Femoro-patellar overstuffing in total knee replacement: assessment of functional implications
Bibliographic record
Abstract
Introduction: Patellofemoral overstuffing is the situation in which the antero-posterior size of the patella and / or femur is increased after total knee arthroplasty. There is a debate in the literature as to whether or not patellofemoral joint overstuffing has a clinically significant effect on post-operative outcomes. Objectives: Our goal was to determine the influence of femoro-patellar overstuffing on the functional outcome of total knee arthroplasty. Methods: It was a retrospective study of 50 total knee arthtroplasty without Patellar resurfacing, with a minimum follow-up of 12 months. We retrospectively collected epidemiological, clinical, therapeutic and evolutionary data. We performed our measurements on standard knee X-ray preoperatively and postoperatively according to the Beldman method. We calculated trochlear overstuffing, condylar overstuffing and distal femoral overstuffing which is primary endpoint. We have considered significant femoropatellar overstuffing when it is more than 15%. We evaluated the functional repercussions of femoro-patellar overstuffing at follow-up, on pain, mobility and the Western Ontario and McMaster Universities osteoarthritis index functional score (WOMAC). Results: This study shows that an increase in anterior femoral offset, posterior condylar offset and distal femroal diameter are associated with worse patient reported pain and function after total knee arthroplasty. Both Condylar and distal femoral overstuffing were statistically significant with all scores (P<0.05). Conclusion: we found that the overstuffed knees after total knee arthoplasty were more painful, stiffer and with lower physical function. Surgeon could take more care during the anterior and posterior femoral resection in order that the offset is not increased following implant insertion.
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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 | 0.002 |
| 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 | 0.000 |
| 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".