Quantifying the effect of hinge axis orientation on the posterior tibial slope angle during medial opening wedge high tibial osteotomy
Bibliographic record
Abstract
Introduction Research has suggested that rotating a medial open wedge high tibial osteotomy hinge axis internally or externally can change the posterior tibial slope and may create abnormal loading patterns through the tibia. Objectives i) to develop and validate a finite element model that estimates posterior tibial slope following a MOWHTO with a prescribed hinge axis; ii) use the model to evaluate the effect hinge axis rotation has on the posterior tibial slope and medial mechanical proximal tibia angle; and iii) quantify the effect of rotating the hinge axis on the stress and strain response within the anterior and posterior regions of the hinge. Methods Five tibia finite element models were reconstructed from computed tomography scans of five cadaveric specimens. Three different hinge axis rotations were tested (15° external rotation, neutral, and 15° internal rotation) in each of the five models and the resulting posterior tibial slope, stresses, and strains were analyzed. Results A 15° externally rotated hinge significantly increased the PTS compared to the pre-operative alignment. The 15° externally rotated hinge experienced greater stresses and strains in the posterior region of the hinge while the 15° internally rotated hinge experienced higher stresses and strains in the anterior region of the hinge. Conclusions The orientation of the medial open wedge high tibial osteotomy hinge can be manipulated to alter the posterior tibial slope but that changes in the stresses can also occur and this should be considered in the pre-surgical planning phase to reduce the risk of complications (e.g., lateral cortical fractures).
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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 | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| 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".