Isolated tibial deformity is the most prevalent varus pattern in North American patients undergoing medial opening wedge high tibial osteotomy
Why this work is in the frame
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Bibliographic record
Abstract
Abstract Purpose To evaluate the location of deformity in varus alignment in a North American population and assess early total knee arthroplasty (TKA) conversion rates and TKA‐free survival following medial opening wedge high tibial osteotomy (MOWHTO) based on the bony deformity location. Methods A retrospective analysis was performed on patients with varus alignment who underwent MOWHTO. Deformity analysis measured the hip–knee–ankle (HKA) angle, mechanical medial proximal tibial angle (mMPTA) and mechanical lateral distal femoral angle (mLDFA) using automated software. An abnormal mMPTA was defined as <85° and an abnormal mLDFA was defined as >90°. Cases were classified into four groups based on deformity location: tibial, femoral, combined or no bony deformity. The differences in TKA conversion rates among groups were analysed using the chi‐square test, while TKA‐free survival was determined using Kaplan–Meier survival analysis, with between‐group differences assessed using the log‐rank test. Results A total of 271 patients were included (mean age: 51.6 years; mean follow‐up: 3.6 years). The mean HKA angle was 173.0° ± 3.1°. Among the 271 patients, 38% ( n = 103), 18% ( n = 48), 11% ( n = 30) and 33% ( n = 90) had tibial, femoral, combined and no bony deformity, respectively. TKA conversion rates were 3% ( n = 3/103), 0% ( n = 0/48), 7% ( n = 2/30) and 9% ( n = 8/90) for the tibial, femoral, combined and no bony deformity groups, respectively, with no significant difference among the groups ( p = 0.080). Kaplan–Meier survival analysis showed no significant difference in TKA‐free survival among the four groups ( p = 0.185). Conclusion In this North American cohort, various varus deformity locations were analysed, with isolated tibial deformity being the most prevalent. Regardless of deformity location, TKA conversion rates remained low, suggesting that MOWHTO may be beneficial even in patients without isolated tibial deformity. Level of Evidence Level III.
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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 | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| 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 it