Hip Replacement or Hip Resurfacing with a Highly Cross-Linked Polyethylene Acetabular Bearing
Bibliographic record
Abstract
BACKGROUND: Most surgeons strongly prefer total hip arthroplasty (THA) over hip resurfacing arthroplasty (HRA). However, it is unknown whether patients prefer the results of 1 procedure over the other. The purpose of this study was to answer 3 questions: (1) Do patients with an HRA on 1 side and a THA on the other notice a difference? (2) Do patients have a preference? (3) What are the reasons for their preference? METHODS: Between 1998 and 2012, 332 patients underwent staged bilateral hip arthroplasties with cementless THA on 1 side and HRA on the other, with a highly cross-linked polyethylene acetabular component used for both. Patient preferences, Harris hip scores, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were recorded by blinded examiners. Patients provided reasons for their preference in semi-structured interviews using both quantitative and qualitative measures. RESULTS: The mean follow-up was 11 years (range, 7 to 21 years). Of 324 patients with complete data, 279 (86%) preferred the HRA, 19 (6%) preferred the THA, and 26 (8%) had no preference. The most common reasons for preference for the HRA were better balance (n = 143), felt more normal (n = 141), better activity participation/more reliable hip during sports (n = 139), and stronger on stairs (n = 129). A fair or poor outcome was reported by the patient after 4 HRAs and 7 THAs. The remainder of the patients reported improved function and satisfactory pain relief and range of motion for both hips. CONCLUSIONS: In conclusion, most patients in this study preferred the side on which the HRA had been done. Since essentially all current hip prostheses perform well, a paired bilateral study may be the optimal way to determine patient preferences and values of HRA compared with THA. LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 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) | 0.007 | 0.001 |
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".