Impact of Surgeon Hand Dominance on Clinical and Functional Outcomes in Total Knee Arthroplasty: A Comparative Evaluation of Right and Left Knees
Bibliographic record
Abstract
BACKGROUND: Total knee arthroplasty (TKA) is a commonly performed surgical intervention for end-stage gonarthrosis and aims to restore function, reduce pain, and improve quality of life. While the impact of surgical technique and implant selection on outcomes is well established, the potential role of surgeon ergonomics and hand dominance in influencing clinical outcomes has not yet been adequately investigated. This study compares the functional, clinical, and radiological outcomes of right and left TKA procedures performed under complete standard protocols by a right-handed surgeon who always operated from the right side of the surgical table. METHODS: This retrospective single-center study evaluated 100 patients (50 right, 50 left knees) who underwent primary TKA between 2020 and 2022 at the Department of Orthopedics and Traumatology, Kastamonu Taşköprü State Hospital, Kastamonu, Türkiye. Demographic, perioperative, functional, and radiological parameters were evaluated. Functional scores (Knee Injury and Osteoarthritis Outcome Score (KOOS), Western Ontario and McMaster Universities Arthritis Index (WOMAC), Kujala, Oxford), pain levels (Visual Analog Scale (VAS)), and range of motion (ROM) were recorded preoperatively, at one month and one year. Radiological results were evaluated using hip-knee-ankle angle (HKAA), medial distal femoral angle (MDFA), and medial proximal tibial angle (MPTA) measurements. Statistical comparisons were made using appropriate parametric and nonparametric tests. RESULTS: Both groups showed significant postoperative improvements in ROM, pain, and functional scores (p < 0.001). The right knee group had superior ROM at one year (p = 0.047), while the left knee group showed better KOOS and Oxford scores at early follow-up (p = 0.042 and p = 0.006, respectively). No significant difference was found in radiological alignment angles (p > 0.05), indicating consistent implant positioning. Hospital stay was longer in the left knee group (p = 0.011). These results show short- and long-term differences between right and left knee prostheses, but neither demonstrates overall clinical superiority. CONCLUSION: Despite minor differences, the laterality of the operated knee did not significantly differ in overall outcomes. These findings emphasize that compliance with standard surgical technique, ergonomic consistency, and patient-specific planning are more effective in achieving TKA success than the surgeon's dominant hand.
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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 | 0.000 |
| 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".