Wan Fang Hospital
  • Taipei, Taiwan
Recent publications
Introduction TWe investigated impacts of particulate matter with an aerodynamic diameter of less than 2.5 μm (PM2.5), relative humidity (RH), and temperature on sleep stages and arousal. Materials and Methods A cross-sectional analysis involving 8,611 participants was conducted at a sleep center in Taipei. We estimated individual-level exposure to RH, temperature, and PM2.5 over 1-day, 7-day, and 30-day periods. Linear regression models assessed the relationship between these environmental factors and sleep parameters across different seasons. Mediation analysis was used to explore PM2.5, RH, and temperature roles in these relationships. Results A 1% increase in RH over 1 and 7 days was associated with changes in non-rapid eye movement (NREM) sleep stages and increases in the arousal index across all seasons. A 1°C increase in temperature over similar periods led to increases in rapid eye movement (REM) sleep. During cold season, changes in RH and temperature were linked to variations in arousal and NREM sleep stages. In hot season, RH and temperature increases were correlated with changes in NREM sleep stages and arousal. Across all groups, a 1-μg/m³ increase in PM2.5 levels was associated with alterations in NREM and REM sleep stages and increases in the arousal index. We found PM2.5 levels mediated relationships between RH, temperature, and various sleep stages, particularly in cold season. Conclusions Lower RH and temperature, contributing to deep sleep reduction and increased arousal, were influenced by elevated PM2.5 exposure, especially during colder months. Enhancing environmental quality and reducing PM2.5 levels may lead to improved sleep quality.
Purpose Epigenetic modifications, such as aberrant DNA methylation, histone alterations, non-coding RNA remodeling, and modulation of transcription factors, are pivotal in the pathogenesis of diverse malignancies. Reactive oxygen species (ROS) have the capacity to impact these epigenetic mechanisms, including DNA methylation, throughout the different stages of cancer development. Therefore, the aim of this review is to address the impact of. Methods Published papers were searched in Pubmed and Google Scholar databases using the keywords “epigenetic”, or “DNA methylation”, or “phytochemicals”, or “chemoprevention” to prepare this review. Results There is mounting evidence indicating that diminishing ROS accumulation within cells can regulate the function of DNA methyltransferases (DNMTs). Moreover, activation of the cellular defense system can impede and potentially reverse the progression of tumors in cancerous cells. As a result, ROS scavengers, antioxidants, and demethylating agents have emerged as potential therapeutic approaches for specific types of cancer. Additionally, dietary phytochemicals present in fruits, vegetables, and herbs, which have been utilized for centuries, exhibit the capability to modulate transcription factors, decrease inflammation, deliver antioxidant benefits, induce cell-cycle arrest, and stimulate apoptosis. Conclusion These phytochemicals can also renew and reprogram the expression of genes that suppress cancer. Thus, prolonged exposure to phytochemicals at low doses represents an innovative therapeutic tactic for the prevention of cancer.
Objective Therapeutic drug monitoring (TDM) indicators have been suggested to predict overall outcome responses to olanzapine (OLZ) treatments in terms of efficacy and metabolic syndrome. This study aimed to investigate whether paraoxonase-1 (PON-1) activity can be used to predict schizophrenia patient outcomes. Methods Schizophrenic patients ( N = 50) aged between 20 and 65 years who received OLZ treatment were recruited, and their Positive and Negative Syndrome Scale scores, PON-1 activity, and olanzapine drug levels normalized by dose (OLZ/D) and its metabolite N-desmethyl-olanzapine (DMO), together with biochemical parameters, were determined. Results PON-1 activity and OLZ/D were significantly correlated in 50 patients (correlation coefficient, r = 0.355; p = 0.0115). There was also a statistically significant correlation between the ratio of PON-1 activity normalized by homocysteine (Hcy) and OLZ/D (correlation coefficient r = 0.361; p = 0.01) and a significant negative correlation between the ratio of PON-1 activity normalized by Hcy and triglyceride/high-density lipoprotein (TG/HDL; correlation coefficient r = −0.328; p = 0.02). Conclusions PON-1 activity can be used as an alternative tool for monitoring TDM through the measurement of OLZ together with its metabolite, DMO, to identify patients who have higher activity. Those who show an optimal response or who have lower activity might have greater cardiometabolic risk under long-term olanzapine treatment. Longitudinal monitoring is warranted to confirm such observations.
Background Global populations are aging, and the numbers of stroke survivors is increasing. Consequently, the need for caregiver support has increased. Because of this and demographic and socioeconomic changes, foreign caregivers are increasingly in demand in many developed countries. Therefore, the perspectives of older adult care recipients regarding foreign caregivers warrants attention. This study explored the experiences of older stroke survivors receiving care from foreign caregivers in Taiwan, examining their expectations, needs, and challenges. Methods This study employed a descriptive qualitative approach, conducting in-depth interviews with 23 older stroke survivors (mean age, 73.4 years; women, 47.8%). Thematic analysis was applied to transcribed data, with reflective memos aiding in meaning derivation. Methodological rigor was ensured through member checking, triangulation, and auditing. Results Three major themes emerged: the motivations for hiring a foreign caregiver, expectations of stroke survivors toward foreign caregivers, and challenges related to employing foreign caregivers. Stroke survivors expected foreign caregivers to be obedient, embrace the local language and culture, and be proficient in caregiving and homemaking. Various challenges, including communication difficulties, cultural differences, skill gaps, and unfavorable attitudes and behaviors among caregivers, were noted. Conclusions Foreign caregivers are a major part of the long-term care workforce and play a crucial role in stroke rehabilitation in aging Asian societies. Older stroke survivors often hire foreign caregivers to alleviate caregiving burdens, and they typically expect foreign caregivers to conform to their needs. However, employing foreign caregivers can be frustrating and stressful. Government intervention and open dialogue is necessary to improve care quality and prevent recurring caregiving problems and conflicts.
Background and objective Relevant research has provided valuable insights into risk factors for bicycle crashes at intersections. However, few studies have focused explicitly on three common types of bicycle crashes on road segments: overtaking, rear-end, and door crashes. This study aims to identify risk factors for overtaking, rear-end, and door crashes that occur on road segments. Material and methods We analysed British STATS19 accident records from 1991 to 2020. Using multivariate logistic regression models, we estimated adjusted odds ratios (AORs) with 95% confidence intervals (CIs) for multiple risk factors. The analysis included 127,637 bicycle crashes, categorised into 18,350 overtaking, 44,962 rear-end, 6,363 door, and 57,962 other crashes. Results Significant risk factors for overtaking crashes included heavy goods vehicles (HGVs) as crash partners (AOR = 1.30, 95% CI 1.27–1.33), and elderly crash partners (AOR = 2.01, 95% CI = 1.94–2.09), and decreased risk in rural area with speed limits of 20–30 miles per hour (AOR = 0.45, 95% CI = 0.43–0.47). For rear-end crashes, noteworthy risk factors included unlit darkness (AOR = 1.49, 95% CI = 1.40–1.57) and midnight hours (AOR = 1.28, 95% CI = 1.21–1.40). Factors associated with door crashes included urban areas (AOR = 16.2, 95% CI = 13.5–19.4) and taxi or private hire cars (AOR = 1.61, 95% CI = 1.57–1.69). Our joint-effect analysis revealed additional interesting results; for example, there were elevated risks for overtaking crashes in rural areas with elderly drivers as crash partners (AOR = 2.93, 95% CI = 2.79–3.08) and with HGVs as crash partners (AOR = 2.62, 95% CI = 2.46–2.78). Conclusions The aforementioned risk factors remained largely unchanged since 2011, when we conducted our previous study. However, the present study concluded that the detrimental effects of certain variables became more pronounced in certain situations. For example, cyclists in rural settings exhibited an elevated risk of overtaking crashes involving HGVs as crash partners.
Introduction: Diabetes mellitus (DM) is associated with worse surgical outcomes, and is a risk factor for bladder cancer and subsequent oncological outcomes. This study evaluated outcomes robot-assisted radical cystectomy (RARC) compared to open radical cystectomy (ORC) in patients with DM. Materials and Methods: Data of adults ≥ 18 years old with DM who underwent radical cystectomy were extracted from the United States National Inpatient Sample database 2005-2018. The outcomes were in-hospital mortality, prolonged length of stay (LOS), and postoperative complications. Results: Data of 2,765 patients were analyzed. Patients who received RARC had a significantly lower odds of prolonged LOS (adjusted odd ratio (aOR) = 0.56, 95% CI: 0.45, 0.71), unfavorable discharge (aOR = 0.74, 95% CI: 0.56, 0.97), urinary complications (aOR = 0.75, 95% CI: 0.57, 0.98) and wound and device-related complications (aOR = 0.59, 95% CI: 0.41, 0.86) than ORC. Of patients < 70 years old, RARC was significantly associated with decreased odds for urinary complications (aOR = 0.59, 95% CI: 0.41, 0.84) and wound and device-related complications (aOR = 0.55, 95% CI: 0.32, 0.94) compared to ORC. In patients with a Charlson Comorbidity Index score of 0-1, RARC was associated with a lower risk of urinary complications (aOR = 0.74, 95% CI: 0.56, 0.98) and wound and device-related complications (aOR = 0.63, 95% CI: 0.43, 0.93) compared to ORC. Conclusions: In patients with DM and bladder cancer, RARC appears to be associated with better short-term outcomes in terms of reduced risks of prolonged LOS, unfavorable discharge, urinary complications, and wound and device-related complications compared to ORC.
Background Triple negative breast cancer (TNBC) belongs to the worst prognosis of breast cancer subtype probably because of distant metastasis to other organs, e.g. lungs. However, the mechanism underlying TNBC metastasis remains largely unknown. Methods Bioinformatics analysis was conducted to evaluate the mRNA/protein expression and prognostic significance of G protein–coupled receptor kinase 6 (GRK6) in BC subtypes. RT-PCR assays were used to test the GRK6 expression in human BC tissues and cell lines. The in vitro cellular migration and in vivo lung colony-forming assays were established to estimate the metastatic potentials of TNBC cells. Western blotting was employed to examine protein phosphorylation, translocation and expression in the designed experiments. Results Here we show that GRK6 upregulation is extensively detected in TNBC compared to normal mammary tissues and other BC subtypes and correlates with an increased risk for distant metastasis in TNBC patients. GRK6 knockdown suppressed but overexpression potentiated the cellular migration and lung colony-forming abilities of TNBC cells. Moreover, our data demonstrated that the posttranslational palmitoylation of GRK6 is extremely critical for activating β-Arrestin 2/mitogen-activated protein kinases (MAPKs)/NF-κB signaling axis and fostering the metastatic potentials of TNBC cells. Accordingly, the pharmaceutical inhibition of GRK6 kinase activity dramatically suppressed the activation of β-Arrestin 2, MAPKs and NF-κB and the cellular migration ability of highly metastatic MDA-MB231 cells. Sequentially blocking the β-Arrestin 2/MAPKs/NF-κB axis with their inhibitors predominantly mitigated the GRK6-promoted migration ability of poorly metastatic HCC1937 cells. Conclusion Our results not only provide a novel mechanism for TNBC metastasis but also offer a new therapeutic strategy to combat metastatic TNBC via targeting GRK6 activity.
Background: High-level median or ulnar nerve injuries and repairs typically result in suboptimal re-innervation of distal muscles. Functioning Free Muscle Transplantation (FFMT) is increasingly recognized as an effective method to restore function in chronic muscle denervation cases. This study investigates the efficacy of using an additional FFMT, neurotized by lateral sprouting axons from a repaired high-level mixed nerve in the upper limb, to enhance distal hand function. Methods: Thirty-five Sprague-Dawley rats were divided into four groups to evaluate the proposed FFMT technique. The infraclavicular median nerve (MN) was transected and repaired in each animal. The nearby musculocutaneous nerve (MCN) was transected, and the terminal nerve after the biceps muscle was divided and embedded into the biceps muscle, creating an FFMT model. The distal stump of the MCN was anchored to the MN, 1.5 mm distal to the MN repair site. Assessments of nerve and muscle function were conducted four months postoperatively. Results: Behavioral analysis, along with measurements of biceps muscle weight and tetanic contraction force, indicated significant recovery in the biceps muscle. Histological staining confirmed re-innervation of the MCN from the repaired MN. Additionally, functional examination of the flexor digitorum superficialis muscle revealed no deterioration associated with the repaired MN. Conclusion: The study demonstrates the potentiality of utilizing lateral sprouting axons from a repaired high-level median nerve to reinnervate an additional FFMT to enhance flexor digitorum superficialis function. The surgical strategy promises recovery of distal muscle function and implies for diverse clinical applications.
Aims We conducted this study to investigate the impact of muscle loss on musculoskeletal health, fall and fracture risks, and activities of daily living (ADL) in elderly patients with osteoporosis. Materials and methods This age- and sex-matched cross-sectional study analyzed data from a medical center involving patients aged ≥ 50 from 2020 to 2022. The included participants were formed into three groups: 100 with osteoporosis only, 100 with osteosarcopenia, and 50 control individuals without osteoporosis and sarcopenia. We compared groups based on their baseline characteristics, bone and muscle health measurements, and the risks of falls and fractures using the STRATIFY scale and FRAX, respectively. Additionally, ADL was assessed using the Barthel Index. A multivariate analysis was performed to identify factors associated with declined ADL in osteosarcopenic patients. Results The mean age was 76.17 years, and 82% were female. The osteosarcopenic group demonstrated poorer bone and muscle quality and quantity, with greater risks of major osteoporotic-related fractures, hip fractures, and falls, as well as significantly decreased ADL than other groups. When comparing sexes, females exhibited worse performance than males across groups. Slow gait speed and high STRATIFY score are independent predictors of declined ADL in osteosarcopenic patients. Conclusion Sarcopenia exacerbates osteoporotic patients, particularly women, worsening bone deterioration, increasing fall and fracture risks, and significantly impairing daily activities. Enhancing walking speed and reducing fall risk can boost independence in individuals with osteosarcopenia. Early detection, proper management, and preventive measures are essential for mitigating these adverse outcomes in high-risk individuals.
Background Effective education and awareness regarding breast cancer are critical. Traditional educational methods often fail to meet the diverse information needs of patients. Patients should be provided with tailored, accessible information to improve their retention and understanding of disease-related information. Purpose This systematic review and meta-analysis evaluated the effectiveness of chatbots for providing breast cancer education. By examining patient satisfaction with and the usability and efficacy of chatbot interventions, this study seeks to support the integration of chatbot technology into cancer education. Methods This review, which was conducted in accordance with PRISMA guidelines, included studies from MEDLINE, Embase, and the Cochrane Library up to May 2024. The main inclusion criterion was chatbot interventions for breast cancer education. Meta-analysis was performed using Review Manager and Open Meta-Analyst software. Results Of the 208 articles initially identified, 6 studies met the inclusion criteria, involving a total of 1342 women with early-stage or at-risk hereditary breast cancer. The meta-analysis revealed that most participants (85 to 99%) reported high satisfaction with chatbot interventions for breast cancer education, with no significant differences in satisfaction compared to genetic counselors or physicians. The chatbot interventions also showed positive effects on knowledge acquisition (mean proportion = 90.8%) and alleviated patients’ symptoms significantly more than routine care. Conclusion This study demonstrated that chatbots can effectively provide personalized and interactive educational support, enhancing patients’ understanding and retention of disease-related information. The integration of chatbot technology into educational programs can empower patients, ultimately promoting breast cancer awareness and prevention.
Background Although various repetitive transcranial magnetic stimulation (rTMS) and theta burst stimulation (TBS) protocols are used, their comparative effectiveness for treating poststroke hemineglect remains unassessed. Objective To investigate rTMS and TBS effects on clinical outcomes in poststroke hemineglect through a systematic review and network meta-analysis. Methods We searched PubMed, EMBASE, and Cochrane Library databases up to March 7, 2024, for trials on rTMS or TBS in poststroke hemineglect. Included studies involved rTMS or TBS with different protocols, sham, or no stimulation, assessing hemineglect severity or impact. The quality of the included studies was evaluated using the PEDro scale. The network meta-analysis was performed using ShinyNMA (version 1.01). Results We analyzed 13 studies with 309 participants. All studies included participants who had experienced right hemisphere stroke. All included studies had a fair to good quality based on PEDro score evaluation. Protocols included continuous TBS (cTBS), high-frequency rTMS (HF-rTMS), and low-frequency rTMS (LF-rTMS) targeting both contralesional and lesional sites. HF-rTMS on the lesional site significantly improved short-term results on the line bisection test and Catherine Bergego Scale; LF-rTMS on the contralesional site improved short-term line bisection; and cTBS on the contralesional site improved long-term line bisection. No severe adverse events or significant inconsistencies were reported. Conclusions Our findings indicate that HF-rTMS targeting the lesional site is the preferred therapeutic approach for the short-term management of poststroke hemineglect. LF-rTMS directed at the contralesional site is a practical alternative. Moreover, cTBS targeting the contralesional site is a viable option because of its long-term effect.
Background This study aimed to investigate the therapeutic effects of vibration therapy for improving upper extremity motor impairment, function, and disability recovery in people with stroke. Design We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. PubMed, EMBASE, the Cochrane Library Database, Physiotherapy Evidence Database (PEDro), China Knowledge Resource Integrated Database, and Google Scholar were searched from inception to May 31, 2024. Randomized controlled trials (RCTs) that evaluated the effects of vibration therapy on upper extremity motor impairment, function, and disability recovery post-stroke were analyzed. Setting and participants Participants with a diagnosis of stroke with hemiplegia (or hemiparesis) were recruited. Methods Methodological quality assessment was performed using the PEDro quality score. Upper extremity motor impairment, function, and disability were the primary outcomes. Upper extremity motor impairment was measured using the Fugl-Meyer Assessment scale and other methods. Upper extremity functions were evaluated using the Wolf Motor Function test or other tools assessing manipulative activities. Disability was assessed using the Functional Independence Measure, Barthel index, and other methods. Results Overall, 30 RCTs including 1621 people with stroke were selected. Compared with the control, vibration therapy exerted significant effects on upper extremity motor impairment [standardized mean difference (SMD) = 1.19; p < 0.00001)], function (SMD = 0.62; p < 0.00001), and disability recovery (SMD = 1.01; p < 0.00001). The subgroup analysis revealed that focal vibration therapy (SMD = 2.14) had favorable effects on disability recovery compared with whole-body vibration therapy (SMD = 2.0). Interventions lasting 4–8 weeks showed significant improvements in motor impairment (SMD = 1.19), motor function (SMD = 0.57), and disability (SMD = 0.84); additionally, the effects of vibration therapy combined with conventional rehabilitation (SMD = 1.03) were superior to those of vibration therapy alone (SMD = 0.21). Conclusions Vibration therapy may be a reliable rehabilitation program to improve upper extremity motor functions and disabilities. Furthermore, vibration therapy should be performed at the earliest possibility after stroke for at least 4–8 weeks. Trial registration The protocol of this study was registered with PROSPERO (Registration number: CRD42022301119).
Background Geriatric hip fractures pose a significant health burden, and inflammation may play a role in the short- and long-term prognosis. However, the prognostic significance of hematologic inflammatory markers in geriatric patients with fractures is not understood. The aim of this systematic review and meta-analysis was to assess the prognostic implications of systemic inflammatory markers on the long-term mortality of older patients with hip fractures. Methods PubMed, EMBASE, and Cochrane CENTRAL were searched from inception to December 19, 2023. Prospective, retrospective cohort, and case–control studies investigating the prognostic impact of hematologic inflammatory markers on mortality after hip fracture were eligible. Pooled hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) were calculated to determine the associations between the markers and mortality risk, with heterogeneity assessed by I² statistic. The quality of the studies was appraised using the Newcastle–Ottawa Scale. Results Ultimately, 7 retrospective studies involving a total of 7212 patients were included. The meta-analysis revealed that the neutrophil-to-lymphocyte ratio (NLR) (HR = 1.04, 95% CI 1.02–1.08), systemic immune–inflammatory index (SII) (HR = 1.03, 95% CI 1.01–1.05), and red cell distribution width (RDW) (HR = 1.07, 95% CI 1.01–1.14) independently correlated with increased long-term mortality. Conclusions Elevated NLR, SII, and RDW are independently associated with increased long-term mortality in older patients with hip fractures. These findings imply the potential value of incorporating these inflammatory indicators to aid in prognostic stratification of geriatric patients with hip fractures.
Non-small cell lung cancer (NSCLC) is commonly treated with tyrosine kinase inhibitors (TKIs). However, adverse events from such treatment can lead to treatment discontinuation and additional medical expenditures. Ambulatory care from oncology pharmacists in patient education and symptom management can benefit patients with NSCLC. In this study, we evaluated the effectiveness of an oncology pharmacy service at a medical center in Taiwan. We retrospectively enrolled 137 patients with NSCLC who initiated treatment with afatinib, gefitinib, or erlotinib between January 2017 and December 2021; 40 of them utilized the oncology pharmacy service (intervention group), and the remaining 97 did not (nonintervention group). To determine the effectiveness of the oncology pharmacy service, we analyzed the following outcomes: adverse event rates, number of hospital visits (unexpected outpatient department visits, emergency department visits, and hospitalization), and medical expenditure. The intervention group had significantly more skin-related adverse events (acneiform rash: 75% vs. 49%; mucositis: 40% vs. 21%; dermatitis: 30% vs. 9%; and paronychia: 85% vs. 28%) but significantly fewer monthly emergency department visits (0.04 vs. 0.17) and unexpected outpatient department visits (0.15 vs. 0.34). The intervention group also had significantly lower expenditure for emergency department visits (NT166.4vs.NT166.4 vs. NT734.8) and nonsignificantly lower expenditure for outpatient department visits. Our findings indicate the value of pharmacist-managed ambulatory oncology care. Although this service did not reduce the incidence rates of adverse events, it reduced the number of unplanned outpatient and emergency department visits and reduced the emergency department expenditure of patients with NSCLC receiving TKIs.
The efficacy and safety of cyclin-dependent kinase (CDK)4/6 inhibitors in patients with breast cancer have been investigated by large-scale trials sponsored by drug companies. A lack of real-world evidence may lead to biases. We systematically reviewed the large-scale clinical trials and real-world data to investigate the efficacy and safety of CDK4/6 inhibitors in patients with breast cancer. We searched PubMed, Embase, and Cochrane Library from the inception of each database to January 2024. We included both prospective and retrospective studies reporting the survival outcomes or adverse effects of CDK4/6 inhibitors in patients with breast cancer. We included 41 prospective trials and 80 retrospective studies involving a total of 69,535 patients. Our meta-analysis of double-arm studies revealed that all types of CDK4/6 inhibitors significantly improved overall survival and progression-free survival. The pooled estimates of the 1-year overall survival (OS) rates and 1-year progression-free survival (PFS) rates in single-arm real-world studies were 74.8% and 49.4% for abemaciclib, 84.1% and 55.7% for palbociclib, and 93.4% and 62.2% for ribobiclib, respectively. In terms of adverse effects, Asian patients were significantly more likely to experience neutropenia and increased alanine aminotransferase, whereas Western patients were significantly more likely to have grade 3 or 4 adverse effects and constipation. CDK4/6 inhibitors can improve OS and PFS in patients with advanced breast cancer. The incidence of adverse effects may differ with drugs and with ethnicity. On the basis of our findings, clinicians can select suitable CDK4/6 inhibitors for patients by conducting thorough clinical evaluations.
Background Septic arthritis is a rare but devastating complication after anterior cruciate ligament reconstruction (ACLR). While early treatment can prevent significant graft complications, outcomes are often inferior to those in uncomplicated ACLR. Furthermore, whether to retain or remove the graft after infection remains debatable. Therefore, we sought to compare the outcomes of septic arthritis post ACLR with uncomplicated ACLR and evaluate graft retention versus removal in infected patients. Methods We conducted a systematic review and meta-analysis in which PubMed, Embase, and Cochrane Library databases were searched. Clinical studies were included if they compared patient-reported, clinician-reported, or radiographic outcomes (minimum follow-up of 12 months) between patients with post-ACLR septic arthritis and those with uncomplicated ACLR or that compared graft retention and removal in patients with post-ACLR septic arthritis. Results Thirteen studies were retrieved. Patients with post-ACLR septic arthritis reported inferior Lysholm Knee Scoring Scale scores (mean difference (MD) 7.53; 95% confidence interval (CI) 3.20–11.86; P = 0.0006), Tegner Activity Scale scores (MD, 1.42; 95% CI 1.07–1.76; P < .00001), and return to sports rates (53% versus 76%, respectively) to those of patients with uncomplicated ACLR. Patients with post-ACLR septic arthritis and those with uncomplicated ACLR did not differ in terms of the pooled estimate of various clinician-reported outcomes, such as the objective International Knee Documentation Committee score, anterior–posterior laxity, pivot shift, and Lachman test results. Furthermore, no significant difference was noted between the aforementioned patient groups regarding osteoarthritis (detected radiographically). Graft retention led to better patient- and clinician-reported outcomes than graft removal. Conclusions Despite similar clinician-reported outcomes and osteoarthritis rates, patients with post-ACLR septic arthritis reported worse outcomes than those with uncomplicated ACLR. Graft retention leads to improved patient- and clinician-reported outcomes compared with the outcomes of graft removal. Our findings may help develop realistic expectations and management strategies for this rare complication.
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270 members
Chih-Hsin Lee
  • Pulmonary Research Center
Ting_I Lee
  • Department of Internal Medicine, Division of Endocrinology and Metabolism
Shao-Jung Li
  • Department of Surgery
sung-chih Hsieh
  • endodontic department
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Taipei, Taiwan