Influence of preoperative medial meniscus extrusion and subchondral bone marrow edema on outcomes after medial opening wedge high tibial osteotomy
Bibliographic record
Abstract
OBJECTIVE: No studies have assessed the correlation between preoperative medial meniscus extrusion (MME) and subchondral bone marrow edema (BME) or which factor influences the outcomes after medial opening wedge high tibial osteotomy (MOWHTO). The present study aimed to determine the influence of preoperative MME and BME on outcomes after MOWHTO. METHODS: This study included 151 patients between January 2019 and January 2022 with a mean follow-up of 3.2 years. MME was classified into 2 groups according to the presence of pathologic MME (≥ 3 mm). BME was graded into 4 groups according to the lesion volume based on the MRI Osteoarthritis Knee Score (MOAKS) criteria. Clinical outcomes were assessed with the Hospital for Special Surgery (HSS) score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Knee Society Score (KSS). RESULTS: The mean ± standard deviation preoperative MME for all patients was 3.6 ± 1.9 mm. A total of 103 patients (68.2%) had pathologic MME. MME significantly increased with increasing BME grade. Those with pathologic MME showed significantly worse outcomes in terms of the WOMAC and KSS for pain and function and HSS score than those without pathologic MME at 1 and 2 years postoperatively (all p < 0.05). A total of 122 patients (80.8%) had BME. Among the 151 patients, 29 (19.2%), 61 (40.4%), 42 (27.8%), and 19 (12.6%) were classified as having an MOAKS of 0, 1, 2, and 3, respectively, with significant differences in the preoperative WOMAC and KSS for pain and function and HSS score among these 4 groups (all P < 0.001). However, there were no significant differences in these indices at 1 or 2 years postoperatively (all P > 0.05). Only MME correlated with worse clinical outcomes in univariate (p < 0.001) and multivariate (p < 0.001) analyses. CONCLUSIONS: Short-term clinical outcomes were worse for patients with preoperative MME greater than 3 mm than for those with preoperative MME less than 3 mm. There were no correlations between preoperative subchondral BME severity and postoperative outcomes.
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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 | 0.004 |
| 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) | 0.001 | 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 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".