Isolated tibial deformity is the most prevalent varus pattern in North American patients undergoing medial opening wedge high tibial osteotomy
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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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 | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 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) | 0.002 | 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".