Fusion vs. Arthroplasty in the Treatment of 1st MTP Arthritis
Bibliographic record
Abstract
Arthrodesis and arthroplasty has been used for the treatment of advanced stage osteoarthritis of the first MTP joint. Arthroplasty techniques consist of Keller's resection arthroplasty, interpositional arthroplasty, hemiarthroplasty and total joint replacement. There is no consensus on the optimal technique of fusion of the MTP joint but successful fusion rates averages between 90-100%. Arthrodesis stabilises the first ray during gait in contrast to resection or interpositional arhroplasty, which is used in older patients with lower functional demand. There is fair evidence to support the treatment of arthrodesis and Keller's resection arthroplasty (Grade B recommendation) and insufficient evidence to support interpositional arthroplasty and total joint replacement (Grade I recommendation). Hemiarthroplasty or resurfacing of the proximal phalanx is only supported by weak evidence (Grade C recommendation). In limited comparative studies (Level II&III), arthrodesis provides superior results and longevity than implant arthroplasty. There is limited survivor analysis on the newer non-silastic implants used for arthroplasty. More randomised prospective studies are needed to evaluate the long term results of these implants.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.028 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".