THE FATE OF ALLOGENIC FEMORAL HEAD BONE GRAFTS USING VARUS-VALGUS CONSTRAINED TOTAL KNEE ARTHROPLASTY IN NEUROPATHIC JOINTS
Bibliographic record
Abstract
Background This study was conducted to assess the clinical and radiologic results of total knee arthroplasty (TKA) with an allogenic bone graft using varus-valgus constrained (VVC) prostheses in knees with severe bone defects and unstable neuropathy. Methods This study included 20 knees of 16 patients who underwent TKA between August 2001 and January 2006 due to unstable knees with severe bone destruction resulting from neuropathic arthritis. At the time of surgery, the mean age of the patients was 56 years. The mean length of the follow-up period was 10.7 years. A VVC condylar prosthesis was used with an allogenic femoral head graft to reconstruct large bony defects. Clinical results were evaluated using the Hospital for Special Surgery (HSS), Knee Society (KS) function, and Western Ontario and McMaster Universities Osteoarthritis (WOMAC) scores. Three-dimensional computed tomography (3D-CT) was used to evaluate the radiological parameters, which included the tibiofemoral angle, loosening or osteolysis of components, and incorporation of the bone graft. Results The preoperative mean HSS, KS function, and WOMAC scores were 40.5, 43.2, and 78.3, respectively, and these scores improved to 86.0, 64.6, and 33.8 at the final follow-up. The mean postoperative alignment was 6.1° of valgus angulation. One knee had instability, another knee had partial bony absorption, which was confirmed using 3D-CT, and the other 18 cases (90%) had satisfactory results. No cases experienced radiolucency, fracture, or infection. Conclusions TKA with an allogenic bone graft using a VVC prosthesis provides a viable option for the treatment of severe bone defects with soft tissue insufficiency in neuropathic knee arthropathy. Level of Study: Level IV, therapeutic study
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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 | 0.001 |
| 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".