Functional outcomes and implications of limb length discrepancy after total knee arthroplasty
Bibliographic record
Abstract
Background The occurrence and perception of LLD after TKA may lead to unsatisfactory results and its consequences are not well studied as the LLD occurring after THA. The objective of this study was to evaluate the incidence, magnitude, implications as well as functional outcomes of LLD in patients after TKA using the WOMAC (Western Ontario and McMaster Universities Arthritis Index) functional score 6 months after surgery. Materials and Methods This was a prospective case series study and included 34 cases. Cases were subjected to pre and postoperative clinical, radiological assessment to detect clinical LLD, flexion deformity (FD), radiological LLD, hip knee angle (HKA), and functional assessment using WOMAC score. The degree of osteoarthritis (OA) according to Kellegren Lawrence classification (KL) was assessed and documented. In addition, the polyethylene insert thickness was documented as well. Results Change in limb length occurred in the 38 (30 cases unilateral, 4 cases bilateral) knees with a mean increase of 1.3 cm ±SD 0.9. The mean improvement of the FD angle was 9.9° ± SD 8.7. The mean HKA before surgery was 11.2° ±SD 6.2 while the mean post-operative HKA was 2.7° ±SD 3.5. WOMAC score of cases included in the study with postoperative radiological LLD < 1 cm didn’t show a significant difference from that of cases with LLD≥ 1 cm. WOMAC score improvement after surgery didn’t correlate with perceived LLD. Also, age, sex, BMI, degree of arthritis, insert size, and FD showed no correlation with postoperative radiological LLD. Increased preoperative HKA showed a significant correlation with increased postoperative radiological LLD. There was a significant difference between postoperative radiological LLD in both groups (< 1 cm and ≥ 1 cm) regarding their postoperative perception of LLD. Conclusion This prospective case series study suggested that there is no significant correlation between LLD and the functional outcome after TKA. Patients with postoperative radiological LLD more than 1 cm are more likely to perceive LLD.
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 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".