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Record W2306968022

TKA IN THE YOUNG ADULT: A REASONABLE SOLUTION?

2013· article· en· W2306968022 on OpenAlexaff
Robert B. Bourne

Bibliographic record

VenueJournal of Bone and Joint Surgery-british Volume · 2013
Typearticle
Languageen
FieldMedicine
TopicTotal Knee Arthroplasty Outcomes
Canadian institutionsWestern University
Fundersnot available
KeywordsMedicineSurvivorship curveArthroplastyTotal knee arthroplastySurgeryPhysical therapyPopulation
DOInot available

Abstract

fetched live from OpenAlex

Patient selection has always been considered an important criterion in determining the success or failure of a TKA. In the early days of TKA, orthopaedic surgeons and patients were both uncertain as to the long-term outcomes and most TKAs were performed in patients >65 years of age. Since that time, a number of peer-reviewed studies have provided Level III evidence indicating that TKA was a reliable procedure with 91% to 99% survivorship during the first decade and 85% to 97% during the second decade of follow-up. These encouraging TKA results have prompted a growth in TKA utilisation, particularly in younger patients and a move away from procedures such as osteotomy and UKA which have been associated with higher re-operation rates. As a result, over the past decade, the fastest growing TKA patient cohorts have been in the 45–54 (337% increase for females, 271% for males) and 55–64 (260% increase for females and 213% for males) year old patient groups! The Swedish Knee Arthroplasty Register has followed Swedish TKA patients since 1975 and has provided useful insights with regards the use of knee arthroplasties in younger patients (i.e. an encouraging TKA revision risk reduction from 1976 to 2009, a higher revision rate for UKAs and higher revision rates for both TKAs and UKAs in younger patients). The Australian National Joint Replacement Registry has also found that age adversely affects knee arthroplasty revision rates, noting higher cumulative, ten-year revision rates for both UKA and TKA patients 75 years of age! In addition, although mobile-bearing TKAs have often been promoted for use in younger patients, higher cumulative revision rates were noted for mobile-bearing TKAs (7%) as compared to fixed-bearing TKAs (5%) at 10 years. In summary, although TKA outcomes have improved with time, the lack of long-term supporting data should prompt surgeons to be cautious in offering TKA to patients with 20 to 40 more years of life expectancy. New TKA bearing couple technologies (ie. cross-linked polyethylenes and improved femoral counterfaces) should be encouraged, but their introduction should not be based on laboratory tests alone, but also supported by safety and efficacy studies in patients and long-term post-market surveillance data.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.001
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.214
Threshold uncertainty score0.413

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0010.001
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

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.

Opus teacher head0.011
GPT teacher head0.211
Teacher spread0.200 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

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".

Quick stats

Citations0
Published2013
Admission routes1
Has abstractyes

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