Periprosthetic fractures of the femur associated with hip arthroplasty
Bibliographic record
Abstract
Periprosthetic fractures following total hip or knee arthroplasty have become more common as the indications and age distribution for these procedures have increased in the last few years. Revision surgery in these patients holds a very high complication rate and therefore measures should be taken to prevent these fractures. Osteolysis with subsequent component loosening has been shown to pose a risk for periprosthetic fractures. Regular follow-up visits could reveal early signs and symptoms of component loosening. Patients who develop loosening should be revised as soon as possible to prevent periprosthetic fractures. The Vancouver classification (intraand post-operative) for periprosthetic fractures associated with total hip replacement has been shown to be reproducible and an excellent guideline for management. Revision surgery for periprosthetic fractures carries a significant risk for complications. This review and instructional article will focus mainly on periprosthetic fractures in hip arthroplasty, although some risk factors and biomechanical considerations are also applicable for periprosthetic fractures of the femur in knee arthroplasty. Greater trochanteric fractures can present intra-operatively or post-operatively. Non-unions of the greater trochanter commonly presents many years down the line in patients where the surgical approach was done through greater trochanteric osteotomy, and are generally difficult to treat. This review will cover some aspects on the fixation methods of these fractures. Finally the hardware and surgical adjuncts to treat periprosthetic fractures will be discussed briefly. The more common fracture patterns (type B2) and the problematic (type B3) will be discussed in more detail.
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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 | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| 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".