The Presence or Absence of Cartilage Regeneration Following Medial Open-Wedge High Tibial Osteotomy Does Not Predict Long-Term Outcomes
Bibliographic record
Abstract
PURPOSE: To assess whether the patients who showed mature cartilage regeneration in the medial compartment in a second-look arthroscopy have better clinical and radiologic long-term outcomes and survivorship compared to immature cartilage regeneration following medial open-wedge high tibial osteotomy (MOWHTO). METHODS: Patients who underwent MOWHTO using a medial locked plate system were retrospectively reviewed between February 2008 and December 2012. All included patients had no concomitant cartilage-restoring procedures, underwent second-look arthroscopy at 2 years postoperatively, and were followed for at least 10 years. Based on arthroscopic findings in the medial femoral condyle, patients were classified into mature and immature cartilage regeneration groups. Clinical outcomes, including the primary outcome of the total Western Ontario and McMaster Universities Osteoarthritis Index score, were compared between the groups using patient-reported outcome measures. The minimal clinically important difference (MCID) was assessed to determine clinical significance. Radiologic progression of osteoarthritis was evaluated using serial changes in the Kellgren-Lawrence grade, and survivorship, defined as conversion to arthroplasty, was analyzed using the Kaplan-Meier method. RESULTS: A total of 83 consecutive knees were included, with 34 in the mature group and 49 in the immature group. The mean follow-up period was 12.1 years (range, 10-15.2 years). No significant differences were observed in clinical outcomes or the proportion of patients achieving the MCID on the Western Ontario and McMaster Universities Osteoarthritis Index scale (MCID 9.1; group M 93.9% vs group I 97.9%, P = .564). Radiologic progression showed a trend of progressing more slowly in the mature group than in the immature group without significance at the latest follow-up (P = .113). The 10-year survival rate was 100% in the mature group and 95.6% in the immature group (P = .099). CONCLUSIONS: The presence or absence of cartilage regeneration in the medial compartment does not predict better long-term outcomes, including radiologic progression, the achievement of MCID in clinical outcomes, or survivorship following MOWHTO. LEVEL OF EVIDENCE: Level IV, retrospective comparative case series.
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 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) | 0.001 | 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".