Complete Release of the Superficial Medial Collateral Ligament in Total Knee Arthroplasty
Bibliographic record
Abstract
BackgroundProper soft-tissue balance was essential in total knee arthroplasty (TKA). Superficial medial collateral ligament (sMCL) release has been recommended in correction of severe varus knee. However, it has concerns of overcorrection. This study aimed to analyze coronal plane laxity in sMCL-released TKA patients.MethodsWe prospectively collected data from TKA patients who were operated from January 2015 to November 2018. All patients went through the same surgical steps; however, sMCL was left intact in mild-to-moderate deformity (sMCL-intact), while it was completely released in patients with severe deformity (sMCL-released). All patients went through the same postoperative protocol. We used stress radiograph with 90 N force to evaluate coronal plane laxity and recorded modified Western Ontario and McMaster Universities Osteoarthritis Index score at 3- to 6-year postoperative appointments.ResultsThere were 46 patients (59 knees) included with an average follow-up time of 48.3 months. The sMCL-intact group consisted of 14 patients (16 knees) with average preoperative mechanical axis (MA) varus of 4.84 degrees exhibited 1.64 mm (0.6-3.6 mm) laxity on medial side and 1.01 mm (0-3.1 mm) on lateral side. The sMCL-released group consisted of 32 patients (43 knees) with average preoperative MA varus of 14.74 degree exhibited 1.96 mm (0.4-4.8 mm) laxity on medial side and 1.57 mm (0.1-5.9 mm) on lateral side. At the time of follow-up, the mean modified Western Ontario and McMaster Universities Osteoarthritis Index in the sMCL-intact and sMCL-released groups were 14.8 and 13.5 (P value .79), respectively. There was no clinical laxity or reoperation of any causes in either groups.ConclusionsComplete release of sMCL in severe varus knee does not result in overcorrection after TKA at the midterm follow-up period. Thus, sMCL release technique could be an effective and safe option for correction of severe varus deformity.
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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 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| 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 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".