Periprosthetic femoral fractures in minimally-invasive anterolateral short stem versus transgluteal straight stem cementless total hip arthroplasty: What are the differences in the femoral and pelvic morphology?
Bibliographic record
Abstract
BACKGROUND: The occurrence of periprosthetic femoral fractures (PFFs) in cementless total hip arthroplasty (THA) might be associated with the proximal femoral morphology and the pelvis. PFFs in short stem THA are associated with an increased Canal Flare Index. PFFs in straight stem THA show a decreased Canal Flare Index. Therefore, this study aims to compare the femoral and pelvic geometry in PFFs between short stem and straight stem THA. METHODS: A retrospective comparative propensity-score matched study was performed. An institutional database of 5358 THAs was screened for early PFFs within the first 90 days after surgery. All cases of 136 PFFs in primary cementless THA were collected and matched, resulting in 67 PFFs in the straight stem and 37 PFFs in the short stem group. Both groups were analyzed regarding several parameters for femoral and pelvic morphology. RESULTS: A significantly lower distance from the anterior superior iliac spine to the greater trochanter (AGT) was detected in the straight stem group (96.4 vs. 104.8 mm, p = 0.024). All other femoral and pelvic parameters did not differ between both groups. Postoperative Vancouver A PFFs were significantly higher in straight stem THA, while postoperative Vancouver B PFFs were significantly higher in short stem THA. CONCLUSION: The morphology of the proximal femur and the pelvis do not differ in several radiological parameters in patients sustaining a PFF between cementless short stem implanted via an anterolateral approach and straight stem THA implanted via a transgluteal approach. While there are differences in the Vancouver types of PFFs, these differences do not reflect any difference in the morphology of the proximal femur and the pelvis.
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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 | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 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) | 0.001 | 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".