Capsular Repair Counteracts the Risk of Dislocation in Hemiarthroplasty Conversion to Total Hip Arthroplasty
Bibliographic record
Abstract
This study investigated whether decreasing the femoral head size, in addition to performing a posterior capsular closure and short external rotator repair, influences the historical rate of dislocation after conversion of a failed hemiarthroplasty (HA) to a total hip arthroplasty (THA) through a posterior approach. We reviewed 15 patients from our prospective arthroplasty database who underwent a conversion from an HA to a THA with closure of the posterior capsule, had downsizing of the femoral head, and had at least a 2-year follow-up. Patients were clinically observed to determine whether their hip dislocated postoperatively or required re-revision. Radiographs were evaluated to assess for known risk factors for dislocation, including component position and restoration of hip biomechanics. The femoral head size was downsized from a mean of 45 mm (range, 42–57 mm) preoperatively to a mean of 32 mm (range, 28–36 mm) postoperatively ( P <.001). Femoral heads sized 36, 32, and 28 mm were used in the revision of 4, 5, and 6 hips, respectively. At the mean 84-month follow-up (range, 24–156 months), there were no dislocations. Attention to surgical technique and closing the posterior capsule can decrease the historically high dislocation rate associated with converting an HA to a total hip replacement using the posterolateral approach. Despite substantial reduction in size of the prosthetic femoral head, there were no postoperative dislocations with closure of the posterior capsule. Downsizing the femoral head during revision THA should be avoided; however, if not feasible, closure of the posterior capsule can offset the otherwise increased risk of dislocation. [ Orthopedics . 2023;46(3):175–179.]
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| 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 | 0.001 |
| 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 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".