The PAT randomised clinical trial: total knee arthroplasty versus patellofemoral arthroplasty in patients with severe arthritis of the patellofemoral joint
Bibliographic record
Abstract
<br/><strong>Aim: </strong>A pragmatic, single centre, double-blind randomized clinical trial was conducted in a National Health Service teaching hospital to evaluate whether there is a difference in functional knee scores, quality of life outcome assessments and complications at one year post intervention between total knee arthroplasty (TKA) and patellofemoral arthroplasty (PFA) in patients with severe isolated patellofemoral arthritis.<br/><strong>Patients and Methods: </strong>This parallel, two-arm, superiority trial was powered at 80%, involving 64 patients with severe isolated patellofemoral arthritis. The primary outcome measure was the functional section of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score at 12 months. Secondary outcomes were the full 24-item WOMAC, Oxford Knee Score (OKS), American Knee Society Score (AKSS), EQ-5D quality of life score, UCLA Physical Activity Rating Scale and complication rates collected at 3, 6 and 12 months. For longer term follow-up OKS, EQ-5D and self-reported satisfaction score were collected at 24 and 60 months.<br/><strong>Results: </strong>Among 64 patients who were randomized, five patients did not receive the allocated intervention, three withdrew and one declined the intervention. There were no statistically significant differences in the patients’ WOMAC function score at 12 months adjusted mean difference, -1.2 [95% CI, -9.2 to 6.8]; P=0.77. There were no clinically significant differences in the secondary outcomes. Complication rates were comparable (superficial surgical site infections, four in the PFA group vs five in the TKA group). There were no statistically significant differences in the patients’ OKS score at 24 and 60 months or self-reported satisfaction score or pain free years.<br/><strong>Conclusions: </strong>Among patients with severe isolated patellofemoral arthritis, this study found no difference in functional outcome at 12 months and long mid-term in the use of PFA compared to TKA. The findings support the use of PFA as an alternative to TKA in the treatment of severe isolated patellofemoral arthritis.
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How this classification was reachedexpand
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 | 0.001 | 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 | 0.001 | 0.002 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.001 |
| 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 itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, 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".