Extended Ischiopubic Fixation Using Porous Metal Augments In Cementless Acetabular Reconstruction During Revision Total Hip Arthroplasty
Bibliographic record
Abstract
Abstract Background: As opposed to rim fixation, 3-point fixation provides sufficient primary stability for cememless cups in the presence of massive bony deficiency. While several methods, including doming augments or flying buttress augments, have been introduced to reconstruct superior supportive points, good methods to establish supportive ischiopubic points are currently lacking. The aims of this study were to introduce the definition, indication and surgical technique of extended ischiopubic fixation (EIF) and to investigate the early clinical and radiographic results and complications of hips revised with EIF.Methods: Patients who underwent revision THA utilizing the technique of EIF with porous metal augments secured in the ischium and/or pubis in a single institution from February 2015 to February 2020 were retrospectively reviewed. 25 patients were included based on the criteria of minimum 2-year follow-up. The median duration of follow-up was 48.06 months (interquartile range: 41.37-62.20 months). The patients’ clinical results were assessed using of the Harris Hip Score and Western Ontario and McMaster Universities Osteoarthritis index and any complications including infection, intraoperative fracture, dislocation, postoperative nerve palsy, hematoma, wound complication and/or any subsequent reoperation(s) were documented. The radiographic results were assessed with the construct stability, the position of the center of rotation and cup orientoration. Results: At the most recent follow-up, 20 (80%) patients rated their satisfaction level as “very satisfied”, 5 (20%) were “satisfied”. The median HHS score improved from 36.00 preoperatively to 81.00 (p＜0.001) while the median WOMAC index score decreased from 74.50 preoperatively to 16.50 at the latest follow-up (p＜0.001). No intraoperative or postoperative complications were identified. All constructs were considered to have obtained stable fixation. The median vertical and horizontal distance between the latest postoperative center of rotation to the anatomic center of rotation improved from 13.62 mm and 8.68 mm preoperatively to 4.42 mm and 4.19 mm, at final follow-up (p<0.001), respectively.Conclusions: Early follow-up of patients reconstructed with porous metal augments using the EIF technique demonstrated satisfactory clinical results with no particular complications, stable fixation and restoration of the center of rotation.
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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 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 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".