PATELLOFEMORAL JOINT SURFACE WEAR IN RETRIEVED FEMORAL COMPONENTS OF A SINGLE DESIGN
Notice bibliographique
Résumé
Introduction Anterior knee pain following total knee arthroplasty continues to be prevalent and may result from abnormal loading of the patellofemoral joint. The kinematics and biomechanics of the patellofemoral joint are complex, and trochlear design likely plays a principle role in affecting patellofemoral contact. As such, understanding the implications of trochlear design on patellofemoral contact remains important. The goal of the present study was to characterize trochlear wear of retrieved femoral components, which may help elucidate the details regarding patellofemoral kinematics and contact properties in relation to design features. Materials and Methods Retrieved femoral components featuring a single design (cobalt-chrome, posterior stabilized, cemented components with fixed bearing design) were included in the study. Components were selected based on similar time-in-vivo, age, and BMI. The trochlea of femoral components was consistently divided into six equal zones. Trochlear wear and surface damage in each zone were assessed using visual inspection under low-magnification light microscopy and light profilometry. Results Ten implants were selected and were used for the topographical analysis. The implants were selected based on time-in-vivo (33.6 months±18), BMI (40.4 kg/m2±13.2), patient age (67.9 years old±13.3) and gender (6 males, 4 females). Revision diagnosis across the implants were infection (n=6), instability (n=2), loosening (n=1), and fracture (n=1). All zones of the trochlea of retrieved femoral components showed evidence of wear on visual assessment, however, surface profilometry showed that the amount of wear in the retrieved components was not significantly different from a new, unused reference component (p>0.05). In fact, surface skeweness was higher in the new component (p=0.026). Modes of wear included scratches (100%), striations (65%), pitting (43%), and delamination (13%). Zone 1, which includes the raised lateral flange, tended to have more damage than the other zones, but this was statistically non-significant (p=0.634). No significant differences were found between the remaining trochlear zones with respect to wear based on visual assessment and light-microscopy (p=0.634) or surface profilometry (p=0.469). No significant differences were found with between proximal and distal wear (p>0.05) as well as medial and lateral trochlear wear (p>0.05). Conclusions Femoral components exhibit trochlear wear after in-vivo use. The amount of wear, however, is not substantially different from its new state and may represent early polishing. While the raised lateral flange zone trended towards greater wear than other zones, this was not statistically significant. Overall, with modern trochlear design, there was no evidence of asymmetric or abnormal loading of the trochlea. Longer term retrieval studies are required to assess patterns of femoral component wear and determine the clinical correlation of these findings.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».