiographic hip alignment with hip abductor strength ratio at discharge after proximal femoral fracture surgery","authors":"Satoshi Hakukawa, Shunsuke Onuma, Kanata Yoshihara","doi":"10.1016/j.jor.2025.12.068","DOIUrl":"10.1016/j.jor.2025.12.068","url":null,"abstract":"<div><h3>Background</h3><div>Hip abductor weakness is common after proximal femoral fracture and may contribute to gait instability. The influence of postoperative hip alignment on early recovery of hip abductor strength during inpatient rehabilitation after surgery remains unclear.</div></div><div><h3>Objective</h3><div>To examine longitudinal changes in hip abductor strength and identify factors associated with the operated-to-non-operated hip abductor strength ratio at discharge, focusing on surgical procedure and radiographic alignment.</div></div><div><h3>Methods</h3><div>This retrospective observational cohort study enrolled 64 patients transferred to a rehabilitation hospital after proximal femoral fracture surgery (34 femoral neck fractures treated with hemiarthroplasty; 30 intertrochanteric fractures treated with cephalomedullary nailing). Hip abductor strength was measured using a handheld dynamometer at rehabilitation admission and discharge and normalized by body weight. Radiographic parameters were measured on supine anteroposterior pelvic radiographs; side-to-side differences (operated minus non-operated) were calculated for the neck–shaft angle, hip center of rotation, femoral offset, and trochanteric height. Multivariable linear regression (ANCOVA-type) was performed with the discharge strength ratio as the dependent variable and the admission strength ratio as an adjustment factor.</div></div><div><h3>Results</h3><div>Hip abductor strength improved on both sides (p < 0.001). The operated side increased from 1.04 ± 0.5 to 1.8 ± 0.7 N/kg and the non-operated side from 1.6 ± 0.6 to 2.3 ± 0.8 N/kg; the operated-to-non-operated ratio improved from 62.7 % to 72.9 %. In the adjusted model (R<sup>2</sup> = 0.325), cephalomedullary nailing (vs hemiarthroplasty) was associated with a higher discharge strength ratio (B = 0.114, p = 0.027). A greater neck–shaft angle difference was also associated with a higher discharge strength ratio (B = 0.0073 per degree, p = 0.011). The admission strength ratio remained a significant predictor (B = 0.245, p = 0.002).</div></div><div><h3>Conclusions</h3><div>Early recovery of the hip abductor strength ratio after proximal femoral fracture was associated with surgical procedure and postoperative neck–shaft angle asymmetry, independent of baseline strength ratio. Postoperative radiographic alignment may aid in stratifying recovery and tailoring rehabilitation, although causal inference is limited.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"74 ","pages":"Pages 131-137"},"PeriodicalIF":1.5,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-31DOI: 10.1016/j.jor.2025.12.067
Itay Ron , Lizi Tamam , Bezalel Peskin , Nabil Ghrayeb , Doron Norman , Jacob Shapira
Background
Femoral neck fractures (FNF) in older adults are frequently managed with either total hip arthroplasty (THA) or hemiarthroplasty (HA). Despite improvements in surgical techniques, mortality rates after hip fracture surgery remain high. Identifying predictors of early mortality may enhance surgical decision-making, optimize perioperative management, and improve patient outcomes.
Purpose
The purpose of this study was to determine the short- and mid-term mortality rates after THA and HA for FNF, to identify clinical, demographic, and laboratory factors associated with 30-, 90-, and 180-day mortality, and to establish clinically relevant cutoff thresholds for significant continuous variables to stratify risk.
Patients and methods
We retrospectively reviewed 2379 consecutive patients treated for sub-capital FNF at a tertiary trauma center between [insert study years]. Of these, 831 underwent THA and 1548 underwent HA. Mortality was assessed at 30, 90, and 180 days postoperatively. Demographic, clinical, and laboratory parameters were analyzed using univariate and multivariate logistic regression models. Receiver operating characteristic (ROC) curve analysis was performed to identify optimal cutoff thresholds for significant continuous predictors.
Results
Among THA patients, mortality was 1.4 % at 30 days, 3.4 % at 90 days, and 5.1 % at 180 days. Postoperative albumin ≤2.85 g/dL predicted 30-day mortality, while C-reactive protein (CRP) > 19.15 mg/dL was independently associated with mortality at 90 and 180 days. Among HA patients, mortality was 6.6 % at 30 days, 12.9 % at 90 days, and 17.6 % at 180 days. Predictors of 30-day mortality included white blood cell count (WBC) > 14.48 × 109/L, albumin <3.55 g/dL, and Charlson Comorbidity Index (CCI) > 7.5. At 90 and 180 days, age >83.65 and > 89.34 years, WBC >13.49 × 109/L, albumin <3.35–3.45 g/dL, creatinine >1.08 mg/dL, and CCI >6.5 were associated with higher mortality risk.
Conclusions
This study identified several laboratory and clinical markers that predict short- and mid-term mortality following hip arthroplasty for FNF. Hypoalbuminemia, elevated inflammatory markers, renal dysfunction, and high comorbidity burden were consistent risk factors. Incorporating these parameters into preoperative assessment may improve patient selection, perioperative optimization, and shared decision-making.
{"title":"Risk factors for mortality in patients following total hip arthroplasty and hemiarthroplasty due to femoral neck fractures","authors":"Itay Ron , Lizi Tamam , Bezalel Peskin , Nabil Ghrayeb , Doron Norman , Jacob Shapira","doi":"10.1016/j.jor.2025.12.067","DOIUrl":"10.1016/j.jor.2025.12.067","url":null,"abstract":"<div><h3>Background</h3><div>Femoral neck fractures (FNF) in older adults are frequently managed with either total hip arthroplasty (THA) or hemiarthroplasty (HA). Despite improvements in surgical techniques, mortality rates after hip fracture surgery remain high. Identifying predictors of early mortality may enhance surgical decision-making, optimize perioperative management, and improve patient outcomes.</div></div><div><h3>Purpose</h3><div>The purpose of this study was to determine the short- and mid-term mortality rates after THA and HA for FNF, to identify clinical, demographic, and laboratory factors associated with 30-, 90-, and 180-day mortality, and to establish clinically relevant cutoff thresholds for significant continuous variables to stratify risk.</div></div><div><h3>Patients and methods</h3><div>We retrospectively reviewed 2379 consecutive patients treated for sub-capital FNF at a tertiary trauma center between [insert study years]. Of these, 831 underwent THA and 1548 underwent HA. Mortality was assessed at 30, 90, and 180 days postoperatively. Demographic, clinical, and laboratory parameters were analyzed using univariate and multivariate logistic regression models. Receiver operating characteristic (ROC) curve analysis was performed to identify optimal cutoff thresholds for significant continuous predictors.</div></div><div><h3>Results</h3><div>Among THA patients, mortality was 1.4 % at 30 days, 3.4 % at 90 days, and 5.1 % at 180 days. Postoperative albumin ≤2.85 g/dL predicted 30-day mortality, while C-reactive protein (CRP) > 19.15 mg/dL was independently associated with mortality at 90 and 180 days. Among HA patients, mortality was 6.6 % at 30 days, 12.9 % at 90 days, and 17.6 % at 180 days. Predictors of 30-day mortality included white blood cell count (WBC) > 14.48 × 10<sup>9</sup>/L, albumin <3.55 g/dL, and Charlson Comorbidity Index (CCI) > 7.5. At 90 and 180 days, age >83.65 and > 89.34 years, WBC >13.49 × 10<sup>9</sup>/L, albumin <3.35–3.45 g/dL, creatinine >1.08 mg/dL, and CCI >6.5 were associated with higher mortality risk.</div></div><div><h3>Conclusions</h3><div>This study identified several laboratory and clinical markers that predict short- and mid-term mortality following hip arthroplasty for FNF. Hypoalbuminemia, elevated inflammatory markers, renal dysfunction, and high comorbidity burden were consistent risk factors. Incorporating these parameters into preoperative assessment may improve patient selection, perioperative optimization, and shared decision-making.</div></div><div><h3>Level of Evidence</h3><div>III</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"74 ","pages":"Pages 124-130"},"PeriodicalIF":1.5,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-31DOI: 10.1016/j.jor.2025.12.064
Patrick Sweeney , James Broderick
Background
Prosthetic hip-associated cobalt toxicity (PHACT) remains a rare but serious complication, potentially leading to missed diagnoses and delayed treatment. This systematic review explores cases of PHACT associated with fractured ceramic bearing followed by revision surgery with metal-on-polyethylene implants. Notably, patients in this subgroup often exhibited earlier symptom onset and elevated cobalt ion levels. Through a systematic review, we aim to explore and summarise the most common symptoms and clinical outcomes associated with PHACT among this specific patient subgroup. Our focus is on identifying patterns of systemic symptoms and associated clinical outcomes.
Methods
Adhering to PRISMA guidelines, we conducted a structured search across PubMed, Medline, and Scopus databases. Inclusion criteria comprised published case reports or case series detailing PHACT cases after ceramic bearing fractures revised to metal-on-polyethylene bearings. Over 30 cases were identified, and their clinical presentations and outcomes were analysed.
Result
The majority of PHACT cases in this cohort presented with cardiovascular manifestations (cardiomyopathy, cardiogenic shock, and heart failure), neurological symptoms (visual impairment, sensorineural hearing loss, and cognitive impairment), and endocrine dysfunction (thyroid dysfunction). Various atypical symptoms were also observed.
Conclusion
PHACT within this patient group presents insidiously with diverse, sometimes overlapping, systemic symptoms. The study highlights the potential for missed diagnoses due to the lack of apparent risk factors or related medical history. This review strongly advocates for proactive, registry data-driven identification of at-risk patients, as well as the opportunity for follow-up assessment and cobalt level monitoring. This study also highlights the importance of ceramic-on-polyethylene based revision in cases of ceramic bearing fractures.
{"title":"A systematic review and meta-analysis of cases of prosthetic hip-associated cobalt toxicity in patients with prosthetic hip ceramic bearing fractures subsequently revised to metal-on-polyethylene implants","authors":"Patrick Sweeney , James Broderick","doi":"10.1016/j.jor.2025.12.064","DOIUrl":"10.1016/j.jor.2025.12.064","url":null,"abstract":"<div><h3>Background</h3><div>Prosthetic hip-associated cobalt toxicity (PHACT) remains a rare but serious complication, potentially leading to missed diagnoses and delayed treatment. This systematic review explores cases of PHACT associated with fractured ceramic bearing followed by revision surgery with metal-on-polyethylene implants. Notably, patients in this subgroup often exhibited earlier symptom onset and elevated cobalt ion levels. Through a systematic review, we aim to explore and summarise the most common symptoms and clinical outcomes associated with PHACT among this specific patient subgroup. Our focus is on identifying patterns of systemic symptoms and associated clinical outcomes.</div></div><div><h3>Methods</h3><div>Adhering to PRISMA guidelines, we conducted a structured search across PubMed, Medline, and Scopus databases. Inclusion criteria comprised published case reports or case series detailing PHACT cases after ceramic bearing fractures revised to metal-on-polyethylene bearings. Over 30 cases were identified, and their clinical presentations and outcomes were analysed.</div></div><div><h3>Result</h3><div>The majority of PHACT cases in this cohort presented with cardiovascular manifestations (cardiomyopathy, cardiogenic shock, and heart failure), neurological symptoms (visual impairment, sensorineural hearing loss, and cognitive impairment), and endocrine dysfunction (thyroid dysfunction). Various atypical symptoms were also observed.</div></div><div><h3>Conclusion</h3><div>PHACT within this patient group presents insidiously with diverse, sometimes overlapping, systemic symptoms. The study highlights the potential for missed diagnoses due to the lack of apparent risk factors or related medical history. This review strongly advocates for proactive, registry data-driven identification of at-risk patients, as well as the opportunity for follow-up assessment and cobalt level monitoring. This study also highlights the importance of ceramic-on-polyethylene based revision in cases of ceramic bearing fractures.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"74 ","pages":"Pages 113-123"},"PeriodicalIF":1.5,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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