Efficacy of isolated femoral revision in cruciate‐retaining total knee arthroplasty instability: A comparative study
Bibliographic record
Abstract
Abstract Purpose This study compares clinical outcomes, implant survival rates and perioperative factors between isolated femoral total knee arthroplasty (TKA) revision (prTKA) and full TKA revision (frTKA) for flexion instability in cruciate‐retaining (CR) prostheses. Methods This retrospective, controlled case series included 66 consecutive patients treated with either full TKA revision ( n = 34) or isolated femoral TKA revision ( n = 32) with flexion instability after CR TKA between 2015 and 2021. To ensure that the groups were uniformly comparable, only patients with one implant system (Triathlon, Stryker) were included. Preoperative demographic data and radiological parameters (e.g., quantification of anteroposterior instability and midflexion instability) were compared between the groups. Postoperative evaluation of implant survival and clinical outcome scores was performed with a minimum follow‐up of 2 years. Patient‐reported outcome measures (PROM) analysis included the Visual Analogue Scale, Kujala, Oxford Knee Score, Western Ontario and McMaster Universities Osteoarthritis Index, Forgotten Joint Score, University of California at Los Angeles Activity‐Level Scale and Knee Osteoarthritis Outcome scores. Statistical evaluations included unpaired, nonparametric t ‐tests and Wilcoxon tests for nominal data. Implant survival analysis was conducted using Kaplan–Meier analysis and log‐rank test. Statistical significance was defined as a p ‐value < 0.05. Results No significant differences were found in the clinical outcomes between the prTKA and frTKA groups across various PROMs. Implant survival rates were comparable (96.9% for prTKA vs. 97.1% for frTKA). Compared to frTKA, prTKA resulted in significantly shorter hospital stays ( p = 0.002), reduced operative time ( p < 0.001), lower blood loss ( p = 0.001) and a decreased inflammatory response ( p < 0.001). Conclusions Partial femoral TKA revision for flexion instability in cruciate‐retaining prostheses yielded clinical outcomes and implant survival rates comparable to full TKA revision in the short‐ to mid‐term follow‐up. These findings suggest that partial femoral revision may be a viable option for carefully selected patients with flexion instability, offering similar clinical efficacy and potential perioperative advantages over complete revision. 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 | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 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".