MIDTERM OUTCOMES OF OSTEOCHONDRAL ALLOGRAFT TRANSPLANTATION FOR FEMORAL HEAD CARTILAGE LESIONS: MINIMUM TWO-YEAR FOLLOW-UP
Bibliographic record
Abstract
The surgical management of large osteochondral lesions of the femoral head in young, active patients remains controversial. Fresh osteochondral allograft transplantation (OAT) can be a highly effective treatment for these lesions in some patients. We study the midterm survivorship and outcomes after fresh osteochondral allograft transplantation at minimum 2-year follow-up. A retrospective review of prospectively collected data was performed for 28 patients (12 female) under the age of 50 years with defined femoral head osteochondral lesions who underwent fresh OAT between 2008 and 2021. Patients were assessed clinically using the modified Harris Hip Score (mHHS) preoperatively and at each follow-up visit. Postoperative radiographs were evaluated for graft integrity and Kellgren & Lawrence Grade for osteoarthritis severity. Complications and reoperation were assessed by chart review. Kaplan-Meier survivorship analyses with 95% confidence intervals were performed for the end point of conversion to total hip arthroplasty. Overall graft survivorship for included patients is 62.7% (39.6-85.8, 95% CI) at 10 years. Nine patients (32.1%) underwent conversion to total hip arthroplasty. There was a significant difference using log rank test between survival for patients with a preoperative diagnosis of avascular necrosis (AVN) versus those with other diagnosis (osteochondritis dissecans and trauma) (P=0.002). At a mean follow-up of 79.7 months (25-164), the mean mHHS score impoved significantly (P Fresh OAT is a viable treatment option for osteochondral defects of the femoral head in young, active patients with minimal preexisting joint deformity. It may delay the need for total hip arthroplasty. Patients with a preoperative diagnosis of AVN had poorer clinical outcomes than those with other diagnoses.
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| 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".