Implant Survival of an Uncemented Modular Femoral Implant in Patients With Severe Femoral Bone Loss and 2‐Stage Hip Revision
Why this work is in the frame
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Bibliographic record
Abstract
Background and Purpose: Revision total hip arthroplasty (rTHA) is a challenging procedure especially in the presence of severe bone loss where implant fixation is compromised. The aim of this study was to evaluate implant survival, clinical outcome, and midterm results in a group of complex patients after femoral revision using an uncemented modular implant design. Patients and Methods: We performed a retrospective study including 100 patients (101 hips) treated with revision THA using an uncemented modular implant design. We identified 51 hips as Paprosky types I‐II and 50 hips as Paprosky III‐IV bone defects. We reviewed operative reports and radiographs. Patients underwent a clinical examination to assess the Harris Hip Score (HHS) and completed patient‐reported outcome measures (PROM), including the Oxford Hip Score (OHS) and the EQ‐5D Visual Analog Scale (VAS). Minimum follow‐up was 2 years (average, 5.8 years; range, 2.0–9.4 years). Results: Among the cases, 46 hips were revised for infection in a 2‐stage procedure and 44 hips for aseptic loosening. 11 hips had periprosthetic fractures of Vancouver type B2 or B3. A total of 5 hips required revision with removal of the femoral implant and 11 patients experienced complications resulting in fracture ( n = 1), dislocation ( n = 10), and soft tissue revision ( n = 1). The 5‐year implant survival estimated by Kaplan–Meier survival analysis was 95% (95%‐CI: 91%–99%). All hips had radiographic evidence of osseointegration and no one with subsidence greater than 5 mm. Additionally, 80% showed radiographic evidence of restoration of proximal femoral bone. Mean HHS was 78. Conclusion: In complex cases of revision THA, using a modular revision femoral system yielded promising results. The 5‐year implant survival estimated by Kaplan–Meier survival analysis was 95% (95%‐CI: 91%–99%), with all hips demonstrating radiographic evidence of osseointegration and no one with subsidence greater than 5 mm. Notably 80% showed radiographic evidence of restoration of proximal femoral bone.
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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 | 0.000 | 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 | 0.001 |
| 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 it