{ "vercy": "1.0-draft", "publication": { "status": "research-draft", "adjudicationStatus": "unreviewed", "publishableCanonical": false, "generatedAt": "2026-09-12T11:04:20Z", "providers": [ "Codex" ], "breadth": "recalled by Codex without web access - no source was read", "missingProviders": [], "pass": 2, "cost": { "grok": { "seconds": 18.5, "error": "Reading additional input from stdin...\nOpenAI Codex v0.153.4\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: 01a09549-10c8-7073-a7df-07eb9bc19266\n--------\nuser\nDescribe what is already known about one registered thing. Answer as JSON only, no prose around it.\n\nThing: luxating patella\nSense to describe: (none recorded)\nDomain code: XCT.STA\nAlso known as: (none)\n\n\nContext for this batch of 1001 things:\n# Batch 044: 100", "usd": 0.0, "recall": true }, "codex": { "seconds": 72.3, "error": "Reading additional input from stdin...\nOpenAI Codex v0.153.4\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: 01a09549-10bd-7b11-a880-a64014abff90\n--------\nuser\nYou are drafting a Vercy meta-model for one registered thing. Answer as JSON only, no prose around it.\n\nThing: luxating patella\nRegistry id: vr.tr.luxating-patella\nPlane / domain: XCT / XCT.STA\nRegistry definition: (none recorded)\nNames folded into this entry:" } }, "enrichment": { "pass": 3, "engine": "claude", "producedAt": "2026-10-06T12:00:00Z", "ingestedAt": "2026-10-06T08:47:48+00:00", "fields": [ "agent_conduct", "ethics", "failure_modes_and_hazards", "owners", "visual_identification" ] }, "gate": { "passed": true, "version": "1.0", "at": "2026-10-07T10:10:30+00:00", "evidence": [ "completeness 1.00", "sense: Wikidata description", "2 live sources", "review by codex: pass" ] } }, "metaModel": { "id": "THING-Q381444", "registryId": "vr.tr.luxating-patella", "name": "luxating patella", "version": "0.1.0-research.1", "entryKind": "thing", "family": "Thing Registry", "domain": [ "XCT.STA" ], "status": "research-draft" }, "canonicalUrl": "https://ver.cy/models/thing/q381444/", "model": { "registry_id": "vr.tr.luxating-patella", "name": "luxating patella", "purpose": "Enable an agent to recognise documented patellar luxation, distinguish mechanical displacement from its functional effects, and support species-appropriate assessment and follow-up.", "definition": "Luxating patella is a condition in which the kneecap intermittently or persistently displaces from the femoral trochlear groove, impairing normal tracking of the knee's extensor mechanism.", "scope_statement": "This model owns luxating patella as a condition in which the kneecap displaces from the femoral trochlear groove, including its episodic or persistent expression in an affected knee or stifle; species must be explicit because the registry supplies no definition establishing a veterinary-only scope.", "in_scope": [ "Affected species, individual, joint and side, with bilateral involvement represented separately", "Direction, persistence, recurrence and reducibility of patellar displacement", "Evidence supporting diagnosis and any species-specific severity classification", "Patellar tracking, associated alignment abnormalities and attributable functional impairment", "Condition-specific management decisions, reassessment and recurrence" ], "out_of_scope": [ "General anatomy of the patella, patellar tendon and knee", "Tibiofemoral dislocation as a separate joint injury", "Patellar fracture, tendon rupture and cruciate ligament disease as independent diagnoses", "General osteoarthritis assessment beyond its relationship to this condition", "Detailed surgical protocols, medication prescribing and rehabilitation programme design" ], "distinguishing_features": [ "Require evidence of the patella leaving its trochlear position; pain, limping or an unusual gait alone does not establish luxation.", "Distinguish complete displacement from partial subluxation or abnormal tracking, preserving the examining clinician's terminology.", "Identify displacement at the patellofemoral articulation rather than treating it as dislocation of the entire knee.", "Separate an intermittently displaced patella that is currently seated from a persistently displaced patella.", "Record fracture, extensor tendon injury and ligament instability separately when present rather than using them as synonyms for luxation." ], "characteristics": [ { "name": "Species and clinical context", "kind": "category", "unit_or_values": "Species; veterinary or human context; age and skeletal maturity", "why_it_matters": "Determines which terminology, examination methods and management evidence apply." }, { "name": "Affected articulation and laterality", "kind": "relation", "unit_or_values": "Individual linked to left or right patellofemoral joint; separate records for both sides", "why_it_matters": "Prevents findings or treatment outcomes from one limb being assigned to the other." }, { "name": "Luxation direction", "kind": "category", "unit_or_values": "Medial; lateral; bidirectional; other documented direction; undetermined", "why_it_matters": "Describes displacement relative to the affected limb and informs anatomical assessment." }, { "name": "Observed patellar position", "kind": "state", "unit_or_values": "Seated; partially displaced; fully displaced; not established, with observation time and joint position", "why_it_matters": "Separates the current examination state from a history of intermittent luxation." }, { "name": "Reducibility and stability after reduction", "kind": "state", "unit_or_values": "Spontaneous return; clinician-reducible; immediately reluxates; not reducible; untested", "why_it_matters": "Captures mechanical behaviour without inferring it from symptoms." }, { "name": "Clinical grade", "kind": "category", "unit_or_values": "Named species-appropriate grading system and grade; ungraded; not applicable", "why_it_matters": "Makes classifications interpretable and prevents transferring a veterinary grade directly to human assessment." }, { "name": "Luxation episode frequency", "kind": "measurement", "unit_or_values": "Episodes per stated observation period, with observer and detection method", "why_it_matters": "Supports longitudinal comparison while preserving the limitations of reported episodes." }, { "name": "Pain and limb function", "kind": "measurement", "unit_or_values": "Named species-appropriate pain or function scale, score and assessment conditions", "why_it_matters": "Records clinical impact independently of mechanical grade." }, { "name": "Associated anatomical abnormality", "kind": "relation", "unit_or_values": "Linked trochlear, femoral, tibial or soft-tissue finding; suspected or demonstrated contribution", "why_it_matters": "Supports assessment of the displacement mechanism without assuming every abnormality is causal." }, { "name": "Diagnostic confidence", "kind": "state", "unit_or_values": "Suspected; clinically demonstrated; historically documented; disputed; unresolved", "why_it_matters": "Controls whether the agent can describe luxation as established or must request further evidence." } ], "affordances": [ "Assemble a side-specific account of observed displacement and reported episodes.", "Check that a recorded grade identifies its classification system and supporting examination findings.", "Identify missing evidence that separates patellar luxation from other causes of knee pain or lameness.", "Prepare a clinician-review summary connecting mechanics, symptoms and associated abnormalities.", "Track management decisions and compare subsequent stability, function and recurrence.", "Flag new trauma, sustained displacement or marked functional deterioration for clinical assessment under an applicable care protocol." ], "agent_conduct": { "may": [ "Explain the condition in people and dogs from medical and veterinary sources.", "Advise owners to see a veterinarian if a dog skips or holds up a leg.", "Record a pet's diagnosis and grade for its keeper." ], "must_not": [ "Diagnose or grade the condition from a description.", "Advise manipulating a kneecap back into place.", "Recommend breeding dogs known to have the condition.", "Give pain medicines not prescribed by a clinician or veterinarian." ], "requires_human": [ "Any surgical decision for a person or animal." ] }, "ethics": { "considerations": [ "Breeding for small size in dogs spreads the condition and causes pain.", "Pain in animals is often missed; owners need honest information." ], "affected_parties": [ "Small dog breeds", "Owners", "Patients" ] }, "owners": { "steward": "The keeper of the animal or the patient; clinicians and veterinarians treat it.", "master_systems": [] }, "visual_identification": [ "A dog hopping or skipping for a few steps on a hind leg.", "A kneecap that moves out of place when the leg is straightened." ], "failure_modes_and_hazards": [ "Arthritis and cartilage damage over time.", "Ligament tears in affected knees." ], "what_it_is_for": [ "Patellar luxation is encountered in human orthopaedic care and veterinary practice, particularly when evaluating abnormal kneecap tracking and limb function.", "Documentation distinguishes intermittent displacement, persistent displacement and recurrent episodes because these describe different mechanical and functional states." ], "standards_and_regulation": [ "The International Classification of Diseases, Tenth Revision, issued by the World Health Organization, provides category M22.0 for recurrent dislocation of the patella in human clinical records." ] }, "sources": [ { "id": "wikidata", "title": "Wikidata item Q381444: luxating patella", "url": "https://www.wikidata.org/wiki/Q381444", "url_status": "live", "what_it_supports": "identity and sense of the item", "checked_by": "wikidata-api" }, { "id": "wikipedia-en", "title": "Wikipedia: Luxating patella", "url": "https://en.wikipedia.org/wiki/Luxating_patella", "url_status": "live", "what_it_supports": "general description of the item", "checked_by": "wikidata-api sitelink" } ], "structure": { "bundles": [ { "id": "condition-identity", "name": "Condition identity", "description": "Establish what counts as luxating patella for this individual and articulation.", "rationale": "The registry name alone does not establish species, displacement extent or whether a present finding or recurrent condition is intended.", "layers": [ { "id": "species-and-joint", "name": "Species and joint", "description": "Locate the condition in a specific individual and patellofemoral articulation.", "findings": [ { "id": "applicable-clinical-context", "name": "Applicable clinical context", "description": "Record species and laterality before interpreting severity or importing clinical guidance.", "questions": [ { "text": "Which species, individual and side does this luxating-patella assessment concern?", "kind": "definition", "id": "applicable-clinical-context-q01" }, { "text": "If both sides are affected, what evidence and assessment belong to each side?", "kind": "boundary", "id": "applicable-clinical-context-q02" } ] } ] }, { "id": "displacement-boundary", "name": "Displacement boundary", "description": "Separate patellar luxation from adjacent instability and injury concepts.", "findings": [ { "id": "documented-patellar-displacement", "name": "Documented patellar displacement", "description": "Patellar dislocation concerns the kneecap moving out of its groove; the record should distinguish this event from broader patellar instability. [AAOS: Unstable Kneecap](https://www.orthoinfo.org/en/diseases--conditions/unstable-kneecap)", "questions": [ { "text": "Was complete luxation demonstrated, or does the evidence establish only subluxation, maltracking or suspected instability?", "kind": "boundary", "id": "documented-patellar-displacement-q01" }, { "text": "Who documented the displacement, when, and through examination, imaging or an earlier clinical record?", "kind": "provenance", "id": "documented-patellar-displacement-q02" } ] } ] } ] }, { "id": "luxation-mechanics", "name": "Luxation mechanics", "description": "Describe where the patella moves and how it behaves during and between episodes.", "rationale": "A single label loses the direction, persistence and reducibility needed to interpret the condition.", "layers": [ { "id": "position-and-direction", "name": "Position and direction", "description": "Capture displacement relative to the trochlear groove under stated observation conditions.", "findings": [ { "id": "observed-displacement-pattern", "name": "Observed displacement pattern", "description": "Record direction and patellar position together with knee angle, loading and whether displacement was spontaneous or elicited by a clinician.", "questions": [ { "text": "In which direction does the patella displace, and under what joint position or activity was this observed?", "kind": "measurement", "id": "observed-displacement-pattern-q01" }, { "text": "Was the patella seated or displaced at this examination, and how does that compare with documented episodes?", "kind": "measurement", "id": "observed-displacement-pattern-q02" } ] } ] }, { "id": "reducibility-and-grade", "name": "Reducibility and grade", "description": "Keep observed mechanical behaviour available alongside any summary classification.", "findings": [ { "id": "supported-mechanical-classification", "name": "Supported mechanical classification", "description": "Veterinary assessment uses grades reflecting displacement and reducibility; retain the underlying observations and the named system. [ACVS: Patellar Luxation](https://www.acvs.org/small-animal/patellar-luxations/)", "questions": [ { "text": "Does the patella return spontaneously, require clinician reduction, immediately reluxate or remain non-reducible?", "kind": "measurement", "id": "supported-mechanical-classification-q01" }, { "text": "Which grading system was used, and which recorded observations justify the assigned grade?", "kind": "provenance", "id": "supported-mechanical-classification-q02" }, { "text": "Were pain, guarding, sedation or examination position documented as limitations on interpretation?", "kind": "measurement", "id": "supported-mechanical-classification-q03" } ] } ] } ] }, { "id": "anatomical-and-diagnostic-context", "name": "Anatomical and diagnostic context", "description": "Connect displacement to assessed anatomy and distinguish concurrent sources of dysfunction.", "rationale": "Treatment planning requires more than confirmation that the patella moves out of position.", "layers": [ { "id": "alignment-and-onset", "name": "Alignment and onset", "description": "Record the supported explanation for onset and abnormal tracking.", "findings": [ { "id": "supported-contributing-anatomy", "name": "Supported contributing anatomy", "description": "Trochlear shape and limb alignment may contribute to veterinary patellar luxation; record demonstrated abnormalities rather than assuming a mechanism from breed or grade. [ACVS: Patellar Luxation](https://www.acvs.org/small-animal/patellar-luxations/)", "questions": [ { "text": "Which trochlear, femoral, tibial or soft-tissue abnormalities have been demonstrated, and by which assessment?", "kind": "provenance", "id": "supported-contributing-anatomy-q01" }, { "text": "What evidence supports developmental, traumatic or unresolved onset in this individual?", "kind": "provenance", "id": "supported-contributing-anatomy-q02" } ] } ] }, { "id": "concurrent-pathology", "name": "Concurrent pathology", "description": "Keep associated injuries and competing explanations separately identifiable.", "findings": [ { "id": "attribution-of-joint-dysfunction", "name": "Attribution of joint dysfunction", "description": "Require explicit attribution of symptoms when luxation coexists with other joint abnormalities.", "questions": [ { "text": "Which findings support luxation as the source of current dysfunction, and which suggest a concurrent injury or disease?", "kind": "boundary", "id": "attribution-of-joint-dysfunction-q01" }, { "text": "What unresolved diagnostic question would additional examination or imaging answer?", "kind": "action", "id": "attribution-of-joint-dysfunction-q02" } ] } ] } ] }, { "id": "clinical-expression-and-course", "name": "Clinical expression and course", "description": "Describe the individual's experienced or observed impairment and its evolution.", "rationale": "Mechanical severity and functional burden need separate records to support meaningful decisions.", "layers": [ { "id": "pain-and-limb-use", "name": "Pain and limb use", "description": "Capture functional effects with species-appropriate observations.", "findings": [ { "id": "attributable-functional-burden", "name": "Attributable functional burden", "description": "Dogs may show intermittent skipping or temporary limb lifting; record observed function and pain separately from anatomical grade. [ACVS: Patellar Luxation](https://www.acvs.org/small-animal/patellar-luxations/)", "questions": [ { "text": "What pain, weight-bearing change or activity limitation occurs during episodes and between them?", "kind": "measurement", "id": "attributable-functional-burden-q01" }, { "text": "Which observations come from a clinician, caregiver or patient, and what scale or observation period was used?", "kind": "provenance", "id": "attributable-functional-burden-q02" } ] } ] }, { "id": "episodes-and-progression", "name": "Episodes and progression", "description": "Represent recurrence and deterioration without conflating recall with direct observation.", "findings": [ { "id": "longitudinal-luxation-pattern", "name": "Longitudinal luxation pattern", "description": "Maintain dated episodes and assessments so changes in displacement, pain and function can be evaluated independently.", "questions": [ { "text": "When was displacement first documented, and how frequent and long-lasting are subsequent episodes?", "kind": "measurement", "id": "longitudinal-luxation-pattern-q01" }, { "text": "Has persistence, reducibility or functional impairment changed under comparable assessment conditions?", "kind": "measurement", "id": "longitudinal-luxation-pattern-q02" } ] } ] } ] }, { "id": "management-and-reassessment", "name": "Management and reassessment", "description": "Connect clinical decisions to explicit indications and measurable outcomes.", "rationale": "An agent needs to explain the basis for a care pathway and recognise when reassessment is needed.", "layers": [ { "id": "management-rationale", "name": "Management rationale", "description": "Record the clinician's selected pathway and the evidence supporting it.", "findings": [ { "id": "individualised-care-decision", "name": "Individualised care decision", "description": "Record observation, conservative care or surgical assessment as a clinician-directed decision grounded in symptoms, mechanics and individual context.", "questions": [ { "text": "What management pathway was selected, by whom, and which functional and mechanical findings support it?", "kind": "action", "id": "individualised-care-decision-q01" }, { "text": "Which new findings should trigger earlier reassessment or referral under the individual's care plan?", "kind": "action", "id": "individualised-care-decision-q02" } ] } ] }, { "id": "stability-and-functional-outcomes", "name": "Stability and functional outcomes", "description": "Assess whether management improves patellar stability and meaningful limb use.", "findings": [ { "id": "documented-treatment-response", "name": "Documented treatment response", "description": "Track patellar position, recurrent luxation, pain and function as distinct outcomes with baseline and follow-up dates.", "questions": [ { "text": "Compared with baseline, what changed in patellar stability, episode frequency, pain and limb use?", "kind": "measurement", "id": "documented-treatment-response-q01" }, { "text": "Does the follow-up evidence indicate persistent luxation, recurrence after documented stability or another cause of impairment?", "kind": "boundary", "id": "documented-treatment-response-q02" }, { "text": "What reassessment or care-plan revision did the responsible clinician recommend?", "kind": "action", "id": "documented-treatment-response-q03" } ] } ] } ] }, { "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-confidence-notes", "name": "Check these first", "description": "Recalled without web access and unsourced; every item is a lead to verify.", "evidence": [ "The registry supplies no species or sense; the term commonly denotes a veterinary condition, but the underlying abnormality also occurs in humans.", "The I-IV grading description is veterinary; it should not be assumed to apply unchanged to human patellar instability.", "This is a recall-based description; no sources or diagnostic classification codes were verified." ], "questions": [ { "id": "evidence-confidence-notes-q01", "text": "Which of these check these first hold for the sense of luxating patella this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-kinds", "name": "Kinds and varieties", "description": "Recalled without web access and unsourced; every item is a lead to verify.", "evidence": [ "Medial patellar luxation", "Lateral patellar luxation", "Developmental patellar luxation", "Traumatic patellar luxation" ], "questions": [ { "id": "evidence-kinds-q01", "text": "Which of these kinds and varieties hold for the sense of luxating patella this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-real-world-use", "name": "Real-world use", "description": "Recalled without web access and unsourced; every item is a lead to verify.", "evidence": [ "Veterinary orthopaedic diagnosis, particularly in dogs and also in cats.", "Assessment of lameness, gait abnormalities and knee instability.", "Clinical grading to inform monitoring and treatment planning.", "Screening for patellar instability in dog breeding programmes." ], "questions": [ { "id": "evidence-real-world-use-q01", "text": "Which of these real-world use hold for the sense of luxating patella this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-measurements", "name": "Typical measurements", "description": "Recalled without web access and unsourced; every item is a lead to verify.", "evidence": [ { "quantity": "Veterinary clinical luxation grade", "typical_range": "I-IV: from manually inducible luxation that reduces spontaneously to permanent luxation that cannot be manually reduced", "unit": "ordinal grade" } ], "questions": [ { "id": "evidence-measurements-q01", "text": "Which of these typical measurements hold for the sense of luxating patella this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-failure-modes-and-hazards", "name": "Failure modes and hazards", "description": "Recalled without web access and unsourced; every item is a lead to verify.", "evidence": [ "Intermittent skipping gait or persistent lameness.", "Pain and reduced limb function.", "Progressive cartilage damage and osteoarthritis.", "Associated skeletal malalignment and abnormal loading of the knee.", "Recurrent luxation after surgical correction." ], "questions": [ { "id": "evidence-failure-modes-and-hazards-q01", "text": "Which of these failure modes and hazards hold for the sense of luxating patella this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-neighbours", "name": "Neighbouring kinds and how to tell them apart", "description": "Recalled without web access and unsourced; every item is a lead to verify.", "evidence": [ { "name": "Patellar dislocation", "difference": "Often denotes the same displacement; 'luxating patella' is especially common in veterinary descriptions of an ongoing tendency to dislocate, whereas human medicine commonly uses 'patellar dislocation' for an episode." }, { "name": "Patellar subluxation", "difference": "The patella is partially displaced rather than completely dislocated from its normal articulation." }, { "name": "Patellar tendinopathy", "difference": "The primary abnormality is in the patellar tendon rather than displacement of the kneecap." }, { "name": "Cranial cruciate ligament disease", "difference": "Instability arises from failure of the cranial cruciate ligament rather than patellar displacement; the conditions can coexist." } ], "questions": [ { "id": "evidence-neighbours-q01", "text": "Which of these neighbouring kinds and how to tell them apart hold for the sense of luxating patella this model covers, and on what evidence?", "kind": "provenance" } ] } ] } ] } ] }, "openQuestions": [ "Does registry provenance restrict this entry to veterinary patellar luxation, or should it also encompass human patellar dislocation under species-specific interpretation?", "Does an existing Vercy world model already own this condition, requiring this registry entry to link to it rather than produce a second publication?", "Should partial subluxation be included as an expression of this entry or remain a linked neighbouring condition?", "Which grading systems and functional measures are sufficiently supported for each included species, particularly cats?", "What evidence supports species-specific reassessment thresholds and the expected relationship between mechanical grade, symptoms and treatment outcomes?" ], "statistics": { "bundles": 6, "layers": 11, "findings": 16, "questions": 28 } }