Paper 48: Distal Tibia Allograft for Recurrent Shoulder Instability: A Comparison of Open Fresh versus Arthroscopic Frozen Grafts
Bibliographic record
Abstract
Objectives: To compare clinical and radiographic outcomes between patients undergoing glenoid reconstruction with frozen DTA and a matched cohort of patients with fresh DTA Methods: A retrospective review was performed of consecutive patients with a minimum of 5% anterior glenoid bone loss (GBL) associated with recurrent anterior shoulder instability who underwent stabilization with either open or arthroscopic DTA glenoid reconstruction and had a minimum of two-year follow up. Consecutive patients undergoing frozen DTA were matched in a 1-to-1 format to patients undergoing fresh DTA by age, body mass index and number of previous shoulder operations. Patients were evaluated postoperatively with the Western Ontario shoulder instability index (WOSI) score, pain relief, and for episodes of recurrent instability. All patients also underwent postoperative imaging evaluation with computed tomography (CT) in which graft incorporation and allograft angle were measured. Statistical analyses were performed using Mann-Whitney U tests and Chi-square tests, respectively, to compare continuous outcomes and categorical variables. Results: A total of 100 patients (50 fresh open DTA, 50 frozen arthroscopic DTA) with a median ± IQR age of 32.0 ± 6.7 and 27.9 ± 15.9 years respectively, were analyzed at minimum 2 years follow-up. There were significantly more males (98% vs 70%, p<0.01) in the fresh DTA group and also had significantly greater glenoid bone loss defects (25% ± 6% vs 21% ± 11, p<0.01). Patients in both groups experienced significant WOSI score improvement (p < 0.05) Both groups demonstrated similar clinical outcomes regarding improvement postoperatively (p=0.61), pain relief (p=0.09), and recurrence rates (p=0.31). There was only one case of recurrent instability among the groups in the open fresh DTA cohort. Analysis of CT data at an average of 15 months postoperatively showed no significant difference between fresh versus frozen DTA groups for average Graft-glenoid interface healing rate, allograft angle, and final anterior-posterior dimensions (graft + glenoid). Conclusions: Open fresh and arthroscopic frozen DTA for anatomic glenoid reconstruction in patients with recurrent anterior shoulder instability results in a clinically stable joint with comparable outcomes and solid allograft healing rates. Additional long-term studies are needed to determine if these results are maintained over time.
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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) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 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".