The effect of postoperative mechanical axis alignment on the revision rate of primary total knee arthroplasty after a follow up of 10 years
Bibliographic record
Abstract
The purpose of this study is to evaluate the effect of postoperative mechanical alignment on clinical outcomes and revision rate by comparing acceptable mechanical axis group from neutral and an outlier mechanical axis. Between 2000 and 2006, clinical and radiographic data of 334 primary TKAs were retrospectively reviewed. Post-operative mechanical axis was investigated within 1 month after TKA. The first group was an acceptable group of 286 knees (85.6%, with mechanical axis of 0°±3°). The second group was an outlier group of 48 knees (14.4%, with mechanical axis of beyond 0°±3°). Clinical outcomes before surgery and at the final follow up were analyzed using scoring method such as Hospital for Special Surgery, Knee Society Score, and Western Ontario & McMaster Universities Osteoarthritis Index (WOMAC) score. Radiologic outcomes including changes of mechanical axis between immediate postop and last follow-up were evaluated. Postoperative complications and revision rates were also evaluated. The mean degrees in change of mechanical axis between immediate postop and last follow-up were greater in the outlier group (1.6°±2.7) than acceptable group (0.8°±2.4). No significance difference in clinical outcome was found between the two groups. The incidence of aseptic loosening, instability, polyethylene wear, polyethylene breakage, and periprosthetic fracture was 2/4/2/2/2 each in the acceptable group and 1/1/2/0/0 each in the outlier group. Six (2.1%) of 286 in the acceptable group and 4 (8.3%) of 48 in the outlier group were revised (p=0.04). The Kaplan-Meier survival analysis showed a tendency towards improved survival with restoration of neutral mechanical axis. However, such improvement was not statistically significant (p=0.25). Restoration of neutral limb alignment is a factor of total knee arthroplasty that can result in less revision rate and higher longevity. However, there are no significant differences in clinical outcomes between the two groups.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot 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.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 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 | 0.002 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".