{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T23:19:30Z","timestamp":1787786370531,"version":"build-2784847793"},"reference-count":43,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100011176","name":"Peking Union Medical College","doi-asserted-by":"publisher","award":["2022002"],"award-info":[{"award-number":["2022002"]}],"id":[{"id":"10.13039\/501100011176","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      Tumor\u2010induced osteomalacia with the culprit tumor located in the knee joint is rare in clinical practice, and previous literature has only been seen in case reports, which pose great challenges to the clinical diagnosis and treatment of such patients. The purpose is to elucidate clinical characteristics and orthopedic surgical treatment experience of tumor\u2010induced osteomalacia (\n                      <jats:styled-content style=\"fixed-case\">TIO<\/jats:styled-content>\n                      ) with causative tumor located in the knee joint region.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Clinical data of all consecutive\n                      <jats:styled-content style=\"fixed-case\">TIO<\/jats:styled-content>\n                      patients with culprit tumors located in the knee joint region was retrospectively analyzed. All patients were surgically treated by an orthopedic bone and soft tissue tumor sub\u2010professional team at Peking Union Medical College Hospital from January 2015 to January 2025. The clinical distribution feature and surgical effects were analyzed, and clinical practice experience was presented.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All nine patients were included in this study. All patients exhibited varying degrees of bone pain and 100% (9\/9) of the patients had limited mobility, often accompanied by difficulties in sitting up, walking, and weakness or fatigue. Approximately 44.4% (4\/9) of the patients had significantly shorter height after initial symptoms appeared. All patients underwent a total of 10 operations to control the causative tumors in the knee joint region. Culprit tumors were located in the patella (one case), infrapatellar fat pad (three cases), suprapatellar capsule (one case), popliteal fossa (three cases), and the entire knee joint (one case), respectively. There was only one case of skeletal involvement, one case with involvement of bones and soft tissues, and seven cases with soft tissue causative tumors. All the patients had a gradual increase in blood phosphorus levels in the short term after the first orthopedic surgery, after a follow\u2010up of 12\u2009months to 10\u2009years. During the follow\u2010up, no patients experienced recurrence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      The causative tumor for\n                      <jats:styled-content style=\"fixed-case\">TIO<\/jats:styled-content>\n                      in the knee joint region is hidden and has diverse locations; however, there is no established orthopedic surgical intervention strategy for these rare entities in clinical practice. Due to the unique anatomical location and complex structure of the knee joint, orthopedic surgeons can adopt different surgical approaches to completely remove the causative tumor. For these patients, the prognosis is satisfactory after complete tumor resection, and the condition can be effectively improved. These findings may help to improve the clinical diagnosis and treatment level of orthopedic physicians for this rare entity.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/os.70204","type":"journal-article","created":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T06:25:51Z","timestamp":1763533551000},"page":"3440-3455","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Surgical Treatment for Osteomalacia Induced by Causative Tumor in the Knee Joint Region: A Single\u2010Center Retrospective Clinical Study Over 10\u2009Years"],"prefix":"10.1111","volume":"17","author":[{"given":"Shuzhong","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xi","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3785-8184","authenticated-orcid":false,"given":"Jinyi","family":"Xing","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen","family":"Huo","sequence":"additional","affiliation":[{"name":"Department of Pathology Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingjing","family":"Zhang","sequence":"additional","affiliation":[{"name":"Institute of Orthopaedic &amp; Musculoskeletal Science, University College London Royal National Orthopaedic Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6321-1268","authenticated-orcid":false,"given":"Yong","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7768-5536","authenticated-orcid":false,"given":"Weibo","family":"Xia","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, National Health Commission Key Laboratory of Endocrinology, State Key Laboratory of Complex Severe and Rare Diseases, Translational Medicine Center, Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,18]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2017.44"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1507\/endocrj.EJ16-0587"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.1642"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00223\u2010022\u201001005\u20108"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00774-016-0756-9"},{"issue":"1","key":"e_1_2_14_7_1","first-page":"33","article-title":"Osteomalacia With Looser's Nodes (Milkman's Syndrome) due to a Raised Resistance to Vitamin D Acquired About the Age of 15\u2009Years","volume":"16","author":"McCance R. 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