Complication Rates and Functional Outcomes After TAA in Patients with Rheumatoid Arthritis Are Less Defined Than for Patients with Osteoarthritis
Bibliographic record
Abstract
Commentary In the study by Wixted et al., the authors retrospectively reviewed complication rates and functional outcomes following primary total ankle arthroplasty (TAA) among patients with rheumatoid arthritis (RA), primary osteoarthritis (OA), and posttraumatic arthritis. The patients with RA were not matched with patients with primary OA, resulting in the RA group having a significantly younger age, higher percentage of female patients, lower body mass index, and higher American Society of Anesthesiologists (ASA) score compared with the OA and posttraumatic arthritis groups. Even though the patients with RA had greater disability preoperatively, at a mean follow-up of 5.7 years, the RA cohort had the lowest rate of major complications. Multivariable regression analysis showed no increased risk of implant failure for the RA cohort compared with the OA and posttraumatic arthritis cohorts. The results of this study are promising but represent a small sample size of 57 patients with RA from among a total of 1,071 patients undergoing primary TAA with mid-term follow-up. In the RA group, 63.2% of the patients were using conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) and 43.9% were using biologic DMARDs (bDMARDs). The sample size was too small to assess the effect of RA medications on outcome. Finally, 6 types of TAA implants were used, with the rates being significantly different among the arthritis groups (p < 0.001). Twenty-four (43.6%) of the 57 patients with RA had Salto-Talaris (Smith & Nephew) implants, which were much less commonly used in patients with OA or posttraumatic arthritis. Whether the Salto-Talaris implant provides better outcomes for patients with RA has not been answered by this study since the sample size was small and longer-term follow-up is needed. Further prospective and long-term studies evaluating patients with RA are required, but this current study demonstrates promising outcomes for patients with this challenging condition.
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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 | 0.002 | 0.023 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| 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".