Paper #122 Arthroscopic autogenous osteochondral graft fixation (mosaicplasty) of unstable osteochondritis dissecans lesions of the knee
Bibliographic record
Abstract
To assess the use of autogenous osteochondral graft fixation (mosaicplasty) in unstable osteochondritis dissecans (OCD) lesions (Clanton type 2 and 3) of the knee. Twenty patients with x-ray and MRI confirmed OCD lesion in their femoral condyle, that had remained symptomatic despite adequate conservative treatment (average 36 months range 24-60), underwent arthroscopic mosaicplasty plug fixation of the lesion. The OCD lesions were all loose at operation and were all fixed rigidly in situ using a varying number of autogenous 4.5mm osteochondral plugs harvested from the edge of the trochlear groove. The average age at operation was 15.9 years (11 - 32 yrs). The patients were prospectively assessed clinically using the IKDC system and by MRI scan at 3, 6 and 12 months and then six monthly. Average follow up was 3 years. The pre-operative IKDC assessments scored the knees as 3 B(Nearly Normal), 6 C(Abnormal) and 11 D(Severely Abnormal), at 6 months this had risen to 16 A(Normal),3 B and by 18 months to 20 A. Joint effusions were present pre-operatively in 17 knees which had all resolved by 6 months. Serial MRI scans documented healing of the osteochondral plugs and a continuous articular cartilage surface layer in all cases by 9 months. Using mosaicplasty plug fixation we were able to obtain healing in all 16 unstable OCD lesions. The benefits of this technique are the ability to obtain rigid stabilization of the fragment using multiple plugs, stimulation of the subchondral blood supply by drilling and autogenous cancellous bone grafting. We present mosaicplasty plug fixation of unstable OCD lesions in the knee as a new technique. The results of fixation are healing in all cases including adolescent and adult cases and recommend its use for this difficult clinical problem.
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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 | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
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".