Primary osteosynthesis augmented with autologous bone graft with total knee arthroplasty in patients with stress fractures of medial femoral condyle with knee osteoarthritis: a cost effective approach
Bibliographic record
Abstract
Background: We report six cases of an arthritic knee with stress fractures of medial femoral condyle causes substantial pain in the medial compartment severe enough to hamper their routine activities. Suggestive findings were appreciated on Skiagram in only one case, in rest was diagnosed by magnetic resonance imaging (MRI). These are likely underdiagnosed and frequently mistaken for primary osteonecrosis. The present report showed that the early detection and treatment of stress injuries in an arthritic knee is imperative to ensure best possible outcome. Methods: Six patients with a mean age of 73.1±5.7 years were registered with an arthritic knee with stress fracture of medial femoral condyle. Primary osteosynthesis augmented with autologous bone-graft with total knee arthroplasty (TKA) done in all patients. All patients were followed up until they became asymptomatic, displayed radiographic healing, and had recovered full range of motion with no pain. Pre and post-operative western ontario and mc-master universities osteoarthritis index (WOMAC) score were recorded and compared. The level of significance was set at 0.05 levels.Results: Mean follow-up was 7.0 years. All patients showed statistically significant improvement in their WOMAC total scores (p <0.05). Stress fractures united with good knee alignment. All patients had recovered full range of motion with no pain at the time of final follow-up. No adverse events were noted in any of the patient treated.Conclusions: The present approach is a successful procedure for the elderly population with an arthritic knee with stress fracture of medial femoral condyle. Return to pre-morbid level of functional activity occurs very swiftly.
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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 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| 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".