The relationship between constitutional alignment and varus osteoarthritis of the knee
Bibliographic record
Abstract
PURPOSE: The role of neutral alignment in total knee arthroplasty (TKA) on short- and long-term outcomes has become controversial. Based on the concept of constitutional varus, it has been suggested that under-correction in TKA in a varus osteoarthritis (OA) population might lead to better clinical outcomes. However, it is still unknown what the relationship between constitutional varus and the development of end-stage OA is. The goal of this study was to analyse the contribution of constitutional varus in a medial OA population and to define a correlation between the constitutional alignment and end-stage varus OA. METHODS: Based on full-length radiographs, corrected for the intra-articular deformity of the knee, of 315 patients with unilateral end-stage medial OA of the knee (Charnley type A), a correlation in the coronal plane was made between medial end-stage OA and the contralateral non-arthritic side. RESULTS: With increasing varus alignment in the arthritic limb, the physiologic limb alignment also became more varus. The proportion of constitutional varus rose with increasing overall alignment and was found to be continuous for males. Constitutional varus was three times higher in men when the overall arthritic alignment was greater more than 6° varus. CONCLUSION: Constitutional varus significantly contributes to varus osteoarthritis and was found to be higher than in the general population. LEVEL OF EVIDENCE: III.
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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 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.004 | 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".