IF 1.6 4区医学 Q3 ORTHOPEDICS

Knee

Pub Date : 2025-01-25 DOI: 10.1016/j.knee.2024.12.014

Mario Alessandri-Bonetti , Riccardo Giorgino , Andrea Costantino , Francesco Amendola , Armando De Virgilio , Laura Mangiavini , Giuseppe M. Peretti , Luca Vaienti , Saïd C. Azoury , Francesco M. Egro

引用次数: 0

Discrepancies in long-leg alignment and knee joint line obliquity between two- and three-dimensional measurements under weight-bearing conditions: Effects on coronal plane alignment of the knee classification

IF 1.6 4区医学 Q3 ORTHOPEDICS

Knee

Pub Date : 2025-01-25 DOI: 10.1016/j.knee.2024.12.008

Ryo Sasaki , Yasuo Niki , Kazuya Kaneda , Yoshitake Yamada , Shu Kobayashi , Kengo Harato , Takeo Nagura , Masaya Nakamura , Masahiro Jinzaki

Background

Long-leg alignment and joint line obliquity have traditionally been assessed using two-dimensional (2D) radiography, but the accuracy of this measurement has remained unclear. This study aimed to evaluate the accuracy of 2D measurements of lateral distal femoral angle (LDFA) and medial proximal tibial angle (MPTA) using upright three-dimensional (3D) computed tomography (CT).

Methods

This study involved 66 knees from 38 patients (34 women, four men) with knee osteoarthritis (OA), categorized by Kellgren–Lawrence (KL) grade. Patients underwent standing long-leg radiography (LLR) and upright CT. Flexion and rotation angles of the femur and tibia were measured from upright CT data, and knees were classified by coronal plane alignment of the knee (CPAK) according to 2D- and 3D-LDFA/MPTA.

Results

Overall, as KL grade increased, femoral external rotation and flexion increased significantly (P < 0.05). Regarding the tibia, flexion increased (P < 0.05) while rotation remained unchanged with increasing KL grade. In mild OA (KL1 or KL2), 2D-LDFA (86.5 ± 1.8°) was significantly larger than 3D-LDFA (85.0 ± 2.5°; P < 0.05), and this difference was also observed in severe OA (KL3 or KL4) (88.7 ± 2.5° vs. 87.7 ± 3.2°; P < 0.05). However, MPTA was comparable between 2D and 3D. The consistency between 2D and 3D CPAK classifications was 48.5% for the entire sample, 25.0% for mild OA, and 61.9% for severe OA.

Conclusion

Based on 3D-LDFA/MPTA data gained from upright CT, 2D radiographic LDFA tended to be inaccurate, which may significantly affect the CPAK classification.

背景：长腿对齐和关节线斜度传统上使用二维（2D）射线摄影进行评估，但这种测量方法的准确性仍不明确。本研究旨在评估使用直立三维计算机断层扫描（CT）对股骨外侧远端角度（LDFA）和胫骨内侧近端角度（MPTA）进行二维测量的准确性：这项研究涉及 38 名膝关节骨性关节炎（OA）患者（34 名女性，4 名男性）的 66 个膝关节，按 Kellgren-Lawrence (KL) 等级分类。患者接受了站立长腿放射摄影（LLR）和直立 CT 检查。根据直立 CT 数据测量股骨和胫骨的屈伸和旋转角度，并根据 2D 和 3D-LDFA/MPTA 按膝关节冠状面排列（CPAK）对膝关节进行分类：总体而言，随着 KL 等级的增加，股骨外旋和屈曲显著增加（P根据直立 CT 获得的 3D-LDFA/MPTA 数据，二维射线 LDFA 往往不准确，这可能会严重影响 CPAK 分级。

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引用次数: 0

The coronal plane alignment of the knee classification of a Japanese population indicates more varus deformity tendency compared with European countries

IF 1.6 4区医学 Q3 ORTHOPEDICS

Knee

Pub Date : 2025-01-25 DOI: 10.1016/j.knee.2024.12.010

Mitsuaki Kubota , Haruka Kaneko , Keiichi Yoshida , Shinnosuke Hada , Youngji Kim , Jun Shiozawa , Jun Tomura , Mayuko Kinoshita , Takaya Otaki , Keiji Kobayashi , Yoshitomo Saita , Masashi Nagao , Yuji Takazawa , Muneaki Ishijima

Purpose

The purpose of this study was to compare the distribution of the coronal plane alignment of the knee (CPAK) phenotype between the healthy population and the arthritic population in Japan.

Methods

The retrospective cross-sectional study included 1049 knees. There were 256 healthy individuals with a total of 512 knees and 310 individuals with a total of 537 arthritic knees who underwent around-knee osteotomy between June 2010 and January 2024. The CPAK phenotype was compared between the healthy population and the arthritic population. Furthermore, the CPAK phenotype rates were compared between Japan and the other countries.

Results

The most common type of CPAK was type II (51.2%), followed by type III (26.4%) and type I (16.6%) in the healthy population, and type I (63.4%), followed by type II (22.9%) and type IV (6.3%) in the arthritic population. There were significant differences in CPAK types I, II, III, IV, VI between the healthy and arthritic populations. The rates of CPAK phenotype in Japan were significantly different from those in the other countries. The rates of apex distal joint line obliquity in the healthy and arthritic population (94.2%, 88.9%) were significantly higher than in the other countries.

Conclusions

There were significant differences in distribution of the CPAK phenotype between the healthy and arthritic populations. Furthermore, the Japanese distribution of the CPAK phenotype was different from other countries. Japanese CPAK types were highly involved in distal joint line apex obliquity, which indicates varus deformity in the future.

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引用次数: 0

AutoCOR: Autonomous condylar offset ratio calculator for post-operative total knee arthroplasty radiographs AutoCOR：用于全膝关节置换术后x线片的自主髁偏移比计算器。

IF 1.6 4区医学 Q3 ORTHOPEDICS

Knee

Pub Date : 2025-01-18 DOI: 10.1016/j.knee.2025.01.002

Gulsade Rabia Cakmak , Ibrahim Ethem Hamamci , Mehmet Kursat Yilmaz , Reda Alhajj , Ibrahim Azboy , Mehmet Kemal Ozdemir

Background

This study aims to automate the measurement process of posterior condylar offset ratio (PCOR) and anterior condylar offset ratio (ACOR) to improve the Total Knee Arthroplasty (TKA) evaluation. Accurate calculation of PCOR and ACOR, performed manually by orthopedic surgeons, is crucial for assessing postoperative range of motion and implant positioning. Manual measurements, however, are time-consuming, prone to human error, and subject to variability. Automating this process could improve precision in clinical practice.

Methods

We developed AutoCOR, a software system that autonomously calculates PCOR and ACOR by utilizing built-in function, employing k-means clustering, from the OpenCV library for image segmentation. The software detects key anatomical landmarks on true postoperative lateral radiographs. The definitions of PCOR and ACOR are PCO (posterior condylar offset) divided by femoral diameter, and ACOR is defined as ACO (anterior condylar offset) divided by femoral diameter, respectively. We tested the algorithm on 50 postoperative lateral radiographs of 32 patients from the Istanbul Kosuyolu Medipol Hospital, which included data from. The assessment process included calculating the mean, standard deviation and plotting the Bland-Altman plots, comparing AutoCOR’s results against ground truth values.

Results

The mean PCOR was 0.984 (SD 0.235) for AutoCOR and 0.972 (SD 0.164) for ground truth values, showing a strong correlation (Pearson r = 0.845, p < 0.0001). The mean ACOR was 0.107 (SD 0.092) for AutoCOR and 0.107 (SD 0.070) for ground truth values, with moderate correlation (Spearman’s rs = 0.519, p = 0.0001).

Conclusion

AutoCOR provides accurate measurements and shows potential to reduce variability in TKA evaluation, improving precision in clinical practice.

背景：本研究旨在自动化测量后髁偏移比（PCOR）和前髁偏移比（ACOR）的过程，以提高全膝关节置换术（TKA）的评估。由骨科医生手动精确计算PCOR和ACOR对于评估术后活动范围和植入物定位至关重要。然而，手动测量是耗时的，容易出现人为错误，并且受到可变性的影响。自动化这一过程可以提高临床实践的准确性。方法：利用OpenCV库中的内置函数，采用k-means聚类，开发了用于图像分割的自动计算PCOR和ACOR的软件系统AutoCOR。该软件在真正的术后侧位x线片上检测关键解剖标志。PCOR和ACOR的定义分别为PCO（后髁偏移）除以股骨直径，ACOR的定义分别为ACO（前髁偏移）除以股骨直径。我们在伊斯坦布尔Kosuyolu Medipol医院的32名患者的50张术后侧位x线片上测试了该算法，其中包括来自。评估过程包括计算平均值，标准差和绘制Bland-Altman图，将AutoCOR的结果与基础真值进行比较。结果：AutoCOR的平均PCOR为0.984 (SD 0.235)，基础真值为0.972 (SD 0.164)，显示出很强的相关性（Pearson r = 0.845, p）。结论：AutoCOR提供了准确的测量结果，并显示出减少TKA评估变异性的潜力，提高了临床实践中的准确性。

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引用次数: 0

Correlation of morphological parameters of the knee affecting the functional outcome in patients with anterior cruciate ligament reconstruction 膝关节形态参数对前交叉韧带重建患者功能预后的影响。

IF 1.6 4区医学 Q3 ORTHOPEDICS

Knee

Pub Date : 2025-01-18 DOI: 10.1016/j.knee.2025.01.003

Prem Kotian , Anshul Tripathi , Rajendra Annappa , Premjit Rabindra Sujir , Prajwal Prabhudev Mane , Keerthan Ranga Nayak U , K. Suprasanna , Megha Thaleppady

Objectives

The literature does not show any studies that correlate between the morphological parameters of knee and functional outcome after anterior cruciate ligament reconstruction. The purpose of this study was to establish a correlation of morphological parameters of the knee in (magnetic resonance imaging) MRI with functional outcome in patients who underwent anterior cruciate ligament reconstruction.

Material and methods

This was an observational study which included 63 patients who underwent anterior cruciate ligament reconstruction. Morphological parameters such as notch width index, medial and lateral tibial slopes and patellar tendon tibial slope angle were interpreted. Functional outcome was measured using IKDC (International knee documentation committee) score and Tegnor-Lysholm scores at 3, 6, 9 and 12 months post operatively.

Results

Group 1(NWI) had least IKDC score (77.5 ± 8.5) and Tegnor-Lysholm score (79 ± 3) at 12 months among patients when compared with other single abnormal morphological parametric values. Group 10 (NWI + PTTS) had least IKDC scores (79 ± 2) and Tegnor-Lysholm scores (91) at 12 months. Overall group 15 (LTS + PTTS) had better IKDC scores (85.3 ± 0.94) and Tegnor-Lysholm scores (93.3 ± 2.4) at 12 months among all the other groups considered. Thirty patients had abnormal notch width index.

Conclusion

Evaluation of knee morphology is important in anterior cruciate ligament injuries as the relevant indices correlate with surgical outcome and helps the surgeon to choose an approach to minimize graft failure. Notch width index is the best of these indices to assess the future likely functional outcome in patients with anterior cruciate ligament reconstruction. Patients having a narrow intercondylar notch width index are at risk of having a poor functional outcome post anterior cruciate ligament reconstruction.

目的：文献没有显示任何研究表明前交叉韧带重建后膝关节形态参数与功能预后之间存在相关性。本研究的目的是建立（磁共振成像）MRI中膝关节形态参数与前交叉韧带重建患者功能预后的相关性。材料和方法：这是一项观察性研究，包括63例接受前交叉韧带重建的患者。对切口宽度指数、胫骨内外侧斜度、髌骨肌腱胫骨斜度角等形态学参数进行分析。术后3、6、9和12个月，使用IKDC（国际膝关节文献委员会）评分和Tegnor-Lysholm评分来测量功能结局。结果：1组（NWI）患者在12个月时IKDC评分（77.5±8.5）和Tegnor-Lysholm评分（79±3）低于其他单一形态学参数值。10组（NWI + PTTS） 12个月时IKDC评分最低（79±2），Tegnor-Lysholm评分最低（91）。总的来说，15组（LTS + PTTS）在12个月时的IKDC评分（85.3±0.94）和Tegnor-Lysholm评分（93.3±2.4）优于其他所有组。切口宽度指数异常30例。结论：在前交叉韧带损伤中，膝关节形态学的评估很重要，因为相关指标与手术结果相关，有助于外科医生选择一种方法来减少移植物失败。缺口宽度指数是评估前交叉韧带重建患者未来可能功能结局的最佳指标。髁间切迹宽度指数较窄的患者在前交叉韧带重建后存在功能不良的风险。

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引用次数: 0

The effect of cognitive task and gait speed on gait spatiotemporal parameters in athletes with anterior cruciate ligament reconstruction: Cross-sectional study 认知任务和步态速度对前交叉韧带重建运动员步态时空参数影响的横断面研究。

IF 1.6 4区医学 Q3 ORTHOPEDICS

Knee

Pub Date : 2025-01-15 DOI: 10.1016/j.knee.2025.01.001

Omid Khoshavi , Javad Sarrafzadeh , Reza Salehi , Zahra Sadat Rezaeian , Zohreh Shafizadegan

Background

Restoring pre-injury normal gait following Anterior Cruciate Ligament Reconstruction (ACLR) is a critical challenge. The purpose of this study was to compare spatiotemporal parameters in athletes following ACL reconstruction with healthy athletes when cognitive load and speed were manipulated.

Methods

Twenty male soccer players with an ACLR history and 20 healthy matched individuals completed walking tasks under four conditions: with and without a cognitive load (auditory Stroop task), and at preferred speed as well as high speed (20% higher than the individual’s preferred speed). Step Width (SW), Step Time (ST), Step Length (SL), as well as Symmetry Indexes (SIs) were measured using three-dimensional (3D) motion analysis. Gait symmetry was evaluated by SIs. The data was analyzed using Three-way analysis of variances with repeated measures (ANOVA 3 × 2).

Results

ST was significantly different between groups (P = 0.04) when the cognitive load was applied at the preferred speed. However, other spatiotemporal parameters were not significantly different between groups in any conditions (p > 0.05). The SW was reduced during high–speed walking with cognitive load in both groups (p = 0.004). High-speed resulted in greater SL (p < 0.001) and lower ST (p < 0.001) in both groups. SI was not significantly different for any parameter between groups under any conditions, however, the interaction of cognitive task × speed was significant for SW (p = 0.03).

Conclusion

Athletes at a mean of 19 months following ACL Reconstruction appear to manage speed and cognitive challenges similar to age and activity matched individuals who have not had surgery.

背景：在前交叉韧带重建（ACLR）后恢复损伤前的正常步态是一个关键的挑战。本研究的目的是比较前交叉韧带重建后运动员与健康运动员在认知负荷和速度被操纵时的时空参数。方法：20名有ACLR病史的男性足球运动员和20名健康匹配者在有认知负荷和无认知负荷（听觉Stroop任务）、首选速度和高速（比个人首选速度高20%）4种条件下完成步行任务。采用三维（3D）运动分析方法测量步宽（SW）、步长（ST）、步长（SL）和对称指数（si）。采用SIs评价步态对称性。采用重复测量的三向方差分析（ANOVA 3 × 2）对数据进行分析。结果：以首选速度施加认知负荷时，组间ST差异显著（P = 0.04）。其他时空参数在各条件下各组间无显著差异（p < 0.05）。两组在有认知负荷的情况下，高速步行时SW均降低（p = 0.004）。结论：前交叉韧带重建后平均19个月的运动员处理速度和认知挑战的能力与未接受手术的年龄和活动匹配的个体相似。

{"title":"The effect of cognitive task and gait speed on gait spatiotemporal parameters in athletes with anterior cruciate ligament reconstruction: Cross-sectional study","authors":"Omid Khoshavi , Javad Sarrafzadeh , Reza Salehi , Zahra Sadat Rezaeian , Zohreh Shafizadegan","doi":"10.1016/j.knee.2025.01.001","DOIUrl":"10.1016/j.knee.2025.01.001","url":null,"abstract":"<div><h3>Background</h3><div>Restoring pre-injury normal gait following Anterior Cruciate Ligament Reconstruction (ACLR) is a critical challenge. The purpose of this study was to compare spatiotemporal parameters in athletes following ACL reconstruction with healthy athletes when cognitive load and speed were manipulated.</div></div><div><h3>Methods</h3><div>Twenty male soccer players with an ACLR history and 20 healthy matched individuals completed walking tasks under four conditions: with and without a cognitive load (auditory Stroop task), and at preferred speed as well as high speed (20% higher than the individual’s preferred speed). Step Width (SW), Step Time (ST), Step Length (SL), as well as Symmetry Indexes (SIs) were measured using three-dimensional (3D) motion analysis. Gait symmetry was evaluated by SIs. The data was analyzed using Three-way analysis of variances with repeated measures (ANOVA 3 × 2).</div></div><div><h3>Results</h3><div>ST was significantly different between groups (<em>P</em> = 0.04) when the cognitive load was applied at the preferred speed. However, other spatiotemporal parameters were not significantly different between groups in any conditions (<em>p</em> > 0.05). The SW was reduced during high–speed walking with cognitive load in both groups (<em>p</em> = 0.004). High-speed resulted in greater SL (<em>p</em> < 0.001) and lower ST (<em>p</em> < 0.001) in both groups. SI was not significantly different for any parameter between groups under any conditions, however, the interaction of cognitive task × speed was significant for SW (<em>p</em> = 0.03).</div></div><div><h3>Conclusion</h3><div>Athletes at a mean of 19 months following ACL Reconstruction appear to manage speed and cognitive challenges similar to age and activity matched individuals who have not had surgery.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"53 ","pages":"Pages 200-207"},"PeriodicalIF":1.6,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Response to letter to the editor by Dr. Liu Aifeng et al. 对刘爱峰等人致编辑信的回复。

IF 1.6 4区医学 Q3 ORTHOPEDICS

Knee

Pub Date : 2025-01-11 DOI: 10.1016/j.knee.2024.12.018

引用次数: 0

Letter to the editor: Validity of wearable sensors for total knee arthroplasty (TKA) rehabilitation: A study in younger and older healthy Participants. Knee. 2024 Oct; 24:51:292-302. 致编辑的信：可穿戴传感器在全膝关节置换术（TKA）康复中的有效性：一项针对年轻和老年健康参与者的研究。2024年10月；24:51:292 - 302。

IF 1.6 4区医学 Q3 ORTHOPEDICS

Knee

Pub Date : 2025-01-09 DOI: 10.1016/j.knee.2024.12.017

Neimeng Gu, Dongdong Cao, Aifeng Liu

引用次数: 0

Preoperative estimation of hamstring autograft graft diameter in anterior cruciate ligament reconstruction with a new simple method using magnetic resonance imaging 磁共振成像在前交叉韧带重建中预估腘绳肌腱自体移植物直径的新方法。

IF 1.6 4区医学 Q3 ORTHOPEDICS

Knee

Pub Date : 2025-01-09 DOI: 10.1016/j.knee.2024.12.016

Emre Kocazeybek, Mehmet Ersin, Murat Yılmaz, Mehmet Ekinci

Background

The aim of this study was to predict intraoperative graft diameter with our new method by evaluating the cross-sectional areas (CSAs) of the hamstrings in axial sections of MRI.

Methods

This study included 78 patients who underwent single-bundle ACLR between 2022 and 2023. MRIs of the patients were evaulated preoperatively and four CSAs of the hamstring tendons were measured in two different regions by two participants. CSA measurements were calculated manually and the total area was measured by adding up these cross-sectional areas separately. This value was considered as the area of a single circle and the radius was calculated using the area formula of the circle (A = πr²)

Results

For participant I, perfect agreement was found in semitendinosus measurement (κ = 0.849), moderate agreement was detected at the medial condyle level (κ = 0.520). For participant II, perfect agreement was found in the medial condyle region (κ = 0.849), substantial agreement was obtained at the joint level (0.631). In the gracilis tendon evaluation of both participants, substantial and moderate agreement was found at the joint level and at the medial condyle level, respectively. CSA of hamstring tendons measured at the joint level by both participants were found to be positively correlated with the intraoperative graft diameter (r = 0.51) (P < 0.05)

Conclusions

Preoperative MRI assesment could be a effective tool for determing preliminary information about the hamstring graft diameters. Moreover, it is observed that quadruple hamstring graft sizes were more correlated with MRI measurements at the joint level than medial condyle level by using circle area formula.

背景：本研究的目的是用我们的新方法通过MRI轴向切片评估腘绳肌的横截面积（csa）来预测术中移植物直径。方法：本研究包括78例在2022年至2023年间接受单束ACLR的患者。术前评估患者的mri，并由两名参与者在两个不同区域测量腘绳肌腱的四个csa。CSA测量是人工计算的，总面积是通过将这些横截面积分别相加来测量的。结果：参与者1的半腱肌测量结果完全吻合（κ = 0.849），内侧髁水平测量结果吻合（κ = 0.520）。对于参与者II，内侧髁区域完全一致（κ = 0.849），关节水平基本一致（0.631）。在两名参与者的股薄肌腱评估中，分别在关节水平和内侧髁水平发现了大量和中度的一致。两组患者在关节水平测得的腘绳肌腱CSA与术中移植物直径呈正相关（r = 0.51）

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引用次数: 0

Abstracts of systematic reviews and meta-analyses investigating meniscal root repair exhibit a high prevalence of reporting bias 调查半月板牙根修复的系统综述和荟萃分析的摘要显示出高度普遍的报告偏倚。

IF 1.6 4区医学 Q3 ORTHOPEDICS

Knee

Pub Date : 2025-01-08 DOI: 10.1016/j.knee.2024.12.013

Jacob L. Kotlier, Pranit Kumaran, Amir Fathi, Joshua M. Yazditabar, Eric H. Lin, Cory K. Mayfield, Frank A. Petrigliano, Joseph N. Liu

Background

To present rates of reporting bias in systematic reviews and meta-analyses investigating meniscal root repair.

Methods

In this systematic review, PubMed, Scopus and Web of Science databases were queried for studies that investigated meniscal root tears treated with root repair. Included studies were systematic reviews and/or meta-analyses published in peer-reviewed journals in the English language with available full-texts. Each abstract was graded in a binary fashion for 15 most severe types of spin. Fisher’s exact test was used to determine if spin varied significantly by year, journal, level of evidence, funding source, or A Measurement Tool to Assess Systematic Reviews Version 2 (AMSTAR 2) confidence category.

Results

Twenty studies were included. All abstracts exhibited spin with a maximum of eight types of spin. The most prevalent categories of spin were “Misleading Reporting” (n = 18), “Inappropriate Extrapolation” (n = 13), and “Misleading Interpretation” (n = 12). There were significant associations between external funding and spin types: 5 (“The conclusion claims the beneficial effect of the experimental treatment despite a high risk of bias in primary studies”) (p = 0.019), 9 (“Conclusion claims the beneficial effect of the experimental treatment despite reporting bias”) (p < 0.001), and 15 (“Conclusion extrapolates the review’s findings to a different population or setting”) (p = 0.049). AMSTAR 2 confidence rating was either “low” (n = 2) or “critically low” (n = 18) in all 20 studies.

Conclusion

This study demonstrated a high prevalence of reporting bias in the abstracts of systematic reviews and meta-analyses investigating meniscal root repair, with significant associations with external funding.

背景：研究半月板牙根修复的系统评价和荟萃分析的报告偏倚率。方法：在本系统综述中，检索PubMed、Scopus和Web of Science数据库，查询有关半月板根撕裂采用根修复治疗的研究。纳入的研究是在同行评议的英文期刊上发表的系统综述和/或荟萃分析，并提供全文。每个摘要以二元方式对15种最严重的自旋类型进行评分。使用Fisher精确检验来确定自旋是否因年份、期刊、证据水平、资金来源或评估系统评价的测量工具版本2 （AMSTAR 2）的可信度类别而显著变化。结果：纳入20项研究。所有的摘要都表现出最多8种自旋。最普遍的旋转类别是“误导性报道”（n = 18），“不适当的外推”（n = 13）和“误导性解释”（n = 12）。外部资助和自旋类型之间存在显著关联：5（“结论声称实验性治疗的有益效果，尽管在初步研究中存在高偏倚风险”）（p = 0.019）， 9（“结论声称实验性治疗的有益效果，尽管报告存在偏倚”）(p结论：该研究表明，调查半月板牙根修复的系统综述和荟萃分析摘要中存在较高的报道偏倚，与外部资金有显著关联。

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引用次数: 0