A systematic review and meta-analysis of hip preservation osteotomy in osteonecrosis of femoral head
Bibliographic record
Abstract
Background: Osteonecrosis of the femoral head occurs when there is insufficient vascularization of the femoral head, leading to bone cell death and potential bone collapse. Osteotomy is a hip preservation procedure often reserved for young patients. Necrotic lesion size and site are believed to be crucial factors in predicting the outcome of the procedure. Methods: The authors performed this systematic review in line with the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) 2020 statement. The review protocol had been registered on PROSPERO. A literature search was performed using electronic databases including studies published within the past 10 years. As our objective was to examine the correlation between preoperative necrotic size and osteotomy outcome, the authors focused on patients with early-stage osteonecrosis of the femoral head who underwent rotational or angular preservation osteotomy. The Newcastle–Ottawa Quality Assessment Scale was utilized to assess the included studies’ quality. Results: Of the 1217 articles initially identified, 18 met the inclusion criteria. Pooled data of 78 hips showed favorable outcomes in Kerboul Angle <200o group with an OR 0.06 (95% CI: 0.01–0.39). Meanwhile, pooled 276 hips were assessed using the JIC type yielded in an OR 0.55 (95% CI: 0.10–2.9), which showed better outcomes for hips with JIC types A, B, and C1. Conclusion: A consensus on eligibility based on necrosis quantification has not been reached when choosing an osteotomy procedure. The ability to predict osteotomy outcomes in patients diagnosed with JIC type A-C1 and a Kerboul angle <200° remains uncertain. It is important to note that prior recommendations to perform osteotomy based on these parameters may still hold relevance attributable to the low importance of the statistical data obtained.
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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 | 0.018 | 0.047 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.021 | 0.036 |
| Bibliometrics | 0.009 | 0.009 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 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".