THREE HUNDRED AND TWENTY-ONE PERIPROSTHETIC FEMORAL FRACTURES
Bibliographic record
Abstract
Background: The purpose of this study was to determine the demographics, incidence, and results of treatment of periprosthetic fractures in a nationwide observational study. Methods: In the years 1999 and 2000, 321 periprosthetic fractures were reported to the Swedish National Hip Arthroplasty Register. All of the associated hospital records were collected. At the time of follow-up, the Harris hip score, a health-related quality-of-life measure (the EuroQol-5D [EQ-5D] index), and patient satisfaction were used as outcome measurements. A radiologist performed the radiographic evaluation. Results: Ninety-one patients, with a mean age of 73.8 years, sustained a fracture after one or several revision procedures, and 230 patients, with a mean age of 77.9 years, sustained a fracture after a primary total hip replacement. Minor trauma, including a fall to the floor, and a spontaneous fracture were the main etiologies for the injuries. A high number of patients had a loose stem at the time of the fracture (66% in the primary replacement group and 51% in the revision group). Eighty-eight percent of the fractures were classified as Vancouver type B; however, there was difficulty with preoperative categorization of the fractures radiographically. There was a high failure rate resulting in a low short to mid-term prosthetic survival rate. The sixty-six-month survival rate for the entire fracture group, with reoperation as the end point, was 74.8% ± 5.0%. One factor associated with fracture risk was implant design. Conclusions: On the basis of these findings, we believe that high-risk patients should have routine radiographic follow-up. Such a routine could identify a loose implant and make intervention possible before a fracture occurred. Furthermore, we recommend an exploration of the joint to test the stability of the implant in patients with a Vancouver type-B fracture in which the stability of the stem is uncertain. Level of Evidence: Prognostic Level II. See Instructions to Authors for a complete description of levels of evidence.
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How this classification was reachedexpand
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 | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 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 | 0.000 |
| 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 itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, 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".