Simulated Biomechanical Analysis of Optimal Knee Alignment for Treating Medial Meniscus Posterior Root Tears
Bibliographic record
Abstract
Background: Medial opening-wedge high tibial osteotomy (MOWHTO) is used to correct varus alignment; however, the optimal knee alignment during MOWHTO for medial meniscus posterior root tears (MMPRTs) remains unclear. Purpose: To determine the optimal biomechanical knee alignment for MMPRT treatment during MOWHTO. Study Design: Controlled laboratory study. Methods: This study used 10 fresh-frozen cadaveric legs from human donors (mean age, 61.3 years [range, 33-75 years]). A joint motion simulator assessed the weightbearing line (WBL) from 30% to 70% (0%: medial border; 100%: lateral border), simulating MOWHTO. Tibiofemoral peak contact pressure (PCP) and mean contact pressure (MCP) were measured using a pressure sensor under a 700-N load. MMPRTs were created via a femoral posterior approach and repaired with suture anchors. Measurements were taken in the intact, MMPRT, and repair conditions at alignments of 30% to 70% WBL, with neutral alignment defined as 50% WBL. Statistical analysis was performed using one-way analysis of variance with the Tukey post hoc test. Results: In the medial compartment, PCP was increased by 43% in the MMPRT condition compared with the intact condition at neutral alignment ( P = .012). MCP was also significantly increased by 57% in the MMPRT condition compared with the intact condition ( P = .006). At varus alignment, PCP and MCP increased in all conditions, with the largest statistically significant differences observed at 30% WBL ( P = .002 and P < .001, respectively). PCP and MCP at neutral alignment in the intact condition were comparable with those at 60% to 65% WBL in the MMPRT condition and at 50% to 55% WBL in the repair condition. In the lateral compartment, PCP and MCP increased at valgus alignment, with no significant differences among conditions. Conclusion: MCP at neutral alignment in the intact condition was similar to that at 60% to 65% WBL in the MMPRT condition and at 50% to 55% WBL in the repair condition, indicating optimal biomechanical alignment targets for MOWHTO in patients with MMPRTs. 50–55% WBL corresponds to slight valgus alignment. Neutral alignment was not considered ideal in this context. Clinical Relevance: These findings provide biomechanical evidence to guide optimal knee alignment during MOWHTO for MMPRTs, potentially improving patient 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 | 0.000 | 0.001 |
| 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".