DISTAL FEMORAL MORPHOLOGY IN HINGED KNEE REPLACEMENT: VALIDATION OF THE NOVEL CITAK CLASSIFICATION
Notice bibliographique
Résumé
When performing arthroplasty around the hip, choice of stem fixation depends partially on proximal femoral morphology, and the Dorr classification is an important consideration in deciding on stem type. Recently, a distal femoral canal morphology classification system was proposed (the Citak Classification) and descriptive data reported in a German population. The classification system has two main components – the inner diameter of the femoral canal at 20cm proximal to the joint line, divided into Types A (narrowest), B, and C (widest), as well as an index value, calculated as the ratio of the above value to the inner diameter of the canal 2cm proximal to the adductor tubercle. Our aim was to descriptively report the classification system in a Canadian population, and analyze its impact on the risk of aseptic loosening. Data was collected for all patients who had undergone a hinged knee replacement in a prospective institutional database. Patients who did not have adequate x-rays for calculation of inner canal diameter and the Citak Index were excluded. Inner diameter of the canal 20cm proximal to the joint line and the Citak Index were calculated for each patient on the x-rays taken immediately prior to the patient undergoing hinged knee replacement. Number of patients in each category is reported descriptively, and mean age and sex distributions were compared between the groups. Revision surgery following hinged knee replacement was tracked, and all-cause revision and aseptic loosening rates were compared between the groups. A total of 59 patients underwent hinged knee replacements between 2004 and 2019 and had adequate x-rays for inclusion. Mean follow-up was 7.52 years (range 1.4 to 16.4 years). Mean age was 71.2 years (Standard Deviation: 12.6). There were 41 female and 18 male patients. For the inner diameter 20cm proximal to the joint line, 31 patients (52.5%) were in Group A, 19 patients (32.2%) in Group B, and 15.3% in Group C. Regarding the Citak Index, 26 patients (44.1%) were in Group A, 20 patients (33.9%) in Group B, and 13 (22.0%) in Group C. Patients in Group C had a significantly older mean age than Groups A or B. Proportion of male and female patients in each group were similar. Rates of all-cause revision was significantly higher in Citak Index Group C (46.2%) compared to Groups B (25.0%) or A (15.4%). There were three cases of aseptic loosening, all of which occurred in patients with a Group C Citak Index. This study has described the Citak Classification System in a Canadian population undergoing hinged knee replacement. Unlike the original descriptive study, where 50% of patients were in Group B, we found that most patients in our cohort were in Group A. As well, Group C patients were more likely to be older, to require revision surgery, and to have aseptic loosening of their hinged knee replacement. Distal femur morphology is an important consideration in selecting stemmed distal femur implants and further study of the anatomy of this region is warranted.
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 distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| 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 | 0,000 | 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) | 0,000 | 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 tête enseignante, 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 ».