Osteoarthritis after major combat trauma: the Armed Services Trauma Rehabilitation Outcome Study
Bibliographic record
Abstract
Abstract Objective To investigate the differences in clinical and radiographic knee OA markers between injured and uninjured UK service personnel. Methods This study was a cross-sectional analysis, 8 years post-injury, of a prospective cohort study. The Knee Injury and Osteoarthritis Outcome Scores (KOOS), radiographic Kellgren and Lawrence (KL) scores and Osteoarthritis Research Society International scores (joint space narrowing, sclerosis, osteophytes) were obtained from 565 uninjured and 579 matched (on sex, age, rank, regiment and role on deployment) major combat injured participants from the Armed Services Trauma Rehabilitation Outcome study; 35 had a knee injury and 142 had an amputation without knee injury. Kruskal–Wallis tests were used to compare between groups for KOOS and radiographic measures. A multiple logistic regression was performed on the effects of injury on radiographic features. Results The mean age at injury was 25.7 years (s.d. 5.2). Injured participants demonstrated worse KOOS values for pain {median 89 [interquartile range (IQR) 72–100] vs 94 [83–100]} and symptoms [median 80 (IQR 60–90) vs 85 (70–95), P < 0.001] and higher scores for radiographic variables than uninjured participants. Injured non-amputated/non-knee-injured participants had worse KOOS values than uninjured participants [pain: 92 (IQR 75–100) vs 94 (83–100); symptoms: 80 (IQR 60–90) vs 85 (70–95), P < 0.01]. Knee-injured participants had worse KOOS values [pain: 67 (IQR 55–85), symptoms: 55 (IQR 35–73), P < 0.001] than all subgroups and worse radiographic measures than injured non-amputated participants. KL score (≥1) and sclerosis were worse for amputees than injured non-amputated participants. Amputees had 4.04-fold increased odds (95% CI 2.45, 6.65) vs uninjured participants and knee-injured participants had 4.06-fold increased odds (95% CI 1.89–8.74) than uninjured participants of knee osteoarthritis (KOA; KL ≥1). Injured participants (without knee injury/amputation) had 1.74-fold (95% CI 1.27, 2.69) increased odds of KOA than uninjured participants. Conclusion Major combat trauma (in addition to knee injury or amputation) has a substantial effect on the development of KOA.
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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 | 0.001 | 0.002 |
| 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 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 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".