Preoperative Strength Training for Patients Undergoing High Tibial Osteotomy: A Prospective Cohort Study With Historical Controls
Bibliographic record
Abstract
STUDY DESIGN: Prospective cohort with historical controls. OBJECTIVE: To examine the effects of a 12-week preoperative high-intensity resistance training program on postoperative outcomes. BACKGROUND: The primary goals of high tibial osteotomy (HTO) are to decrease pain and improve overall function during activities of daily living and participation in sport and recreation in relatively young, active individuals with knee osteoarthritis. However, the postoperative recovery typically requires a considerable period of protected weight-bearing that can result in substantial deficits in muscular strength. METHODS: Fourteen patients (mean ± SD, 48.0 ± 7.8 years; 13 males, 1 females), scheduled for medial opening wedge HTO, completed a 12-week preoperative high-intensity isokinetic resistance training program focusing on quadriceps and hamstrings strength. These patients were matched to baseline clinical and demographic characteristics of 14 patients who previously received a medial opening wedge HTO without preoperative training. All outcomes were measured before and 6 months after surgery. The sport and recreation subscale of the Knee Injury and Osteoarthritis Outcome Score (KOOS) was the primary outcome of interest. Secondary outcomes included the other KOOS subscales, scores on the Lower Extremity Functional Scale, and selected kinematic and kinetic variables obtained from 3-dimensional gait analysis. RESULTS: The patients in the preoperative training group achieved significantly greater scores on the KOOS sport and recreation (mean ± SD, 58.6 ± 16.6 versus 42.1 ± 20.4; mean difference, 16.4; 95% CI: 2.0, 30.9) and activities of daily living (mean ± SD, 85.3 ± 9.3 versus 76.9 ± 12.0; mean difference, 8.4; 95% CI: 0.1, 16.8) subscales. There were no significant differences between groups on other outcomes. CONCLUSION: The present findings suggest preoperative high-intensity resistance training of the quadriceps and hamstrings before HTO improves postoperative functioning in sport, recreation, and activities of daily living. LEVEL OF EVIDENCE: Therapy, level 2b.
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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 | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".