Cemented Femoral Fixation: The North Atlantic Divide
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
European nations, especially Scandinavian countries, have used cemented fixation since the introduction of total hip arthroplasty. In Sweden, with arguably the best national-level data on prostheses survivorship, >90% of all stems are fixated with cement. In sharp contrast, it is estimated that in the United States, >88% of all femoral stems use cementless technology. This represents a diametrically opposed difference in philosophical approach: the so-called North Atlantic Divide. The departure in North America from cemented femoral stems can be traced to the coinage of the phrase "cement disease," which implicated cement as a leading cause of osteolysis. This led to prolific innovation of uncemented technologies in North America, while European countries favored standardization enabled by the national arthroplasty registries. The term "cement disease" has been proven to be a misnomer, as supported by excellent outcomes from the Scandinavian registries, as well as excellent long-term outcomes for cemented stems in United States series, even in patients younger than 50 years. Like uncemented stems, there is variability in survivorship between femoral stems, and this appears to be related to specific design features. Despite the excellent long-term results, the use of cemented femoral components in Europe and Canada is decreasing in favor of uncemented stems. The reasons for this are not immediately obvious.
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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 | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| 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 it