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Record W2580459017

DEEP INFECTION AFTER HIP REPLACEMENT: DID THE EARTH JUST MOVE?

2015· article· en· W2580459017 on OpenAlexaff
Clivе P. Duncan

Bibliographic record

VenueJournal of Bone and Joint Surgery-british Volume · 2015
Typearticle
Languageen
FieldMedicine
TopicOrthopedic Infections and Treatments
Canadian institutionsUniversity of British Columbia
Fundersnot available
KeywordsMedicineHip replacementStage (stratigraphy)Physical examinationSurgeryKnee replacementJoint replacementInternal fixationImplantOrthopedic surgeryArthroplasty
DOInot available

Abstract

fetched live from OpenAlex

The practice at most centers in North America for the investigation and management of non-acute infection after hip replacement has been relatively standard for some time. Diagnosis has depended on a thorough history, physical examination, plain radiographs, straightforward laboratory inflammatory markers, joint aspiration for bacteriologic study, intraoperative frozen section in selected cases, and intraoperative synovial biopsies for confirmatory bacteriologic evaluation. The cornerstone of treatment on this continent has revolved around two-stage revision hip replacement, with increasing popularity for the use of interval articulating antibiotic loaded spacers, and increasing use of cementless fixation at the second stage. But this standard approach has been under increasing scrutiny in recent years, for good reason. The use of more precise “best evidence” paradigms on which to base the diagnosis have been developed. There is encouraging work on the application of more specific synovial and serum markers. The need to remove all implant material in all cases has been challenged. And there is evidence that the two stage approach is associated with greater morbidity, mortality and cost. The latter has led to a re-examination of the role and results of single-stage exchange revision, at least in selected cases, where the patient is immune competent, the soft tissue and bone anatomy is not badly deficient, the organism is known, and the antibiotic sensitivity is favorable. The most encouraging of the recent developments is the increasing consensus that multicenter collaborative study is required if we are to make genuine progress in the one-stage/two-stage debate. At least one multicenter prospective randomised study is scheduled to commence in 2015.

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 distilled prediction

Teacher imitation

Not 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.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.048
Threshold uncertainty score0.403

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0010.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

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.

Opus teacher head0.025
GPT teacher head0.243
Teacher spread0.218 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

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".

Quick stats

Citations0
Published2015
Admission routes1
Has abstractyes

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