Bibliographic record
Abstract
It is now well recognised that adverse local tissue reaction (so called pseudotumor or ALTR) may follow the use of metal-on-metal arthroplasty, the source of the metal being the primary bearing surface (the articulation itself) or a modular junction within the construct, such as the trunnion. This is more likely seen if a large femoral head has been used. We are aware of this risk and have implemented surveillance systems worldwide to facilitate its early diagnosis and prompt management. Less well known, and silent in its initial development, is adverse local reaction following metal-on-polyethylene hip replacement. Initially the problem is unknown to the patient and the surgeon. Typically there follows unexplained pain (due to synovitis), loss of motion, sometimes the development of a mass, followed by increasing dysfunction as the inflammatory, destructive process invades the surrounding soft tissues. Radiographic features are late to follow (focal osteolysis), unless cross-sectional imaging is considered (ultrasound and/or metal suppressed MRI) early in the process. Serum metal ions are an important adjunct in its diagnosis, and it is now acknowledged that the previously used level of 7 ppb is much higher than that required to recognise the entity. Typically there is a reverse of the usual CrCo ratio, and a recent study has suggested that a raised serum Co alone is adequate to assist in the diagnosis Four important lessons have been learned at our center in recent years and will be demonstrated in this case-based presentation designed for surgeons in practice. It is hoped that the cases and supportive literature will prove useful in advancing the early diagnosis of this troublesome and often silent condition.
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 | 0.002 | 0.010 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.005 | 0.012 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.010 | 0.014 |
| Insufficient payload (model declined to judge) | 0.016 | 0.010 |
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".