Efficacy of two bone grafting methods for Vancouver B3 type PFFs in uncemented stems: a retrospective study of functional and radiological outcomes from 2000 to 2017
Bibliographic record
Abstract
Abstract Background Peripheral femoral fractures (PFFs) are a devastating complication after total hip arthroplasty (THA). The accepted treatment for the Vancouver B3 fracture is revision surgery. However, there is still no consensus on which bone grafting technique to treat the bone defect around the femoral prosthesis in revision surgery. Therefore, we designed a retrospective study to evaluate the efficacy of ICA (impacted cancellous allograft) and ICA+CSA (cortical strut allograft) in B3-type PFFs revision surgery using uncemented stems. Methods We retrospectively assessed 47 Vancouver-type B3 PFFs in 47patients who have been treated between 2000 and 2017. All patients underwent intraoperative bone grafting.18 patients treated with ICA and 29 patients treated with ICA+CSA. Functional outcomes were assessed using Harris hip score, SF-36 scores and complications. Radiological findings were classified using Engh standard. Kaplan–Meier survival curve was used to assess patient and implant survival. Results There were 18 males and 29 females with an average age of 62.5 ± 9.9 years. The average follow-up time was 63.5 months. 90.7% of patients achieved fracture healing and 17.0% received secondary revision surgery. The overall 5-year Kaplan–Meier survival rate for the patients was 64.7% (95% CI, 50.6-78.8), and the 10-year rate was 47.4% (95% CI, 30.4–64.5). The last evaluated mean SF-36 was 46.1; Harris hip scores were 44.6 (3 months), 61.7 (12 months); respectively. Conclusions The use of ICA and ICA+CSA to reconstruct bone stock can provide stable prosthesis support and satisfactory fracture healing rate.
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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 | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 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".