Periprosthetic fractures of the proximal femur within first year of the index hip prosthesis.
Bibliographic record
Abstract
INTRODUCTION: Periprosthetic fractures are a serious complication of implants prosthetic. The aim of this review is to analyze incidence and predisposing factors of periprosthetic fractures of the proximal femur within first year of the index hip prosthesis. MATERIALS AND METHODS: Between 1998 and 2017 we have performed 4240 hip replacements (F 2661, M 1579): 2877 total hip arthroplasties (67,9%) and 1363 hemiartrhoplasties (32,1%). Hip replacements with cemented stem were 2173 (51,2%), while cementless ones were 2067 (48,8%). In the same period we admitted 121 hip periprosthetic fractures, 26 of which (0,6%) within the first year of the index surgery. We examined the medical and radiographic records of this last cohort of patients (F 19, M 7) following the Vancouver System, Dorr Classification and Stem Size Index. RESULTS: The cause was a low-energy trauma in 25 cases (96.1%); the primary diagnosis was hip fracture in 20 patients (76.9%); 8 patients were taking chronic osteoporosis medication (30.7%); 14 patients were affected by neuropsychiatric disease (53.8%); cementless stems were found in 18 cases, 12 of which were oversized (SSI < 0,8). According to Vancouver System, fractures were classified as follows: 10 type B1, 14 type B2 and 2 type C. As far as the proximal femoral shape, 2 cases were Dorr type A, 7 Dorr type B and 17 Dorr type C. CONCLUSIONS: The incidence of periprosthetic fractures in the aftermath of stem implant is twice as high with uncemented stems. The Vancouver type B1/B2 is the most common. Predisposing factors are: female sex, hip fracture, chronic osteoporosis medication, neuropsychiatric disease and oversized uncemented stem (SSI < 0.8).The evidence level is IV.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| 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) | 0.001 | 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 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".