Risk factors for periprosthetic femoral fractures around total hip arthroplasty: a systematic review and meta‐analysis
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
BACKGROUND: Periprosthetic fractures are becoming increasingly common, often leading to poor patient outcomes. The aim of this study was to identify risk factors associated with periprosthetic femoral fractures (PPFFx). METHODS: Two independent reviewers conducted a systematic review of the databases MEDLINE, Embase and Cochrane Library according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, from the earliest available date to December 2017. We included all clinical articles reporting more than 100 post-operative PPFFx around total hip arthroplasty (THA). Outcomes included demographics, fracture type, risk factors and time to fracture. RESULTS: A total of 12 868 PPFFx were reported across 18 eligible studies; 64% occurred following primary THA and 36% occurred after revision THA, and 66% of all fractures were in females. Vancouver B2 fractures were the most common type (39%). We found the odds of sustaining a PPFFx is significantly lower after a primary THA compared to revision THA (odds ratio 0.31, 95% confidence interval 0.24-0.40, P < 0.00001). The incidence of PPFFx is 2.96 per 1000 person-years following primary THA compared to 9.08 per 1000 person-years following revision THA (odds ratio 0.33, 95% confidence interval 0.27-0.40). The time to fracture was 6.03 years following primary THA and 4.08 years following revision THA. Gender and cementation did not significantly affect the odds of fracture. CONCLUSION: The odds of sustaining a PPFFx following revision THA is three times greater compared to primary THA. Other risk factors including gender and cementation did not affect the odds of fracture.
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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 | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.016 | 0.008 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 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 it