{ "model": { "rank": 1556, "code": "thing-q37425", "model_id": "vr.tr.knee", "name": "knee", "purpose": "Enable an AI agent to recognise a knee, record its structural and functional state, and distinguish supported actions from actions requiring further assessment or authority.", "family": "Thing Registry", "category": "Physical world and living systems", "status": "research-draft", "kind": "thing", "plane": "PHY", "domain": "PHY.OBJ", "industry": "", "version": "", "url": "/models/thing/q37425/", "tier": 2, "score": 139, "payload": { "layer": "wikidata", "aliases": [ "osteoarthritic knee", "human female knees", "right knee", "left knee", "stifle joint" ], "aliasCount": 5, "merged": 5, "knownIn": 139, "facets": null, "markers": [], "lexicalClass": "", "senseRank": null, "alsoRegisteredAs": "vr.tr.knee-artifact", "source": { "dataset": "wikidata", "item": "Q37425", "url": "https://www.wikidata.org/wiki/Q37425", "license": "CC0 1.0" } }, "research": { "vercy": "1.0-draft", "publication": { "status": "research-draft", "adjudicationStatus": "unreviewed", "publishableCanonical": false, "generatedAt": "2026-09-06T21:08:43Z", "providers": [ "Codex", "Grok" ], "missingProviders": [], "pass": 2, "cost": { "grok": { "usd": 0.04615586, "turns": 2, "seconds": 336.5, "error": null }, "codex": { "seconds": 64.4, "error": "Reading additional input from stdin...\nOpenAI Codex v0.153.3\n--------\nworkdir: R:\\02_PROJECTS\\02_Meta_Models_Platforms\\Ver.cy\\current\\thing-registry-backlog\nmodel: gpt-6-astra\nprovider: openai\napproval: never\nsandbox: read-only\nreasoning effort: none\nreasoning summaries: none\nsession id: 01a07888-3762-7813-b641-22f68f9a6636\n--------\nuser\nYou are drafting a Vercy meta-model for one registered thing. Answer as JSON only, no prose around it.\n\nThing: knee\nRegistry id: vr.tr.knee\nPlane / domain: PHY / PHY.LIV\nRegistry definition: (none recorded)\nNames folded into this entry: (none)\n\nA Vercy model s" } } }, "metaModel": { "id": "THING-Q37425", "registryId": "vr.tr.knee", "name": "knee", "version": "0.1.0-research.1", "entryKind": "thing", "family": "Thing Registry", "domain": [ "PHY.LIV" ], "status": "research-draft" }, "canonicalUrl": "https://ver.cy/models/thing/q37425/", "model": { "registry_id": "vr.tr.knee", "name": "knee", "purpose": "Enable an AI agent to recognise a knee, record its structural and functional state, and distinguish supported actions from actions requiring further assessment or authority.", "definition": "The knee is the compound synovial modified-hinge joint of the lower limb in which the femoral condyles articulate with the tibial plateaus (the tibiofemoral joint, with interposed menisci) and the patella articulates with the femoral trochlea (the patellofemoral joint), transmitting load and permitting flexion, extension and limited rotation under ligamentous constraint.", "scope_statement": "This draft owns an individual human knee as a joint complex and associated local anatomical region, including its identity, articulations, supporting tissues, movement, symptoms, and intervention history; applicability to nonhuman knees remains unresolved.", "in_scope": [ "Left or right knee identity, anatomical boundaries, and relationship to its person and limb", "Tibiofemoral and patellofemoral articulations and their local structural condition", "Menisci, ligaments, capsule, and the knee-related portions of the extensor mechanism", "Knee movement, stability, loading, and contribution to specific activities", "Local symptoms, examination findings, investigations, and changes over time", "Knee-specific procedures, implants, restrictions, and assessment needs" ], "out_of_scope": [ "The person's complete health history and systemic disease models", "Hip, ankle, and whole-limb conditions beyond their recorded effects on the knee", "Complete models of the femur, tibia, fibula, muscles, nerves, or blood vessels", "Whole-person gait, athletic performance, and rehabilitation programme management", "Implant product specifications, manufacturing records, and device inventory", "Independent models of injuries or diseases that may affect multiple anatomical sites" ], "distinguishing_features": [ "Locate the joint complex between the distal femur and proximal tibia, with the patella associated anteriorly; a reference to the leg alone does not identify a knee.", "Determine whether a record concerns the knee complex or only the patella; the patella is a component, not the entire knee.", "Distinguish the patellofemoral articulation from the tibiofemoral articulation while retaining both within the same knee identity.", "Check whether 'knee pain' identifies only a reported symptom location or also establishes a local structural condition; the former does not establish the latter.", "Distinguish the anatomical knee from a knee replacement device; an implanted knee retains anatomical identity while relating to a separate device." ], "characteristics": [ { "name": "Laterality", "kind": "category", "unit_or_values": "left | right | unresolved", "why_it_matters": "Prevents observations, imaging, and actions from being assigned to the opposite knee." }, { "name": "Anatomical configuration", "kind": "state", "unit_or_values": "Recorded native, altered, reconstructed, or replaced structures, with unknowns explicit", "why_it_matters": "Determines which structures are present and how observations should be interpreted." }, { "name": "Affected articulation or compartment", "kind": "category", "unit_or_values": "medial tibiofemoral | lateral tibiofemoral | patellofemoral | multiple | unlocalised", "why_it_matters": "Localises findings without treating every knee condition as affecting the entire complex." }, { "name": "Flexion and extension range", "kind": "measurement", "unit_or_values": "degrees, with angle convention, active or passive method, position, and date", "why_it_matters": "Makes motion restriction and change interpretable and comparable." }, { "name": "Stability assessment", "kind": "state", "unit_or_values": "Direction, named assessment, result or grade, examiner, and assessment conditions", "why_it_matters": "Separates measured laxity from reported giving way and preserves the basis of the assessment." }, { "name": "Pain pattern", "kind": "state", "unit_or_values": "Location, onset, duration, provoking activity, rest symptoms, and named severity scale", "why_it_matters": "Connects symptoms to circumstances without converting symptoms into a diagnosis." }, { "name": "Swelling and effusion", "kind": "state", "unit_or_values": "Observed location, onset, assessment method, and present | absent | uncertain result", "why_it_matters": "Distinguishes joint fluid findings from other forms of local swelling." }, { "name": "Task-specific function", "kind": "state", "unit_or_values": "Task, assistance, tolerance, symptoms, and observed or reported performance", "why_it_matters": "Shows what the knee permits during activities such as stairs, kneeling, or rising from a chair." }, { "name": "Local tissue condition", "kind": "state", "unit_or_values": "Named structure, finding, assessment method, date, and certainty", "why_it_matters": "Keeps evidence about cartilage, menisci, ligaments, and tendons anatomically specific." }, { "name": "Intervention and restriction relationship", "kind": "relation", "unit_or_values": "Linked procedure, implant, clinical instruction, responsible professional, and effective dates", "why_it_matters": "Supports action decisions using the knee's actual treatment history and current instructions." } ], "affordances": [ "Associate symptoms, examination records, and imaging with the correct knee and local structure.", "Compare knee motion, swelling, symptoms, and task performance across dated assessments.", "Identify missing or conflicting evidence before attributing symptoms to a particular knee structure.", "Check a proposed knee-related activity against recorded restrictions and assessment requirements.", "Link knee procedures and implants to subsequent structural and functional observations.", "Flag recorded concerns for qualified review using an applicable clinical protocol." ] }, "sources": [ { "id": "kenhub-knee-joint", "title": "Knee joint: anatomy, ligaments and movements", "url": "https://www.kenhub.com/en/library/anatomy/the-knee-joint", "what_it_supports": "Joint type, bones, tibiofemoral versus patellofemoral articulations, ligaments and menisci, innervation, blood supply, and named movements.", "url_status": "live" }, { "id": "radiopaedia-knee-joint", "title": "Knee joint", "url": "https://radiopaedia.org/articles/knee-joint-1", "what_it_supports": "Modified-hinge classification, largest synovial joint, compartment geometry, menisci, and published flexion/extension/rotation ranges used in imaging.", "url_status": "unverified" }, { "id": "iqwig-knee-work", "title": "In brief: How does the knee work?", "url": "https://www.ncbi.nlm.nih.gov/books/NBK561512/", "what_it_supports": "Three-compartment model, typical flexion to about 150°, and rotation of a flexed knee (about 10° inward, 30° outward).", "url_status": "live" }, { "id": "iso-21536-2023", "title": "ISO 21536:2023 Non-active surgical implants - Joint replacement implants - Specific requirements for knee-joint replacement implants", "url": "https://www.iso.org/standard/77045.html", "what_it_supports": "That total and partial knee replacements, with or without patellofemoral replacement, are a regulated implant class with specified performance, materials and test methods.", "url_status": "blocked" }, { "id": "cismef-knee-joint", "title": "knee joint", "url": "https://www.cismef.org/page/detail/en/RAD_CO_RID2751", "what_it_supports": "Cross-walk of the joint into SNOMED CT, FMA, MeSH, UBERON, NCIt, ICD-11 extension, ICF, RadLex and related anatomy codes.", "url_status": "live" }, { "id": "loinc-100165-0", "title": "LOINC 100165-0 Knee range of motion", "url": "https://loinc.org/100165-0", "what_it_supports": "A standard observation identifier for quantitative knee range of motion in degrees, including use in Knee Society Score panels.", "url_status": "live" }, { "id": "jama-knee-pain-2023", "title": "Evaluation and Treatment of Knee Pain: A Review", "url": "https://doi.org/10.1001/jama.2023.19675", "what_it_supports": "Population-scale osteoarthritis burden, patellofemoral pain and meniscal-tear prevalence, and first-line versus surgical management.", "url_status": "blocked" }, { "id": "acr-af-oa-2019", "title": "2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11488261/", "what_it_supports": "Joint-specific OA treatment recommendations, including tibiofemoral versus patellofemoral bracing.", "url_status": "live" }, { "id": "icd10cm-2022-m17", "title": "ICD-10-CM order file (2022) - M17 Osteoarthritis of knee and related deformity codes", "url": "https://ftp.cdc.gov/pub/health_statistics/nchs/publications/ICD10CM/2022/icd10cm_order_2022.txt", "what_it_supports": "US clinical coding of knee osteoarthritis and knee deformity with mandatory laterality.", "url_status": "live" } ], "structure": { "bundles": [ { "id": "knee-identity-and-boundaries", "name": "Knee identity and boundaries", "description": "Establish which knee is represented and which anatomical structures its records concern.", "rationale": "Laterality mistakes and confusion between a joint, a component, and a symptom location undermine every subsequent decision.", "layers": [ { "id": "person-limb-and-side", "name": "Person, limb, and side", "description": "Bind the knee to its anatomical owner and side.", "findings": [ { "id": "identified-knee", "name": "Identified knee", "description": "Record the person, limb, and laterality, including unresolved or conflicting identification.", "questions": [ { "text": "Which person's knee is this, and what establishes its left or right side?", "kind": "definition", "id": "identified-knee-q01" }, { "text": "Do examination notes, images, and procedure records agree on the knee's identity?", "kind": "provenance", "id": "identified-knee-q02" } ] } ] }, { "id": "joint-complex-boundary", "name": "Joint complex boundary", "description": "Separate the knee complex from individual components and neighbouring anatomy.", "findings": [ { "id": "anatomical-coverage", "name": "Anatomical coverage", "description": "Identify the articulations and local supporting structures covered by each observation.", "questions": [ { "text": "Does this observation concern the tibiofemoral articulation, patellofemoral articulation, supporting tissues, or an unlocalised knee region?", "kind": "definition", "id": "anatomical-coverage-q01" }, { "text": "Where should this record link to a neighbouring bone, tendon, joint, or limb model instead of extending the knee's ownership?", "kind": "boundary", "id": "anatomical-coverage-q02" } ] } ] } ] }, { "id": "articulations-and-supporting-tissues", "name": "Articulations and supporting tissues", "description": "Represent the knee's articular surfaces, menisci, stabilising structures, and extensor mechanism.", "rationale": "Different knee structures can produce overlapping symptoms while requiring distinct evidence and action constraints.", "layers": [ { "id": "articular-and-meniscal-condition", "name": "Articular and meniscal condition", "description": "Localise observations to joint compartments, cartilage, and menisci.", "findings": [ { "id": "surface-and-meniscus-findings", "name": "Surface and meniscus findings", "description": "Record compartment-specific structural observations without assuming that an imaging finding explains symptoms.", "questions": [ { "text": "Which articular surface or meniscus is described, and what condition was observed?", "kind": "definition", "id": "surface-and-meniscus-findings-q01" }, { "text": "Which examination, imaging study, or procedure supports the observation, and when was it obtained?", "kind": "provenance", "id": "surface-and-meniscus-findings-q02" } ] } ] }, { "id": "stabilisers-and-extensor-mechanism", "name": "Stabilisers and extensor mechanism", "description": "Represent knee ligaments, capsule, and the structures involved in active extension.", "findings": [ { "id": "supporting-tissue-integrity", "name": "Supporting tissue integrity", "description": "Record structure-specific integrity, prior repair or reconstruction, and the limits of available evidence.", "questions": [ { "text": "Which ligament, capsular structure, or extensor mechanism component is intact, altered, repaired, or uncertain?", "kind": "definition", "id": "supporting-tissue-integrity-q01" }, { "text": "What evidence supports that assessment, and does it describe tissue appearance, mechanical function, or both?", "kind": "provenance", "id": "supporting-tissue-integrity-q02" } ] } ] } ] }, { "id": "motion-stability-and-load", "name": "Motion, stability, and load", "description": "Describe how the knee moves and behaves under specified assessment and activity conditions.", "rationale": "Structural descriptions alone do not establish available movement, stability, or functional capacity.", "layers": [ { "id": "range-and-stability-assessment", "name": "Range and stability assessment", "description": "Capture reproducible motion and stability observations.", "findings": [ { "id": "measured-knee-mechanics", "name": "Measured knee mechanics", "description": "Record flexion, extension, and assessed laxity with methods and conditions.", "questions": [ { "text": "What active and passive flexion and extension were measured, using which angle convention and position?", "kind": "measurement", "id": "measured-knee-mechanics-q01" }, { "text": "What directional stability assessments were performed, and what results, symptoms, or assessment limitations were recorded?", "kind": "measurement", "id": "measured-knee-mechanics-q02" } ] } ] }, { "id": "loaded-task-performance", "name": "Loaded task performance", "description": "Connect knee behaviour to activities and external support.", "findings": [ { "id": "activity-dependent-capacity", "name": "Activity-dependent capacity", "description": "Record performance during walking, stairs, chair rise, squatting, kneeling, or other relevant tasks.", "questions": [ { "text": "During which task, load, and assistance conditions were pain, giving way, catching, or movement limitation observed or reported?", "kind": "measurement", "id": "activity-dependent-capacity-q01" }, { "text": "Which task limitations are attributed to the knee, and which may involve the hip, ankle, balance, or another condition?", "kind": "boundary", "id": "activity-dependent-capacity-q02" } ] } ] } ] }, { "id": "symptoms-and-state-assessment", "name": "Symptoms and state assessment", "description": "Track local symptoms, examination signs, temporal changes, and the strength of proposed explanations.", "rationale": "A knee model must distinguish what a person experiences, what an assessor observes, and what has actually been established.", "layers": [ { "id": "symptom-location-and-course", "name": "Symptom location and course", "description": "Describe pain, swelling, stiffness, and mechanical symptoms over time.", "findings": [ { "id": "dated-knee-symptom-pattern", "name": "Dated knee symptom pattern", "description": "Record onset, location, triggers, duration, and change while preserving the reporter's meaning.", "questions": [ { "text": "Where and when do pain, swelling, or stiffness occur, and how have they changed relative to an injury, procedure, or activity?", "kind": "measurement", "id": "dated-knee-symptom-pattern-q01" }, { "text": "When someone reports locking or giving way, what precisely happened, and was it reported, witnessed, or reproduced during assessment?", "kind": "provenance", "id": "dated-knee-symptom-pattern-q02" } ] } ] }, { "id": "evidence-and-clinical-interpretation", "name": "Evidence and clinical interpretation", "description": "Keep observed signs, investigation results, and clinical conclusions distinguishable.", "findings": [ { "id": "supported-state-judgement", "name": "Supported state judgement", "description": "Link any conclusion about the knee's state to dated evidence and explicitly retain unresolved explanations.", "questions": [ { "text": "Which local signs and investigation findings support the recorded interpretation, and who made that interpretation?", "kind": "provenance", "id": "supported-state-judgement-q01" }, { "text": "What remains unresolved about a local knee cause, a referred symptom, or a systemic contributor?", "kind": "boundary", "id": "supported-state-judgement-q02" } ] } ] } ] }, { "id": "interventions-and-action-constraints", "name": "Interventions and action constraints", "description": "Connect prior knee interventions and current clinical instructions to proposed actions.", "rationale": "Repairs, reconstructions, replacements, and current restrictions can change how knee findings should guide activity and assessment.", "layers": [ { "id": "altered-anatomy-and-procedure-history", "name": "Altered anatomy and procedure history", "description": "Record procedures that changed the knee and link any implanted components.", "findings": [ { "id": "post-intervention-configuration", "name": "Post-intervention configuration", "description": "Identify treated structures, procedure dates, and resulting anatomical changes without substituting a device record for the knee.", "questions": [ { "text": "Which knee structures were repaired, reconstructed, removed, or replaced, and on what dates?", "kind": "provenance", "id": "post-intervention-configuration-q01" }, { "text": "Which details describe the anatomical knee, and which belong in linked procedure or implant records?", "kind": "boundary", "id": "post-intervention-configuration-q02" } ] } ] }, { "id": "current-permissions-and-review-needs", "name": "Current permissions and review needs", "description": "Represent applicable restrictions, their authority, and conditions requiring further assessment.", "findings": [ { "id": "supported-next-action", "name": "Supported next action", "description": "Evaluate proposed knee-related actions against documented instructions, evidence gaps, and applicable review protocols.", "questions": [ { "text": "What current instructions govern weight bearing, knee motion, bracing, or activity, and who issued them for what period?", "kind": "action", "id": "supported-next-action-q01" }, { "text": "Does the proposed action require additional assessment or qualified review under the applicable protocol, given this knee's recorded condition?", "kind": "action", "id": "supported-next-action-q02" } ] } ] } ] }, { "id": "evidence-and-external-alignment", "name": "Evidence and external alignment", "description": "What the world already says about this thing, gathered so the model can be checked against it.", "rationale": "A model that cannot be lined up against existing standards, identifiers and practice cannot be adopted by anyone who already uses them.", "layers": [ { "id": "reported-evidence", "name": "Reported evidence", "description": "Findings from the breadth pass, kept separate from the structural claims.", "findings": [ { "id": "evidence-kinds", "name": "Kinds and varieties", "description": "Reported by the breadth pass; each item needs checking against its source before it becomes normative.", "evidence": [ "tibiofemoral joint (medial and lateral condylar articulations)", "patellofemoral joint", "medial tibiofemoral compartment", "lateral tibiofemoral compartment", "native (unreplaced) knee", "total knee replacement (total knee arthroplasty)", "unicompartmental / partial knee replacement", "laterality: right knee versus left knee" ], "questions": [ { "id": "evidence-kinds-q01", "text": "Which of these kinds and varieties hold for the sense of knee this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-identifiers", "name": "Identifiers and schemes", "description": "Reported by the breadth pass; each item needs checking against its source before it becomes normative.", "evidence": [ { "scheme": "Terminologia Anatomica / Latin", "value_or_pattern": "articulatio genus (also articulatio genu); articulatio patellofemoralis", "note": "Preferred anatomical names used in TA-aligned teaching sources; numeric TA98/TA2 codes for the joint as a whole were not retrieved in this pass." }, { "scheme": "SNOMED CT", "value_or_pattern": "Knee joint structure (body structure); Entire knee joint (body structure)", "note": "Preferred terms from CISMeF mappings; numeric SCTIDs were not retrieved." }, { "scheme": "FMA", "value_or_pattern": "Knee joint", "note": "Entity name from CISMeF; numeric FMAID not retrieved." }, { "scheme": "MeSH", "value_or_pattern": "Knee joint", "note": "Descriptor name from CISMeF; MeSH Unique ID not retrieved." }, { "scheme": "UBERON", "value_or_pattern": "knee joint", "note": "Concept name from CISMeF; numeric UBERON ID not retrieved." }, { "scheme": "ICD-11", "value_or_pattern": "Knee joint (anatomy extension code)", "note": "Used to locate findings and procedures; the exact extension-code string was not retrieved." }, { "scheme": "ICD-10-CM", "value_or_pattern": "M17* (osteoarthritis of knee); S83* (dislocation, sprain and strain of joints and ligaments of knee); M21.06* / M21.26* (valgus / flexion deformity of knee)", "note": "Disease, injury and deformity codes that take the knee as the site, with right/left/unspecified laterality in ICD-10-CM." }, { "scheme": "LOINC", "value_or_pattern": "100165-0", "note": "Knee range of motion, quantitative, in degrees; a measurement of the joint rather than an identifier of the organ." }, { "scheme": "NCIt", "value_or_pattern": "Knee Joint", "note": "Concept name from CISMeF." }, { "scheme": "RadLex", "value_or_pattern": "knee joint (constitutional part of knee)", "note": "RID code not retrieved; CISMeF treats the joint as a part of the knee region." } ], "questions": [ { "id": "evidence-identifiers-q01", "text": "Which of these identifiers and schemes hold for the sense of knee this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-standards-and-regulation", "name": "Standards and regulation", "description": "Reported by the breadth pass; each item needs checking against its source before it becomes normative.", "evidence": [ "ISO 21536:2023 - Non-active surgical implants - Joint replacement implants - Specific requirements for knee-joint replacement implants (International Organization for Standardization, ISO/TC 150/SC 4).", "EN ISO 21536:2024 - same title, European adoption of ISO 21536:2023 (CEN).", "ISO 21534 and ISO 7207-1 - general joint-replacement and knee-implant vocabulary referenced by ISO 21536 (International Organization for Standardization).", "2019 American College of Rheumatology / Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee (ACR and Arthritis Foundation).", "Surgical Management of Osteoarthritis of the Knee, clinical practice guideline (American Academy of Orthopaedic Surgeons).", "ICD-10-CM (National Center for Health Statistics / CMS) for laterality-specific coding of knee disease, injury and deformity in US records.", "Terminologia Anatomica (FIPAT / IFAA) for the official anatomical names of the joint and its parts." ], "questions": [ { "id": "evidence-standards-and-regulation-q01", "text": "Which of these standards and regulation hold for the sense of knee this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-real-world-use", "name": "Real-world use", "description": "Reported by the breadth pass; each item needs checking against its source before it becomes normative.", "evidence": [ "Primary load-bearing joint of gait, standing, sitting, stair climbing and squatting; examined clinically for effusion, alignment, ligament laxity and range of motion.", "Imaged with standing radiographs and MRI as the default work-up for pain, locking, instability and osteoarthritis.", "Common site of sports injury (ACL, meniscus, collateral ligaments) and of arthroscopic repair or reconstruction.", "End-stage tibiofemoral osteoarthritis is treated by total or unicompartmental knee arthroplasty under ISO 21536-class implants; patellofemoral pain is usually managed with exercise, taping or orthoses rather than surgery.", "Outcome is scored with instruments such as KOOS and the Knee Society Score, which include LOINC-coded range-of-motion items." ], "questions": [ { "id": "evidence-real-world-use-q01", "text": "Which of these real-world use hold for the sense of knee this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-measurements", "name": "Typical measurements", "description": "Reported by the breadth pass; each item needs checking against its source before it becomes normative.", "evidence": [ { "quantity": "knee flexion range of motion", "typical_range": "120 to 150 (from 0° extension; soft-tissue bulk and age dependent)", "unit": "degree" }, { "quantity": "knee extension, including physiologic hyperextension", "typical_range": "0; some people 5 to 10 of hyperextension; beyond about 10 is often treated as genu recurvatum", "unit": "degree" }, { "quantity": "internal (medial) rotation with the knee flexed", "typical_range": "about 10", "unit": "degree" }, { "quantity": "external (lateral) rotation with the knee flexed", "typical_range": "about 10 active to about 30; up to about 60 reported as passive", "unit": "degree" }, { "quantity": "patellar articular-cartilage thickness (adult, central)", "typical_range": "up to about 6 at peak (around age 30)", "unit": "millimetre" }, { "quantity": "patellar articular surface area (adult)", "typical_range": "about 12", "unit": "square centimetre" } ], "questions": [ { "id": "evidence-measurements-q01", "text": "Which of these typical measurements hold for the sense of knee this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-failure-modes-and-hazards", "name": "Failure modes and hazards", "description": "Reported by the breadth pass; each item needs checking against its source before it becomes normative.", "evidence": [ "Knee osteoarthritis (gonarthrosis): activity-related pain, stiffness under 30 minutes, joint-space loss; estimated 654 million people worldwide; may progress to arthroplasty.", "Meniscal tear: traumatic (often under 40, twisting) or degenerative (often with OA over 40); about 12% of adults; displaced bucket-handle tears can lock the joint.", "Cruciate or collateral ligament rupture or sprain (especially ACL), producing instability, giving-way and secondary meniscal or chondral damage.", "Patellofemoral pain: anterior pain in active people under 40; lifetime prevalence about 25%; squat-related pain is sensitive but not specific.", "Alignment failure: genu varum, genu valgum, flexion contracture, genu recurvatum (hyperextension beyond about 10°).", "Intra-articular fracture (tibial plateau, distal femur, patella), dislocation, haemarthrosis, bursitis and septic arthritis.", "After replacement: implant wear, loosening, infection, stiffness, instability and the higher rate of serious adverse events seen with total knee replacement versus continued non-surgical care." ], "questions": [ { "id": "evidence-failure-modes-and-hazards-q01", "text": "Which of these failure modes and hazards hold for the sense of knee this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-regional-variation", "name": "Regional variation", "description": "Reported by the breadth pass; each item needs checking against its source before it becomes normative.", "evidence": [ "Clinical and ICD language: English 'osteoarthritis of the knee' versus 'gonarthrosis' / 'gonarthrose' in ICD-derived European usage.", "Nerve and ligament English: 'common peroneal' remains common in radiology; TA-aligned sources prefer 'common fibular'.", "US ICD-10-CM requires right/left/unspecified laterality on knee OA and deformity codes (e.g. M17.11 versus M17.12); WHO ICD-10 often does not.", "Implant practice splits total versus unicompartmental replacement and cruciate-retaining versus posterior-stabilized designs; ISO 21536 now defines 'maximum claimed flexion' because demanded flexion is not uniform across patients and markets." ], "questions": [ { "id": "evidence-regional-variation-q01", "text": "Which of these regional variation hold for the sense of knee this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-neighbours", "name": "Neighbouring kinds and how to tell them apart", "description": "Reported by the breadth pass; each item needs checking against its source before it becomes normative.", "evidence": [ { "name": "knee region (regio genus)", "difference": "The region is a body-location class (skin, bursae, popliteal fossa, extra-articular fat); the knee joint is the synovial articulations. Test: presence of articular surfaces and a joint cavity, not merely a topographic landmark." }, { "name": "proximal tibiofibular joint", "difference": "A separate synovial joint at the fibular head, not one of the three knee compartments. Test: the articulation is fibular head to lateral tibial condyle, outside the tibiofemoral meniscal cavity." }, { "name": "patella (kneecap)", "difference": "A sesamoid bone in the quadriceps-patellar tendon, not the joint. Test: bone continuity and sesamoid position versus the two synovial articulations that use its posterior surface." }, { "name": "hip joint", "difference": "Proximal neighbour whose pain is often referred to the knee. Test: groin or greater-trochanter pain and hip rotation reproducing symptoms, with a quiet knee examination and imaging." }, { "name": "temporomandibular joint", "difference": "Another diarthrodial hinge with a fibrocartilage disc, sometimes analogized to the knee; different bones, load and surgical frequency. Test: mandible-temporal articulation versus femur-tibia-patella." } ], "questions": [ { "id": "evidence-neighbours-q01", "text": "Which of these neighbouring kinds and how to tell them apart hold for the sense of knee this model covers, and on what evidence?", "kind": "provenance" } ] } ] } ] } ] }, "openQuestions": [ "Does vr.tr.knee cover human knees only, or must species-specific knee anatomy and terminology be represented?", "What precise regional boundary should govern ownership of bursae, the proximal tibiofibular joint, the popliteal region, and adjacent tendon segments?", "Which established Vercy models already own anatomical joints, knee disorders, procedures, and implants, and how should this entry link to them?", "Which validated assessment methods, grading systems, and measurement conventions should be supported for different ages and clinical contexts?", "Which authoritative clinical protocols should govern review triggers and action constraints, including after repair, reconstruction, or replacement?" ], "statistics": { "bundles": 6, "layers": 11, "findings": 18, "questions": 28 } }, "draft": { "generator": "vr.draft.v3", "status": "draft-generated", "researched": false, "archetype": "device, machine or tool", "method": "Written from the archetype playbook - what this kind of thing needs beyond identity and provenance - and from the structure that recurred across 6,333 models already researched by two engines. Applied to this entry by rule. No source was read for this thing and no claim here is researched. This entry carries no facets of its own, so they were inferred from its domain - a guess about a whole domain applied to one thing.", "facetsInferred": true, "nextPass": "A researcher replaces this draft with a sourced specification. Treat every sentence below as a proposal to argue with.", "purpose": "Give an agent a durable, checkable way to recognise a knee, record what state it is in, and decide what may be done with it.", "whatItIs": "Enable an AI agent to recognise a knee, record its structural and functional state, and distinguish supported actions from actions requiring further assessment or authority.", "characteristics": { "substance": "material", "origin": "manufactured", "agency": "inert", "mobility": "varies" }, "whatYouCanDoWithIt": [ "observed and measured" ], "distinguishingFeatures": [ "Names folded into this entry, which a task may need to split apart again: osteoarthritic knee, human female knees, right knee, left knee, stifle joint.", "5 finer distinctions are held as aliases rather than separate entries, because telling them apart needs a task that asks for it.", "Described in 139 Wikipedia languages, which is a measure of how widely the thing is known, not of how important it is." ], "openQuestionsForResearch": [ "Which of the bundles below does a real task actually need, and which are ceremony?", "What does this thing have that the facets do not capture at all?", "Which neighbouring kind is most often confused with a knee, and on what evidence are they told apart?" ], "whatItIsMadeOf": "matter you can touch", "physicalCharacter": [ "Mobility varies between examples.", "Does nothing on its own; everything it does, something else did to it.", "These come from the domain this entry sits in rather than from the entry itself, so treat them as a first guess about the whole domain applied to one thing." ], "whatCanBeDoneWithIt": [ "observe it, measure it, record its state" ], "howItIsRecognised": [ "Recognised by form, by the arrangement of its controls, and by markings - a plate, a model number, a certification mark. Form alone rarely separates two models that do very different things." ], "relatedModels": [ { "relation": "covers", "note": "Finer kinds folded into this entry because telling them apart needs a task that asks for it. Each is a model waiting to be split out when one does.", "targets": [ "osteoarthritic knee", "human female knees", "right knee", "left knee", "stifle joint" ] } ], "standing": "Described in 139 Wikipedia languages, which measures how widely it is written about rather than how important or how common it is. 5 finer distinctions are held inside this entry as names rather than as separate models.", "structure": { "bundles": [ { "id": "identity-and-classification", "name": "Identity, naming and classification", "description": "How an agent tells one knee from another, and a knee from things that resemble it.", "rationale": "Recognition comes before every other claim. Without stable identity nothing else in the model can be trusted to be about the same thing twice.", "layers": [ { "id": "naming-and-identifiers", "name": "Names and identifiers", "description": "The names this thing goes by and the identifiers that survive translation and time.", "findings": [ { "id": "preferred-name-and-aliases", "name": "Preferred name, aliases and local names", "description": "Which name to use, which names mean the same thing, and which merely sound similar.", "questions": [ { "id": "preferred-name-and-aliases-q01", "text": "What identifies and describes the name of a knee, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "preferred-name-and-aliases-q02", "text": "Who or what asserted this about the name of a knee, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "preferred-name-and-aliases-q03", "text": "What may an agent decide or do once the name of a knee is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] }, { "id": "stable-identifiers", "name": "Stable identifiers and external keys", "description": "Identifiers that keep pointing at this kind of thing across systems and languages.", "questions": [ { "id": "stable-identifiers-q01", "text": "What identifies and describes an identifier for a knee, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "stable-identifiers-q02", "text": "Who or what asserted this about an identifier for a knee, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "stable-identifiers-q03", "text": "What may an agent decide or do once an identifier for a knee is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] }, { "id": "classification-and-granularity", "name": "Classification and granularity", "description": "Where a knee sits among kinds, and how finely a task needs to cut it.", "findings": [ { "id": "kind-and-parents", "name": "Kind, parents and neighbouring kinds", "description": "The classes this thing belongs to and the ones it is next to.", "questions": [ { "id": "kind-and-parents-q01", "text": "What identifies and describes the kind of a knee, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "kind-and-parents-q02", "text": "Who or what asserted this about the kind of a knee, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "kind-and-parents-q03", "text": "What may an agent decide or do once the kind of a knee is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] }, { "id": "distinguishing-features", "name": "Distinguishing features", "description": "What separates a knee from the things most often confused with it.", "questions": [ { "id": "distinguishing-features-q01", "text": "What identifies and describes what distinguishes a knee, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "distinguishing-features-q02", "text": "Who or what asserted this about what distinguishes a knee, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "distinguishing-features-q03", "text": "What may an agent decide or do once what distinguishes a knee is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] } ] }, { "id": "form-and-composition", "name": "Form, composition and condition", "description": "What a knee is made of, what shape and size it takes, and what state it is in.", "rationale": "A physical thing can be measured, and a model that cannot record its measurements cannot support any decision that depends on them.", "layers": [ { "id": "form-and-dimensions", "name": "Form and dimensions", "description": "Shape, size, mass and the ranges these take across examples.", "findings": [ { "id": "measurable-dimensions", "name": "Measurable dimensions and their units", "description": "The quantities worth recording and the units they are recorded in.", "questions": [ { "id": "measurable-dimensions-q01", "text": "What identifies and describes the dimensions of a knee, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "measurable-dimensions-q02", "text": "Who or what asserted this about the dimensions of a knee, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "measurable-dimensions-q03", "text": "What may an agent decide or do once the dimensions of a knee is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] }, { "id": "material-and-composition", "name": "Material and composition", "description": "Materials, parts and how they are put together.", "findings": [ { "id": "parts-and-materials", "name": "Parts and materials", "description": "What a knee is built from and which parts are replaceable.", "questions": [ { "id": "parts-and-materials-q01", "text": "What identifies and describes the composition of a knee, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "parts-and-materials-q02", "text": "Who or what asserted this about the composition of a knee, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "parts-and-materials-q03", "text": "What may an agent decide or do once the composition of a knee is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] }, { "id": "condition-and-integrity", "name": "Condition and integrity", "description": "Wear, damage, health and the difference between working and broken.", "findings": [ { "id": "condition-assessment", "name": "Condition, damage and health", "description": "How the condition of a knee is judged and by whom.", "questions": [ { "id": "condition-assessment-q01", "text": "What identifies and describes the condition of a knee, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "condition-assessment-q02", "text": "Who or what asserted this about the condition of a knee, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "condition-assessment-q03", "text": "What may an agent decide or do once the condition of a knee is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] } ] }, { "id": "place-and-movement", "name": "Place and movement", "description": "Where a knee is, how it got there and where it may go (varies).", "rationale": "A thing that can move needs its position recorded with a time, or every later claim about it is about a place it has left.", "layers": [ { "id": "location-and-placement", "name": "Location and placement", "description": "Position, containment and the reference frame the position is given in.", "findings": [ { "id": "position-and-frame", "name": "Position, container and reference frame", "description": "Where a knee is, and what that position is measured against.", "questions": [ { "id": "position-and-frame-q01", "text": "What identifies and describes the location of a knee, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "position-and-frame-q02", "text": "Who or what asserted this about the location of a knee, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "position-and-frame-q03", "text": "What may an agent decide or do once the location of a knee is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] }, { "id": "movement-and-transfer", "name": "Movement and transfer", "description": "How a knee is carried, installed or relocated.", "findings": [ { "id": "movement-events", "name": "Movement events and constraints", "description": "What counts as a movement, what records it and what limits it.", "questions": [ { "id": "movement-events-q01", "text": "What identifies and describes the movement of a knee, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "movement-events-q02", "text": "Who or what asserted this about the movement of a knee, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "movement-events-q03", "text": "What may an agent decide or do once the movement of a knee is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] } ] }, { "id": "state-and-lifecycle", "name": "State and lifecycle", "description": "The states a knee passes through and the events that move it between them.", "rationale": "Most decisions about a thing depend on what state it is in now, which is a claim with a time on it, not a property.", "layers": [ { "id": "lifecycle-stages", "name": "Lifecycle stages", "description": "From coming into existence to ceasing to be one of these.", "findings": [ { "id": "stages-and-transitions", "name": "Stages and transitions", "description": "The stages worth naming and what moves a knee between them.", "questions": [ { "id": "stages-and-transitions-q01", "text": "What identifies and describes the lifecycle of a knee, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "stages-and-transitions-q02", "text": "Who or what asserted this about the lifecycle of a knee, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "stages-and-transitions-q03", "text": "What may an agent decide or do once the lifecycle of a knee is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] }, { "id": "observations-and-status", "name": "Observations and current status", "description": "What is observed about a knee, how often and by whom.", "findings": [ { "id": "observation-record", "name": "Observation record", "description": "How an observation of a knee is recorded so that it can be superseded rather than overwritten.", "questions": [ { "id": "observation-record-q01", "text": "What identifies and describes an observation of a knee, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "observation-record-q02", "text": "Who or what asserted this about an observation of a knee, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "observation-record-q03", "text": "What may an agent decide or do once an observation of a knee is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] } ] }, { "id": "function-and-principle", "name": "Function and operating principle", "description": "What knee is for and how it achieves it.", "rationale": "Two devices with the same name can work on different principles, and the principle is what predicts failure and constrains use.", "layers": [ { "id": "intended-function", "name": "Intended function", "description": "The job it does, and the jobs it is used for anyway.", "findings": [ { "id": "function-record", "name": "Function, principle and variants", "description": "What it does, how, and which variants do it differently.", "questions": [ { "id": "function-record-q01", "text": "What function does knee perform, on what operating principle, and which variants differ in that principle?", "kind": "definition" }, { "id": "function-record-q02", "text": "What use falls outside the intended function but happens in practice?", "kind": "boundary" } ] } ] }, { "id": "capacity-and-rating", "name": "Capacity and rating", "description": "The numbers that say what it can do and where it stops.", "findings": [ { "id": "ratings", "name": "Ratings and their conditions", "description": "Rated capacity, power, throughput and the conditions each assumes.", "questions": [ { "id": "ratings-q01", "text": "What ratings characterise knee, in what units, and under what stated conditions?", "kind": "measurement" }, { "id": "ratings-q02", "text": "What happens beyond the rating - degradation, refusal, damage - and how is that detected?", "kind": "action" } ] } ] } ] }, { "id": "operation-and-state", "name": "Operation, controls and state", "description": "How knee is operated and what state it is in right now.", "rationale": "An agent acting on a device needs its current state and the controls that change it, not just its specification.", "layers": [ { "id": "controls-and-modes", "name": "Controls and modes", "description": "What can be set, what that changes, and what is interlocked.", "findings": [ { "id": "control-surface", "name": "Control surface and interlocks", "description": "The settings available and the conditions that block them.", "questions": [ { "id": "control-surface-q01", "text": "What controls and modes does knee have, and what does each change?", "kind": "definition" }, { "id": "control-surface-q02", "text": "Which actions are interlocked or forbidden in which state, and what must be true before acting?", "kind": "action" } ] } ] }, { "id": "condition-and-maintenance", "name": "Condition and maintenance", "description": "Wear, service intervals, consumables and the line between working and broken.", "findings": [ { "id": "service-record", "name": "Condition, service and consumables", "description": "What is consumed, what is serviced, and how condition is judged.", "questions": [ { "id": "service-record-q01", "text": "What consumables and service does knee need, at what interval, and on whose authority?", "kind": "measurement" }, { "id": "service-record-q02", "text": "What evidence separates a unit that is working from one that is out of service?", "kind": "boundary" } ] } ] } ] }, { "id": "kind-model-unit", "name": "Kind, model and unit", "description": "Whether a claim about knee is about the kind, a product line, or one physical unit.", "rationale": "This is the boundary most often got wrong for made things, and getting it wrong mixes a catalogue entry with the machine in the yard.", "layers": [ { "id": "level-of-reference", "name": "Level of reference", "description": "The three levels and what belongs at each.", "findings": [ { "id": "level-rules", "name": "What belongs to kind, model and unit", "description": "Which properties are shared by all of them and which are not.", "questions": [ { "id": "level-rules-q01", "text": "Which facts about knee hold for every one of them, which for a model, and which only for one unit?", "kind": "boundary" }, { "id": "level-rules-q02", "text": "What identifies an individual unit, and what should an agent do when it has only the kind?", "kind": "action" } ] } ] }, { "id": "standards-and-conformity", "name": "Standards and conformity", "description": "The standards a working example must meet and who attests it.", "findings": [ { "id": "conformity", "name": "Standards, marks and attestation", "description": "Which standard applies, who certifies, and what the mark means.", "questions": [ { "id": "conformity-q01", "text": "Which standards govern knee, issued by whom, and what does conformity actually assert?", "kind": "provenance" }, { "id": "conformity-q02", "text": "What may an agent conclude from a certification mark, and what may it not?", "kind": "boundary" } ] } ] } ] }, { "id": "provenance-and-evidence", "name": "Provenance, evidence and time", "description": "Where every claim about a knee came from and when it held.", "rationale": "A claim without a source and a time cannot be superseded, only overwritten, and an agent that overwrites loses the ability to explain itself.", "layers": [ { "id": "source-and-authority", "name": "Source and authority", "description": "Who said it, on what evidence, and how strongly.", "findings": [ { "id": "claim-provenance", "name": "Claim provenance and confidence", "description": "The authority behind each claim about a knee and how confident it is.", "questions": [ { "id": "claim-provenance-q01", "text": "What identifies and describes a claim about a knee, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "claim-provenance-q02", "text": "Who or what asserted this about a claim about a knee, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "claim-provenance-q03", "text": "What may an agent decide or do once a claim about a knee is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] }, { "id": "time-and-versions", "name": "Time, versions and supersession", "description": "When a claim was true, when it was learnt, and what replaced it.", "findings": [ { "id": "validity-and-supersession", "name": "Validity period and supersession", "description": "How an old claim about a knee is retired without being erased.", "questions": [ { "id": "validity-and-supersession-q01", "text": "What identifies and describes the validity of a claim about a knee, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "validity-and-supersession-q02", "text": "Who or what asserted this about the validity of a claim about a knee, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "validity-and-supersession-q03", "text": "What may an agent decide or do once the validity of a claim about a knee is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] } ] } ] }, "statistics": { "bundles": 8, "layers": 17, "findings": 19, "questions": 51 } } } }