Cementless Metaphyseal Fitting Anatomic Total Hip Arthroplasty with a Ceramic-on-Ceramic Bearing in Patients Thirty Years of Age or Younger
Bibliographic record
Abstract
BACKGROUND: The number of midterm or long-term studies on the current generation of cementless total hip replacements with alumina-on-alumina ceramic bearings in patients younger than thirty years of age is limited. The purpose of this study was to evaluate the midterm results of the cementless metaphyseal fitting anatomic total hip prosthesis in patients younger than thirty years of age, with a particular emphasis on the prevalence of thigh pain, resorption of bone due to stress-shielding of the proximal part of the femur, aseptic loosening, and osteolysis. METHODS: We reviewed the cases of ninety-six patients (127 hips) who had a cementless total hip arthroplasty when they were thirty years or younger at the time of surgery. All surgical procedures were performed by a single surgeon. The most common diagnoses were osteonecrosis (54.3%) and developmental dysplasia of the hip (20.5%). Demographic data, the Harris hip score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and University of California, Los Angeles (UCLA) activity scores were recorded. Radiographic evaluation was used to evaluate implant fixation and osteolysis. The minimum follow-up interval was ten years (mean, 14.6 years; range, ten to sixteen years). RESULTS: The mean preoperative Harris hip score, WOMAC score, and UCLA activity score were 41 points, 66 points, and 3 points, respectively. At the time of final follow-up, the mean Harris hip score, WOMAC score, and UCLA activity score were 95 points, 16 points, and 8 points, respectively. No patient had thigh pain after one year postoperatively. All of the femoral stems and all but one of the acetabular components were well-fixed at the time of final follow-up. No hip exhibited squeaking, ceramic fracture, loosening, or osteolysis at the time of the final follow-up. CONCLUSIONS: These results in patients thirty years of age or younger suggest that the cementless metaphyseal fitting anatomic total hip prosthesis provides outstanding midterm fixation and substantial pain relief well into the second decade postoperatively. Moreover, the alumina-on-alumina ceramic bearing provides a high rate of survivorship without osteolysis.
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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 | 0.001 | 0.000 |
| 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 | 0.000 |
| 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".