Clinical Outcomes After Computed Tomography-Based Total Knee Arthroplasty: A Surgeon’s First 1,000 Cases
Bibliographic record
Abstract
INTRODUCTION: Computed tomography scan (CT)-based three-dimensional (3D) modeling operative technologies have been shown to improve upon many perioperative results of manual total knee arthroplasties (TKAs). Although patient satisfaction has been reported for CT-based TKAs, studies evaluating large cohorts are limited. The purpose of this study was to compare the clinical outcomes of a surgeon's first 1,000 CT-based TKAs with manual TKAs during a minimum follow-up time of approximately six months. Specifically, we analyzed: (1) survivorship; (2) functional outcomes; (3) radiographic outcomes (i.e., alignment, progressive radiolucencies); and (4) complications. MATERIALS AND METHODS: A total of 1,000 consecutive primary CT-based total knee arthroplasty cases (988 patients) performed by a single surgeon at a single center between July 1, 2016 and July 1, 2021 were compared to a total of 1,000 consecutive manual TKAs (996 patients) completed by the same surgeon between May 18, 2013 and July 1, 2016. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) surveys were collected at approximately six months postoperatively. Subgroup analyses were performed on the physical function and pain scores. Follow-up radiographs were also examined for alignment, progressive radiolucencies, and/or loosenings. RESULTS: There was 100% survivorship at approximately six months follow up. The mean physical function score for the manual cohort and CT-based cohort were 10 ± 4 (range, 0 to 32) and 5 ± 4 (range, 0 to 22), respectively (p<0.05). The mean pain score for the manual cohort and CT-based cohort were 4 ± 4 (range, 0 to 20) and 3 ± 2 (range, 0 to 15), respectively (p<0.05). The mean total WOMAC score for the manual cohort and CT-based cohort were 13 ± 9 (range, 0 to 44) and 8 ± 7 (range, 0 to 33), respectively (p<0.05). None of the manual or CT-based cases exhibited progressive radiolucencies by final follow up. There were no postoperative medical and/or surgical complications at final follow up in the two cohorts. DISCUSSION/CONCLUSIONS: The 1,000 CT-based TKA clinical outcomes from this study continue to support great survivorship and radiographic outcomes, minimal complications, as well as improved physical function, pain, and total WOMAC scores. Therefore, those who undergo CT-based 3D modeling total knee arthroplasties should have the advantage of superior patient satisfaction.
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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 | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".