Quality of Life Following Proximal Femoral Replacement Using a Modular System in Revision THA
Bibliographic record
Abstract
BACKGROUND: Proximal femoral replacement using a segmental modular system is one option for revision THA in the presence of severe bone loss or periprosthetic fracture. While many papers report function in these patients, they do not describe the quality of life. QUESTIONS/PURPOSES: We evaluated the quality of life in patients undergoing proximal femoral replacement using a segmental modular system for severe bone loss. PATIENTS AND METHODS: We retrospectively reviewed 63 patients undergoing complex revision THA using a modular replacement system for nonneoplastic conditions between April 1996 and June 2006. Average age was 73 years (range, 23-94 years). Twenty-one patients were lost to followup and six patients died before 2-year minimum followup. The remaining 36 patients were followed for an average of 3.2 years (range, 2-10 years). Study patients were matched by age-decade to a control group of patients undergoing conventional revision THA. At baseline, both groups were comparable with respect to age, comorbidities, and quality-of-life scores. RESULTS: At last followup, the modular system group showed improvement in WOMAC function, WOMAC pain, Oxford score, and the SF-12 mental component. Compared to the control group, the modular system group scored lower on WOMAC function and Oxford scores, but there were no differences in any other scores. CONCLUSIONS: In patients with severely compromised bone stock, a segmental modular replacement system can improve the quality of life. Special attention should be given to the stability of the hip intraoperatively and a constrained acetabular liner should be used when the risk of postoperative dislocation is high. LEVEL OF EVIDENCE: Level III, therapeutic study. See the 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 | 0.017 | 0.004 |
| 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 | 0.001 | 0.003 |
| 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".