Femoral Revision Hip Arthroplasty: A Comparison of Two Stem Designs
Bibliographic record
Abstract
UNLABELLED: For various reasons the tapered, fluted, modular titanium (TFMT) stem has become our component of choice over cylindrical, nonmodular cobalt chrome (CNCC) components for THA revision. We therefore asked whether the TFMT femoral components better achieved three important goals of revision arthroplasty than CNCC stems: (1) improving quality of life; (2) avoiding complications; and (3) preserving or restoring femoral bone stock. We compared patients undergoing femoral component revision hip arthroplasty with either a CNCC (N = 105) component or a TFMT (N = 95) component to determine if the increased use of TFMT components is justified. We retrospectively reviewed all patients undergoing revision total hip arthroplasty between January 2000 and March 2006. All eligible patients completed outcome questionnaires (WOMAC, SF-12, Oxford-12, UCLA Activity Score, and Satisfaction Scores). Radiographs were evaluated for loosening and preservation or restoration of the proximal femur host bone. The TFMT and CNCC cohorts were comparable with respect to age, gender, diagnosis, and comorbidities. The TFMT cohort had worse preoperative bone defects (65% Paprosky 3B and 4). The TFMT cohort had higher outcome scores (WOMAC pain, WOMAC stiffness, Oxford-12, and Satisfaction), fewer intraoperative fractures, and better restoration of the proximal femur host bone. Our data suggest the TFMT stem provided improved clinical outcomes (improved quality of life, decreased complications, and preservation of bone stock) than the CNCC stem. LEVEL OF EVIDENCE: Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.002 |
| 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".