Coronal alignment in total knee arthroplasty and its effect on functional outcome: A retrospective study
Notice bibliographique
Résumé
Background This retrospective study was conducted to compare the coronal alignment of the lower extremity before and after surgery in patients undergoing total knee replacement by assessing the mechanical axis in the full-length weight-bearing radiograph taken preoperatively and post-operatively, and to assess the clinical outcome after TKA with reference to the mechanical axis. Method Fifty eight patients who underwent primary TKA from date October 2013 to March 2017 were included in the study. The patient’s demographics such as age, gender primary TKA were noted. All patients underwent clinical and radiological evaluation, including standardized radiographs (anterior-posterior long-leg X-ray). For clinical outcome scoring the Hospital for Special Surgery score (HSS) and Western Ontario and McMaster Universities Arthritis Index (WOMAC) were used. One-way ANOVA was used to compare the outcome of the surgery and the alignment (p <0.05). Result Out of the 58 patients included in the study, 16 (27.58%) were male and 42 (72.41%) were female with age ranged between 34 to 88 years (mean 65.44 years). The male patient’s age ranged from 53 to 85 (median 63 years) and that of female patients ranged from 52 to 83 (median 65.5 years). The overall mean HSS score improved from 59.86 ± 10.91 preoperatively to 82.52 ± 11.04 in one year postoperatively (<0.0001) and WOMAC score improved from 33.98 ± 11.25 to 10.4 ± 6.06 (P<0.0001) after 1 year from the TKA respectively. Both showed a significant difference in the results. There were 50 patients with pre-operative Varus alignment and 8 with pre-operative valgus alignment. Pre-operative Varus groups have a post-operative HSS score of83.98±9.962153 and that of pre-operative valgus groups has HSS score of 77.625±14.20199. Similarly, pre-operative Varus group had a postoperative WOMAC score of 9.38±5.27949 and that of the valgus group had 12±9.273618. In these two groups, there was no significant difference between their post-operative HSS score (P=0.2571) and WOMAC score (P=0.4590). After the surgery, 25 patients (43.10%) had varus alignment, 22 patients (37.9%) had neutral alignment and 11 patients (18.97%) had valgus alignment. The post-operative mechanical axis group was divided into the post-op varus group, post op neutral group, and post-op valgus group. After comparing within the groups, the neutral group had the highest HSS score (91.3636±4.1946, lowest WOMAC score (5.2272±1.37945), P<0.005, which showed the best result and the HSS score of post-operative varus group was (82.12±7.5), the WOMAC score was (9.64±4.344) showing the moderate result. The postoperative valgus group has HSS score (68.82 + 9.39), WOMAC score (16.3636 + 8.205), showing worst result. Conclusion Total Knee Arthroplasty is a good treatment modality for primary osteoarthritis. The coronal alignment before surgery has no significant effect on the function after total knee arthroplasty. However, the post-operative coronal alignment of the lower limbs was related to the clinical function of the patients. The outcome of the patient with the mechanical axis was the best with neutral groups followed by the Varus group and was the worst in the valgus group.
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 | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| 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 ».