Long-term Outcome of Shelf Grafts in Total Hip Arthroplasty for Developmental Hip Dysplasia
Bibliographic record
Abstract
Primary total hip arthroplasty (THA) in patients with osteoarthrosis secondary to developmental hip dysplasia is often complex due to anterolateral acetabular bone deficiency. The use of femoral head (shelf) autograft during the index arthroplasty provides nonimmunogenic, osteoconductive support with the potential for enhanced bone stock should revision surgery be required. Few long-term studies document the outcome of the use of shelf grafts in primary THA or quantify the need for further bone graft at revision surgery. A retrospective analysis was conducted of a single surgeon's series of 31 THAs performed in 25 patients with developmental hip dysplasia. Postoperative biplanar radiographic analysis was performed at 3 and 6 months and annually thereafter for a mean of 14 years (range, 8-18 years). Grafts were assessed for union, resorption, and displacement. The need for acetabular bone graft at revision surgery was recorded. Bony union was observed in 93% of cases; fibrous union developed in the remaining 7%. There was no graft displacement. In 71% of cases, less than one-third of the graft had resorbed; one-third to one-half had resorbed in the remaining 29% of cases. Of 10 patients revised (all for loosening of the acetabular component), 2 required structural allograft for inadequate bone stock. Femoral head autograft allows effective acetabular coverage with excellent rates of union, exhibits minimal graft resorption in the long-term, and rarely requires further acetabular allograft in revision surgery.
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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 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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 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".