Maximising stability after revision hip arthroplasty for vancouver B periprosthetic fractures
Bibliographic record
Abstract
Objectives: The risk of hip dislocation after revision total hip arthroplasty can be as high as 27% following surgery for periprosthetic fractures. A novel technique described by the senior authors in 2015, involving a transtrochanteric osteotomy and minimal superior capsulotomy, minimises this risk.Design: Prospective cohort study Setting: Sir Charles Gairdner Hospital, Hollywood Private HospitalPatients: Forty-two patients with Vancouver B type periprosthetic hip fractures, fixed using our superior capsulotomy technique. Intervention: The approach involves extending the fracture proximally to the tip of the greater trochanter, splitting the gluteal tendons and superior capsule in the same plane, in a titrated manner such that the head dislocates from the socket with a ‘pop’. The femoral component is revised and the cup and liner retained.Main Outcome Measurements: The primary outcome of interest was dislocation rate.Results: Patients averaged 80 years of age. Mean follow up was 31 months (range 12 months to 5 years). The primary finding was zero cases of hip joint dislocation. The average Oxford hip score was 31/48, the physical component and mental component Short Form 12 mean scores were 31.7 and 53.6 respectively at 1 year following revision. Functional scores did not significantly thereafter at 2 and 5 years. Mean subsidence at 1-year post operatively was 8.73mm. Two stems were revised.Conclusion: The outcomes of this operative technique in revision arthroplasty of Vancouver B periprosthetic hip fractures is promising, with no cases of hip dislocation, along with satisfactory patient clinical outcomes.Level of Evidence: Prospective Cohort Study, Level II.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot 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.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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 teacher head, 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".