First Metatarsophalangeal Joint Polyvinyl Alcohol Hydrogel Implant Hemiarthroplasty: Current Operative Technique
Bibliographic record
Abstract
Polyvinyl alcohol hydrogel implant hemiarthroplasty for the first metatarsophalangeal joint has been shown to be an effective, safe, motion-preserving, surgical treatment alternative to fusion for hallux rigidus in a level I, randomized controlled trial. To obtain optimal results, however, surgeons must be sure to perform the appropriate surgical technique as well as educate patients regarding pertinent risks, benefits, and the associated recovery process. Achievement of results commensurate with those published in the randomized controlled trial is predicated on an understanding of the various technical aspects of the surgical procedure, such as avoiding excessive heat during reaming, ensuring appropriate implant positioning, and appreciating the need for performing associated procedures when anatomically appropriate, as well as their potential effect on clinical outcome. This paper will review the initial technique described in 2013 and provide key clinical care suggestions resulting from the 10 years of experience with polyvinyl alcohol hydrogel implant hemiarthroplasty for the surgical treatment of hallux rigidus. Levels of Evidence: Diagnostic Level V. See Instructions for Authors for a complete description of levels of evidence.
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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 | 0.003 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
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".