Three Hundred and Twenty-one Periprosthetic Femoral Fractures
Bibliographic record
Abstract
BACKGROUND: The purpose of this study was to determine the demographics, incidence, and results of treatment of periprosthetic fractures in a nationwide observational study. METHODS: In the years 1999 and 2000, 321 periprosthetic fractures were reported to the Swedish National Hip Arthroplasty Register. All of the associated hospital records were collected. At the time of follow-up, the Harris hip score, a health-related quality-of-life measure (the EuroQol-5D [EQ-5D] index), and patient satisfaction were used as outcome measurements. A radiologist performed the radiographic evaluation. RESULTS: Ninety-one patients, with a mean age of 73.8 years, sustained a fracture after one or several revision procedures, and 230 patients, with a mean age of 77.9 years, sustained a fracture after a primary total hip replacement. Minor trauma, including a fall to the floor, and a spontaneous fracture were the main etiologies for the injuries. A high number of patients had a loose stem at the time of the fracture (66% in the primary replacement group and 51% in the revision group). Eighty-eight percent of the fractures were classified as Vancouver type B; however, there was difficulty with preoperative categorization of the fractures radiographically. There was a high failure rate resulting in a low short to mid-term prosthetic survival rate. The sixty-six-month survival rate for the entire fracture group, with reoperation as the end point, was 74.8% +/- 5.0%. One factor associated with fracture risk was implant design. CONCLUSIONS: On the basis of these findings, we believe that high-risk patients should have routine radiographic follow-up. Such a routine could identify a loose implant and make intervention possible before a fracture occurred. Furthermore, we recommend an exploration of the joint to test the stability of the implant in patients with a Vancouver type-B fracture in which the stability of the stem is uncertain.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
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 source (direct Gemma or distilled Codex), 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".