Revision of Well-Fixed Mechanically-Aligned Total Knee Arthroplasty Using Kinematic Alignment for the Restoration of Joint Line Obliquity: Report of a Surgical Technique
Bibliographic record
Abstract
Despite advances in technology and procedures, primary total knee arthroplasty can still result in an unsatisfied patient up to 20% of the time. Many indications for revising total knee arthroplasty have been established, including infection, aseptic loosening, wear, and instability. A newer indication being used in our center is that of a mechanically aligned knee, in which the prosthetic joint line has been substantially altered with respect to the native joint line. In this surgical technique report, we describe a method of revising a painful mechanically aligned total knee arthroplasty using the principles of kinematic alignment, using either the patient's preoperative long-axis radiographs, if available, or those of their contralateral limb, as a guide for the measurement of native joint line obliquity. Although this may be controversial, in our practice, this diagnosis has become an established indication for revision knee arthroplasty, with high success rates and patient satisfaction. In this brief surgical technique report, we present the details of one of our cases.
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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) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.001 | 0.001 |
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".