Are asymmetric tibial baseplates superior in primary total knee arthroplasty? A systematic review of clinical studies
Bibliographic record
Abstract
Background: Despite the asymmetric nature of the native tibial condyles, traditional primary total knee arthroplasty (TKA) has overwhelmingly employed the use of symmetric tibial baseplates. However, designs exist utilizing an asymmetric tibial baseplate that mimics normal tibial anatomy. The purpose of this review was to assess the functional and radiographic outcomes of asymmetric tibial base plates. Methods: Embase, MEDLINE, and Web of Science were searched for relevant literature from database inception until September 2019, and after screening by two reviewers, studies investigating the use of asymmetric tibial baseplates in primary TKA were included. Demographic data as well as data on revision rates, functional and radiographic outcomes, and complications were recorded. A risk of bias assessment was performed for all studies. Results: Overall, 24 studies were identified with a total of 4776 patients (4937 knees). Seventeen studies (1895 knees) reported a pooled revision rate of 2.4% (45/1845) at a mean follow-up of 72.9 mo. TKA with an asymmetric baseplate resulted in improvement of range of motion and functional outcome scores postoperatively, as well as radiographic evidence of good tibial component positioning and bone coverage. Lastly, the overall pooled complication rate of reporting studies was 12.7%. Conclusions: The use of an asymmetric tibial baseplate in primary TKA is a safe and effective option, with the potential for improved component alignment and tibial coverage. However, more evidence is needed to determine if there are significant differences in failure rates and postoperative functional outcomes before justifying the implementation of a new and potentially more costly technology. Level of Evidence: Level IV.
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 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 | 0.018 | 0.073 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.011 | 0.010 |
| Bibliometrics | 0.015 | 0.013 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.004 | 0.003 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 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".