Relationship between surgical balancing and outcome measures in total knees
Bibliographic record
Abstract
BACKGROUND: The purpose of the study was to investigate the accuracy of balancing which could be achieved at total knee surgery and its relation to functional outcomes. METHODS: During surgery, the forces on the medial and lateral plateaus were measured at 10-15 degrees flexion in 101 patients, using an instrumented tibial trial, with equal forces being targeted. Of the initial 101 cases, 71 cases completed all follow-up visits to 1 year. At each follow-up visit, the function was measured using the Knee Society Scoring System, and varus and valgus laxity angles were measured. RESULTS: The mean medial/(medial + lateral) compartmental force ratio was 0.52, with a standard deviation of 0.09. The total contact force was 217 Newtons, with a standard deviation of 72 Newtons. No correlations were found between the functional scores and the compartmental force ratio or total contact force. However, the mean varus and valgus laxity angles, 2.8 and 2.3 degrees, respectively, were very close to the angles of normal intact knees. CONCLUSIONS: The likely reason for the lack of correlation of function was that the large majority of the balancing ratios were within the range 0.4-0.6 but with a wide spread of functional scores typical of total knee study groups. However, the normal varus and valgus angles achieved at follow-up indicated that equal balancing in early flexion was a reasonable surgical target. Using instrumented tibial trials enabled accurate and consistent balancing values to be achieved, as well as normal varus and valgus laxity angles, which may be important in obtaining optimal outcomes.
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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 | 0.002 | 0.012 |
| 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 | 0.000 |
| 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".