FRACTURE PATTERNS AROUND A CEMENTLESS ANATOMIC STEM AND RISK FACTORS FOR PERIPROSTHETIC FRACTURE
Bibliographic record
Abstract
Introduction and Aims: Periprosthetic fracture is a serious complication of increasing incidence in joint replacement. Our aim was to evaluate periprosthetic fracture patterns in our series of 1152 primary hip arthroplasties using a cementless proximally hydroxyapatie coated anatomic stem and to identify risk factors from parameters measured in our assessment of these patients. Method: All patients with periprosthetic fracture following primary total hip arthroplasty using the Anatomique Benoist Girard I (ABG I) hip system were identified. Parameters studied included time of fracture after surgery, patient age and fracture classification. The pre-operative cortical index in the fracture group was measured and compared with a group matched for age, gender, diagnosis, and body mass index. 1152 ABG I primary hip arthroplasties were performed in 1037 patients from 1991–1997. Osteoarthritis was diagnosed in 93% of cases. The average age was 65 years; there were 536 females and 501 males. Mean follow-up was 79.6 months. Results: Thirty-two patients, 16 male and 16 female, suffered a periprosthetic fracture. Thirty-one patients were treated for osteoarthritis and one for a femoral neck fracture. We retrieved complete records on 28 patients. The average age of the fracture group was 73 years, compared to 65 years for the whole series (p Distinct fractures patterns were related to time from initial surgery. Four fractures occurred within three months of surgery; these early fractures exhibited a particular pattern. The remaining 24 occurred between four and 114 months after surgery. These late fractures exhibited a different but consistent fracture pattern. Two fractures in the early group were identified immediately post-operatively. All others presented after minor low energy trauma. The mean cortical index in the fracture group was 47% and in the matched group 51%. If the pre-operative cortical index is below 50%, the risk of periprosthetic fracture is 4.75 greater (odds ratio 4.75 CI 1.5–15.00). All fractures were adequately classified and managed by guidelines in the Vancouver classification. Conclusion: This study identified distinct fracture patterns related to time from surgery. Cortical index and age have predictive value in pre-operative assessment of fracture risk: cortical index below 50 and age above 70 are risk factors for periprosthetic fracture and should be considered with other parameters to minimise risk of this complication.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 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 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 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".