Cementation for Femoral Head Osteonecrosis: A Preliminary Clinic Study
Bibliographic record
Abstract
Treatment for femoral head osteonecrosis has been less successful in late stages of the disease, after progression to collapse. The current authors treated 21 patients (22 hips) with Stage III osteonecrosis by a technique of open reduction and fixation with methylmethacrylate cement (cementation). The followup ranged from 1 to 3 years (average, 1.7 years). Patient progress was followed using preoperative and postoperative Harris hip scores, Western Ontario and McMaster Universities Osteoarthritis Index, and a health status questionnaire (Short Form-36). Patients were staged preoperatively using the Association Research Circulation Osseous international classification system and radiographic evaluation was done intraoperatively and postoperatively. The Harris hip score, Western Ontario and McMaster Universities Osteoarthritis Index, and Short Form-36 physical health scores improved significantly from 53.5 to 78.0, 66.0 to 48.1, and 27.0 to 40.0, respectively. The outcome was worse for patients with more advanced disease. Six patients, all with severe disease, had total hip arthroplasty. Cementation is technically simple, enables patients' immediate postoperative pain relief and improvement in mobility, and has the potential to restore and maintain the sphericity of the femoral head after collapse. The high failure rate (27%) at short-term followup, although comparable with other reported techniques, does not support generalized use for Stage III disease. Currently the use of this procedure is restricted to symptomatic, young patients (younger than 40 years), preferably with mild to moderate Stage III disease (degree of head involvement < 30% and degree of collapse < 4 mm).
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 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 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".