EP2.7 Joint instability of the Hip, Knee and Shoulder: Are they all made equal?
Bibliographic record
Abstract
Abstract Purpose: The burden of joint instability on the patient’s general health has been well recognized in the shoulder and knee but not as much in the hip. The purpose of the study is to compare patients have undergone corrective surgery for instability of the hip knee, and shoulder to better understand their relative impact on quality of life. Methods: 230 instability correction procedures performed between 1-Jun-2018 and 31-Jan-2023 were included in the analysis: 62 dysplastic hips [Mean Age 31 (16-47), BMI 25 (18-33), ASA 2.0 (1-3) and 7 Male (11%)], 112 knees with ligamentous injuries[Mean Age 34 (18-61), BMI 27 (16-48), ASA 1.6 (1-3) and 62 Male (55%)], and 56 unstable shoulders [Mean Age 38 (18-67), BMI 27 (20-37), ASA 2.0 (1-3) and 39 Male (70%)]. Intra-operative surgical details including, arthroscopic treatment, as well as labral, cartilage, and bone corrections, were collected. Pre-operative and 1-year post-operative Physical and Mental PROMIS patient-reported outcome measures were also compiled. Results: In the hip group surgeries were: periacetabular osteotomy (PAO) (71%), PAO with scope (23%), and Arthroscopy alone (6%); in the shoulder group: 61% of patients received a scope, and 39% received open surgery; in the knee group: 85% of patients received ACL surgery alone while 15 received both ACL and Meniscus treatment. All patients exhibited improvements in their functional score with hip instability having the worst physical outcomes Pre- and Postoperatively. Mean Pre-operative Physical Health PROMIS score was [Hip 40.1 (SD 6.9); Knee 48.3 (SD 7.7); Shoulder 46.6 (SD 8.0)] and 12 months post-operative was [Hip 45.2 (SD 7.6); Knee 50.4 (SD 6.2); Shoulder 48.8 (SD 7.7)]. Mean Pre-operative Mental Health PROMIS score was [Hip 38.8 (SD 8.5); Knee 48.6 (SD 8.9); Shoulder 48.1 (SD 10.3)] and 12 months post-operative was [Hip 41.6 (SD 9.3); Knee 48.6 (SD 9.5); Shoulder 47.5 (SD 10.0)]. Conclusion: Joint instability carries a significant burden on patients’ both physical and mental quality of life. More importantly, instability from a bony deformity i.e. hip dysplasia is as impactful as soft tissue/ligamentous instability of shoulder and knee. This analysis adds further validity to instability as the leading pathomechanism of hip dysplasia.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| 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) | 0.000 | 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".