Poster 161: No Differences in Outcomes but Differing Rates of Surgery at Ten Years Among Patients Without Unstable Chondral Lesions Versus Those With Unstable Chondral Lesions (Left In Situ) at the Time of Arthroscopic Partial Meniscectomy
Bibliographic record
Abstract
Objectives: The purpose of this study was to compare 10-year outcomes among patients with unstable chondral lesions (CL-noDeb) and patients without unstable chondral lesions (NoCL) found at the time of arthroscopic partial meniscectomy (APM). Methods: We conducted a secondary analysis of data from the Chondral Lesions and Meniscal Procedures Trial (ChAMP) level 1 trial at 10-year follow-up. One-hundred-fifteen patients had 10-year outcomes for CL-noDeb vs. NoCL groups, including the Western Ontario and McMaster Universities Arthritis Score (WOMAC), Knee Injury and Osteoarthritis Outcomes Score (KOOS), Visual Analog Scale (VAS), Short-form Health Survey (SF-36) and subsequent surgeries. A physical assessment was performed by a trained research assistant. Two surgical orthopaedic sports medicine fellows assessed joint space narrowing on weight-bearing radiographs. Our primary outcome was WOMAC Pain score. Continuous variables were compared with t-tests and linear regression and categorical variables were compared with chi-squared tests, Fisher Exact Tests, and logistic regression. Regression models obtained mean differences (MDs) with corresponding 95% confidence intervals by adjusting for weight. Statistical significance was defined as p < 0.05. Results: Of the original sample of 163 patients (CL-noDeb 92, NoCL 71), 115 (CL-noDeb 64 [69.6%] and NoCL 51 [71.8%], p=0.888) had outcomes. There were no significant demographic differences between the two groups, aside from preoperative weight and BMI (Table 1). Fifteen patients underwent subsequent surgery (Figure 1). Among those who did not have later surgery, there was no significant difference in the WOMAC pain between the CL-noDeb (90.3 [95% CI, 86.3-94.3]), and the NoCL group (91.3 [95% CI, 87.2-95.5]). There was also no significant difference in other patient reported outcome measures, range of motion (Table 2), or joint space narrowing. However, there was a significantly lower rate of subsequent surgery in the NoCL group compared to the CL-noDeb group for both the index and contralateral leg (Figure 2). Conclusions: This 10-year follow-up level 1 study of patients who underwent APM found that the presence of unstable chondral lesions was associated with a significantly higher rate of subsequent arthroplasty. Patients without unstable chondral lesions had more favorable outcomes at 10-year follow-up. Careful preoperative assessment and selection criteria for APM may help educate patients and reduce the rate of post-meniscectomy arthroplasty.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.017 | 0.002 |
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".