Ten‐year follow‐up of a total knee prosthesis combining multi‐radius, ultra‐congruency, posterior‐stabilization and mobile‐bearing insert shows long‐lasting clinically relevant improvements in pain, stiffness, function and stability
Bibliographic record
Abstract
Abstract Purpose There is a paucity of data available on total knee prostheses combining dual‐radius, ultra‐congruency, posterior‐stabilization and mobile‐bearing insert. This prospective cohort study aimed to assess the clinical evolution of the FIRST® prosthesis (Symbios Orthopédie, Yverdon, CH), the earliest prosthesis with this particular design. It was hypothesized that the primary outcomes, evaluating pain, stiffness, function and stability, would improve following arthroplasty and remain improved during the follow‐up period of 10 years. Methods All patients programmed for a total knee arthroplasty using a FIRST® prosthesis at our university hospital between 2006 and 2008 were invited to participate. Study knees were evaluated pre‐operatively as well as one, five and ten years post‐operatively. Patients filled out questionnaires at each evaluation point and had a radiographic assessment at the five‐year and ten‐year follow‐ups. Primary outcomes were the total, pain, stiffness and function measures of the Western Ontario and McMaster Universities Osteoarthritis questionnaire (WOMAC) and the knee and function measures of the Knee Society Score (KSS). Friedman and Wilcoxon’s rank‐sum tests were used to compare measures across time points. Results Hundred and twenty four prostheses were included (baseline demographics: 69.9 ± 8.3 years old, 28.1 ± 4.3 kg/m2, 54% male) and 68 could be followed during ten years. Five prostheses underwent a revision. All other prostheses lost at follow‐up were lost for reasons unrelated to the prosthesis. All primary measures reported statistically and clinically significant improvements between baseline and the three follow‐up evaluations. Statistically significant improvements at the three follow‐up evaluations were also observed for most secondary measures. There was no implant loosening. At ten‐year follow‐up, radiolucent lines were observed in 2.9% femoral implants and 1.5% tibial implants. Conclusion The positive results observed in all domains of assessment and the small revision rate demonstrated an effective functioning of the FIRST® prosthesis during the ten‐year follow‐up period. The results, globally similar to those previously published for other prosthesis designs, encourage the development of assistive methods to select the most appropriate designs on an individual basis. Level of evidence IV, prospective cohort study.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| 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) | 0.002 | 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 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".