{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T13:22:14Z","timestamp":1793020934547,"version":"4.5.0"},"reference-count":36,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T00:00:00Z","timestamp":1638316800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,12,2]],"date-time":"2021-12-02T00:00:00Z","timestamp":1638403200000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Musculoskelet Disord"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Serum C-reactive protein (CRP) trends are critical for monitoring patients\u2019 treatment response following a two-stage exchange arthroplasty for periprosthetic joint infection (PJI) of the hip. However, CRP trends are poorly described in the literature. The primary aim of this study was to identify the relationships between PJI treatment outcomes and our proposed CRP trend definitions, parameters, and microbiological data. The secondary aim was to investigate CRP trends after the occurrence of spacer-related complications.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We conducted a retrospective review of 74 patients treated with a two-stage exchange protocol for PJI in a tertiary referral joint center between 2014 and 2016. Patients with factors that may affect CRP levels (inflammatory arthritis, concomitant infections, liver and kidney diseases, and intensive care admissions) were excluded. CRP trends were categorized into five types and PJI treatment outcome was defined as \u201csuccess\u201d or \u201cfailure\u201d according to the Delphi criteria.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Treatment was successful in 67 patients and failed in 7 patients. Multivariate logistic regression analysis showed that type 5 CRP, defined as serum CRP fluctuation without normalization after first stage surgery (odds ratio [OR]: 17.4; 95% confidence interval [CI]: 2.3\u2013129.7; <jats:italic>p<\/jats:italic>\u2009=\u20090.005), and methicillin-resistant <jats:italic>Staphylococcus aureus<\/jats:italic> (MRSA; OR: 14.5; 95% CI: 1.6\u2013131.7; <jats:italic>p<\/jats:italic>\u2009=\u20090.018) were associated with treatment failure. Spacer-related complications occurred in 18 patients. Of these, 12 had elevated CRP levels at later follow-up, while six had no elevation in CRP levels.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>We found that MRSA infection and type 5 CRP were associated with PJI treatment failure.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12891-021-04893-3","type":"journal-article","created":{"date-parts":[[2021,12,2]],"date-time":"2021-12-02T14:04:36Z","timestamp":1638453876000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Trend of serum C-reactive protein is associated with treatment outcome of hip Periprosthetic joint infection undergoing two-stage exchange arthroplasty: a case control study"],"prefix":"10.1186","volume":"22","author":[{"given":"Zhong-Yan","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Chih","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih-Hsiang","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Szu-Yuan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tung-Wu","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheng-Hsun","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,12,2]]},"reference":[{"issue":"6","key":"4893_CR1","doi-asserted-by":"publisher","first-page":"646","DOI":"10.3109\/17453674.2011.636671","volume":"82","author":"H Dale","year":"2011","unstructured":"Dale H, Skr\u00e5mm I, L\u00f8wer HL, Eriksen HM, Espehaug B, Furnes O, et al. Infection after primary hip arthroplasty: a comparison of 3 Norwegian health registers. Acta Orthop. 2011;82(6):646\u201354.","journal-title":"Acta Orthop"},{"issue":"5","key":"4893_CR2","doi-asserted-by":"publisher","first-page":"555","DOI":"10.1016\/j.otsr.2013.07.001","volume":"99","author":"N Reina","year":"2013","unstructured":"Reina N, Delaunay C, Chiron P, Ramdane N, Hamadouche M. Infection as a cause of primary total hip arthroplasty revision and its predictive factors. Orthop Traumatol Surg Res. 2013;99(5):555\u201361.","journal-title":"Orthop Traumatol Surg Res"},{"key":"4893_CR3","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1186\/s12891-016-0962-6","volume":"17","author":"R Kasch","year":"2016","unstructured":"Kasch R, Assmann G, Merk S, Barz T, Melloh M, Hofer A, et al. Economic analysis of two-stage septic revision after total hip arthroplasty: what are the relevant costs for the hospital's orthopedic department? BMC Musculoskelet Disord. 2016;17:112.","journal-title":"BMC Musculoskelet Disord"},{"issue":"7","key":"4893_CR4","doi-asserted-by":"publisher","first-page":"1363","DOI":"10.1007\/s00264-014-2309-y","volume":"38","author":"M Wolf","year":"2014","unstructured":"Wolf M, Clar H, Friesenbichler J, Schwantzer G, Bernhardt G, Gruber G, et al. Prosthetic joint infection following total hip replacement: results of one-stage versus two-stage exchange. Int Orthop. 2014;38(7):1363\u20138.","journal-title":"Int Orthop"},{"issue":"3\u20134","key":"4893_CR5","doi-asserted-by":"publisher","first-page":"551","DOI":"10.1081\/JDI-100104737","volume":"23","author":"V Panichi","year":"2001","unstructured":"Panichi V, Migliori M, De Pietro S, Taccola D, Bianchi AM, Norpoth M, et al. C reactive protein in patients with chronic renal diseases. Ren Fail. 2001;23(3\u20134):551\u201362.","journal-title":"Ren Fail"},{"issue":"1","key":"4893_CR6","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1161\/01.ATV.0000148324.63685.6a","volume":"25","author":"A Kerner","year":"2005","unstructured":"Kerner A, Avizohar O, Sella R, Bartha P, Zinder O, Markiewicz W, et al. Association between elevated liver enzymes and C-reactive protein: possible hepatic contribution to systemic inflammation in the metabolic syndrome. Arterioscler Thromb Vasc Biol. 2005;25(1):193\u20137.","journal-title":"Arterioscler Thromb Vasc Biol"},{"issue":"4","key":"4893_CR7","doi-asserted-by":"publisher","first-page":"326","DOI":"10.7326\/L15-5126","volume":"163","author":"I Kushner","year":"2015","unstructured":"Kushner I, Antonelli MJ. What should we regard as an \"elevated\" C-reactive protein level? Ann Intern Med. 2015;163(4):326.","journal-title":"Ann Intern Med"},{"issue":"2S","key":"4893_CR8","doi-asserted-by":"publisher","first-page":"S439","DOI":"10.1016\/j.arth.2018.09.028","volume":"34","author":"A Aalirezaie","year":"2019","unstructured":"Aalirezaie A, Abolghasemian M, Busato T, Dennis D, Ghazavi M, Holst DC, et al. Hip and knee section, treatment, two-stage exchange: proceedings of international consensus on orthopedic infections. J Arthroplast. 2019;34(2S):S439\u201343.","journal-title":"J Arthroplast"},{"issue":"11","key":"4893_CR9","doi-asserted-by":"publisher","first-page":"2992","DOI":"10.1007\/s11999-011-2102-9","volume":"469","author":"J Parvizi","year":"2011","unstructured":"Parvizi J, Zmistowski B, Berbari EF, Bauer TW, Springer BD, Della Valle CJ, et al. New definition for periprosthetic joint infection: from the workgroup of the musculoskeletal infection society. Clin Orthop Relat Res. 2011;469(11):2992\u20134.","journal-title":"Clin Orthop Relat Res"},{"issue":"5","key":"4893_CR10","doi-asserted-by":"publisher","first-page":"265","DOI":"10.7150\/ijms.6.265","volume":"6","author":"J Jung","year":"2009","unstructured":"Jung J, Schmid NV, Kelm J, Schmitt E, Anagnostakos K. Complications after spacer implantation in the treatment of hip joint infections. Int J Med Sci. 2009;6(5):265\u201373.","journal-title":"Int J Med Sci"},{"issue":"Pt B","key":"4893_CR11","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1016\/j.ijsu.2017.07.044","volume":"54","author":"OJ Diamond","year":"2018","unstructured":"Diamond OJ, Masri BA. Articulating antibiotic impregnated spacers in prosthetic joint infections: Where do we stand? Int J Surg. 2018;54(Pt B):345\u201350.","journal-title":"Int J Surg"},{"issue":"2","key":"4893_CR12","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1055\/s-0039-1697608","volume":"7","author":"A Rava","year":"2019","unstructured":"Rava A, Bruzzone M, Cottino U, Enrietti E, Rossi R. Hip spacers in two-stage revision for Periprosthetic joint infection: a review of literature. Joints. 2019;7(2):56\u201363.","journal-title":"Joints."},{"issue":"7","key":"4893_CR13","doi-asserted-by":"publisher","first-page":"1331","DOI":"10.1016\/j.arth.2014.03.009","volume":"29","author":"J Parvizi","year":"2014","unstructured":"Parvizi J, Gehrke T. International Consensus Group on Periprosthetic Joint I. Definition of periprosthetic joint infection. J Arthroplasty. 2014;29(7):1331.","journal-title":"J Arthroplasty"},{"issue":"6","key":"4893_CR14","doi-asserted-by":"publisher","first-page":"1247","DOI":"10.1097\/01.TA.0000130757.53559.BF","volume":"56","author":"PH Hsieh","year":"2004","unstructured":"Hsieh PH, Chen LH, Chen CH, Lee MS, Yang WE, Shih CH. Two-stage revision hip arthroplasty for infection with a custom-made, antibiotic-loaded, cement prosthesis as an interim spacer. J Trauma. 2004;56(6):1247\u201352.","journal-title":"J Trauma"},{"issue":"9","key":"4893_CR15","doi-asserted-by":"publisher","first-page":"1989","DOI":"10.2106\/00004623-200409000-00018","volume":"86","author":"PH Hsieh","year":"2004","unstructured":"Hsieh PH, Shih CH, Chang YH, Lee MS, Shih HN, Yang WE. Two-stage revision hip arthroplasty for infection: comparison between the interim use of antibiotic-loaded cement beads and a spacer prosthesis. J Bone Joint Surg Am. 2004;86(9):1989\u201397.","journal-title":"J Bone Joint Surg Am"},{"issue":"11","key":"4893_CR16","doi-asserted-by":"publisher","first-page":"e0166545","DOI":"10.1371\/journal.pone.0166545","volume":"11","author":"SH Lee","year":"2016","unstructured":"Lee SH, Tai CL, Chen SY, Chang CH, Chang YH, Hsieh PH. Elution and mechanical strength of vancomycin-loaded bone cement: in vitro study of the influence of brand combination. PLoS One. 2016;11(11):e0166545.","journal-title":"PLoS One"},{"issue":"3","key":"4893_CR17","doi-asserted-by":"publisher","first-page":"223","DOI":"10.2106\/JBJS.16.00290","volume":"99","author":"YH Hsu","year":"2017","unstructured":"Hsu YH, Hu CC, Hsieh PH, Shih HN, Ueng SW, Chang Y. Vancomycin and ceftazidime in bone cement as a potentially effective treatment for knee Periprosthetic joint infection. J Bone Joint Surg Am. 2017;99(3):223\u201331.","journal-title":"J Bone Joint Surg Am"},{"issue":"10","key":"4893_CR18","doi-asserted-by":"publisher","first-page":"2405","DOI":"10.1093\/jac\/dkr277","volume":"66","author":"ES Darley","year":"2011","unstructured":"Darley ES, Bannister GC, Blom AW, Macgowan AP, Jacobson SK, Alfouzan W. Role of early intravenous to oral antibiotic switch therapy in the management of prosthetic hip infection treated with one- or two-stage replacement. J Antimicrob Chemother. 2011;66(10):2405\u20138.","journal-title":"J Antimicrob Chemother"},{"key":"4893_CR19","first-page":"345475","volume":"2015","author":"SY Chen","year":"2015","unstructured":"Chen SY, Hu CC, Chen CC, Chang YH, Hsieh PH. Two-stage revision arthroplasty for Periprosthetic hip infection: mean follow-up of ten years. Biomed Res Int. 2015;2015:345475.","journal-title":"Biomed Res Int"},{"issue":"11","key":"4893_CR20","doi-asserted-by":"publisher","first-page":"3541","DOI":"10.1016\/j.arth.2018.06.015","volume":"33","author":"TL Tan","year":"2018","unstructured":"Tan TL, Goswami K, Fillingham YA, Shohat N, Rondon AJ, Parvizi J. Defining treatment success after 2-stage exchange arthroplasty for Periprosthetic joint infection. J Arthroplast. 2018;33(11):3541\u20136.","journal-title":"J Arthroplast"},{"issue":"11","key":"4893_CR21","doi-asserted-by":"publisher","first-page":"1450","DOI":"10.1302\/0301-620X.95B11.33135","volume":"95-b","author":"J Parvizi","year":"2013","unstructured":"Parvizi J, Gehrke T, Chen AF. Proceedings of the International Consensus on Periprosthetic Joint Infection. Bone Joint J. 2013;95-b(11):1450\u20132.","journal-title":"Bone Joint J"},{"issue":"2S","key":"4893_CR22","doi-asserted-by":"publisher","first-page":"S369","DOI":"10.1016\/j.arth.2018.09.021","volume":"34","author":"A Aalirezaie","year":"2019","unstructured":"Aalirezaie A, Bauer TW, Fayaz H, Griffin W, Higuera CA, Krenn V, et al. Hip and knee section, diagnosis, Reimplantation: proceedings of international consensus on orthopedic infections. J Arthroplast. 2019;34(2S):S369\u201379.","journal-title":"J Arthroplast"},{"issue":"7","key":"4893_CR23","doi-asserted-by":"publisher","first-page":"1699","DOI":"10.1007\/s11999-009-0742-9","volume":"467","author":"E Ghanem","year":"2009","unstructured":"Ghanem E, Azzam K, Seeley M, Joshi A, Parvizi J. Staged revision for knee arthroplasty infection: what is the role of serologic tests before reimplantation? Clin Orthop Relat Res. 2009;467(7):1699\u2013705.","journal-title":"Clin Orthop Relat Res"},{"issue":"6 Suppl","key":"4893_CR24","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1016\/j.arth.2010.05.006","volume":"25","author":"SK Shukla","year":"2010","unstructured":"Shukla SK, Ward JP, Jacofsky MC, Sporer SM, Paprosky WG, Della Valle CJ. Perioperative testing for persistent sepsis following resection arthroplasty of the hip for periprosthetic infection. J Arthroplast. 2010;25(6 Suppl):87\u201391.","journal-title":"J Arthroplast"},{"issue":"4","key":"4893_CR25","doi-asserted-by":"publisher","first-page":"1002","DOI":"10.1007\/s11999-010-1619-7","volume":"469","author":"SK Kusuma","year":"2011","unstructured":"Kusuma SK, Ward J, Jacofsky M, Sporer SM, Della Valle CJ. What is the role of serological testing between stages of two-stage reconstruction of the infected prosthetic knee? Clin Orthop Relat Res. 2011;469(4):1002\u20138.","journal-title":"Clin Orthop Relat Res"},{"issue":"4","key":"4893_CR26","doi-asserted-by":"publisher","first-page":"447","DOI":"10.1007\/s00402-015-2404-6","volume":"136","author":"S Hoell","year":"2016","unstructured":"Hoell S, Moeller A, Gosheger G, Hardes J, Dieckmann R, Schulz D. Two-stage revision arthroplasty for periprosthetic joint infections: what is the value of cultures and white cell count in synovial fluid and CRP in serum before second stage reimplantation? Arch Orthop Trauma Surg. 2016;136(4):447\u201352.","journal-title":"Arch Orthop Trauma Surg"},{"issue":"11","key":"4893_CR27","doi-asserted-by":"publisher","first-page":"3049","DOI":"10.1007\/s11999-011-2030-8","volume":"469","author":"SM Mortazavi","year":"2011","unstructured":"Mortazavi SM, Vegari D, Ho A, Zmistowski B, Parvizi J. Two-stage exchange arthroplasty for infected total knee arthroplasty: predictors of failure. Clin Orthop Relat Res. 2011;469(11):3049\u201354.","journal-title":"Clin Orthop Relat Res"},{"issue":"2","key":"4893_CR28","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1007\/s00264-017-3700-2","volume":"42","author":"HML M\u00fchlhofer","year":"2018","unstructured":"M\u00fchlhofer HML, Knebel C, Pohlig F, Feihl S, Harrasser N, Schauwecker J, et al. Synovial aspiration and serological testing in two-stage revision arthroplasty for prosthetic joint infection: evaluation before reconstruction with a mean follow-up of twenty seven months. Int Orthop. 2018;42(2):265\u201371.","journal-title":"Int Orthop"},{"issue":"2","key":"4893_CR29","doi-asserted-by":"publisher","first-page":"364","DOI":"10.1097\/01.blo.0000533618.31937.45","volume":"477","author":"JB Stambough","year":"2019","unstructured":"Stambough JB, Curtin BM, Odum SM, Cross MB, Martin JR, Fehring TK. Does change in ESR and CRP guide the timing of two-stage arthroplasty Reimplantation? Clin Orthop Relat Res. 2019;477(2):364\u201371.","journal-title":"Clin Orthop Relat Res"},{"issue":"12","key":"4893_CR30","doi-asserted-by":"publisher","first-page":"1009","DOI":"10.2106\/JBJS.17.00599","volume":"100","author":"MK Dwyer","year":"2018","unstructured":"Dwyer MK, Damsgaard C, Wadibia J, Wong G, Lazar D, Smith E, et al. Laboratory tests for diagnosis of chronic Periprosthetic joint infection can help predict outcomes of two-stage exchange. J Bone Joint Surg. 2018;100(12):1009\u201315.","journal-title":"J Bone Joint Surg"},{"issue":"11","key":"4893_CR31","doi-asserted-by":"publisher","first-page":"3254","DOI":"10.1016\/j.arth.2020.06.007","volume":"35","author":"SP Maier","year":"2020","unstructured":"Maier SP, Klemt C, Tirumala V, Oganesyan R, van den Kieboom J, Kwon YM. Elevated ESR\/CRP ratio is associated with reinfection after debridement, antibiotics, and implant retention in chronic Periprosthetic joint infections. J Arthroplast. 2020;35(11):3254\u201360.","journal-title":"J Arthroplast"},{"issue":"8","key":"4893_CR32","doi-asserted-by":"publisher","first-page":"2060","DOI":"10.1007\/s11999-010-1296-6","volume":"468","author":"MF Kurd","year":"2010","unstructured":"Kurd MF, Ghanem E, Steinbrecher J, Parvizi J. Two-stage exchange knee arthroplasty: does resistance of the infecting organism influence the outcome? Clin Orthop Relat Res. 2010;468(8):2060\u20136.","journal-title":"Clin Orthop Relat Res"},{"issue":"6","key":"4893_CR33","doi-asserted-by":"publisher","first-page":"e444","DOI":"10.1016\/j.ijid.2009.02.017","volume":"13","author":"E Ghanem","year":"2009","unstructured":"Ghanem E, Antoci V Jr, Pulido L, Joshi A, Hozack W, Parvizi J. The use of receiver operating characteristics analysis in determining erythrocyte sedimentation rate and C-reactive protein levels in diagnosing periprosthetic infection prior to revision total hip arthroplasty. Int J Infect Dis. 2009;13(6):e444\u20139.","journal-title":"Int J Infect Dis"},{"issue":"4","key":"4893_CR34","doi-asserted-by":"publisher","first-page":"837","DOI":"10.1007\/s00264-020-04889-z","volume":"45","author":"IK Sigmund","year":"2021","unstructured":"Sigmund IK, Holinka J, Staats K, Sevelda F, Lass R, Kubista B, et al. Inferior performance of established and novel serum inflammatory markers in diagnosing periprosthetic joint infections. Int Orthop. 2021;45(4):837\u201346.","journal-title":"Int Orthop"},{"issue":"1","key":"4893_CR35","doi-asserted-by":"publisher","first-page":"264","DOI":"10.1186\/s12891-020-03283-5","volume":"21","author":"ZY Huang","year":"2020","unstructured":"Huang ZY, Huang Q, Wang LY, Lei YT, Xu H, Shen B, et al. Normal trajectory of Interleukin-6 and C-reactive protein in the perioperative period of total knee arthroplasty under an enhanced recovery after surgery scenario. BMC Musculoskelet Disord. 2020;21(1):264.","journal-title":"BMC Musculoskelet Disord"},{"issue":"1","key":"4893_CR36","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1097\/CORR.0000000000000332","volume":"477","author":"RN Maniar","year":"2019","unstructured":"Maniar RN, Navaneedhan G, Ranvir S, Maniar AR, Dhiman A, Agrawal A. What is the Normal trajectory of Interleukin-6 and C-reactive protein in the hours and days immediately after TKA? Clin Orthop Relat Res. 2019;477(1):41\u20136.","journal-title":"Clin Orthop Relat Res"}],"updated-by":[{"DOI":"10.1186\/s12891-022-05002-8","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2022,1,15]],"date-time":"2022-01-15T00:00:00Z","timestamp":1642204800000}}],"container-title":["BMC Musculoskeletal Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12891-021-04893-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12891-021-04893-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12891-021-04893-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,1,15]],"date-time":"2022-01-15T18:03:47Z","timestamp":1642269827000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcmusculoskeletdisord.biomedcentral.com\/articles\/10.1186\/s12891-021-04893-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12]]},"references-count":36,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["4893"],"URL":"https:\/\/doi.org\/10.1186\/s12891-021-04893-3","relation":{},"ISSN":["1471-2474"],"issn-type":[{"value":"1471-2474","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12]]},"assertion":[{"value":"4 October 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 November 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 December 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 January 2022","order":4,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Correction","order":5,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"A Correction to this paper has been published:","order":6,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"https:\/\/doi.org\/10.1186\/s12891-022-05002-8","URL":"https:\/\/doi.org\/10.1186\/s12891-022-05002-8","order":7,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The research was approved by the Institutional Review Board in Chang Gung Memorial Hospital, Taiwan (102-1846B), and the informed consent in the study was waived. All methods were carried out in accordance with relevant guidelines and regulations.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"1007"}}