Reduced periprosthetic fracture rate for a cemented anatomical versus a tapered polished stem in hip arthroplasty: A 6‐year follow‐up of a prospective observational cohort study
Bibliographic record
Abstract
Purpose: In older patients requiring a hip arthroplasty, the cemented straight collarless polished tapered stems (PTSs) have been linked to an increased risk of periprosthetic femur fractures (PFFs) when compared to anatomically shaped stems (ASs). This study aims to perform a 6-year follow-up of PFF rates and other adverse events of an orthopaedic department's full transition from a cemented PTS to a cemented AS. Methods: = 534). Outcomes included the PFF rate, periprosthetic joint infection (PJI) and prosthetic dislocation. A Cox proportional hazards model was used to estimate outcomes. Results: Most patients (77.2%, mean age 82 years) underwent surgery for a hip fracture. The 6-year PFF rate was 4.6% for the PTS group and 0.9% for the AS group. PFF patterns differed between groups, with Vancouver B fractures being more common in the PTS group. The AS group had lower rates of PJIs (3.6% vs. 1.7%) and dislocations (4.4% vs. 1.3%) than the PTS group. Conclusion: Transitioning from a PTS to an AS could reduce the PFF rate and other adverse events in hip arthroplasty. The findings are relevant for hospitals treating older and frail patients, as the mean age in this study was >80 years. Further research in different settings is warranted to confirm these results. Level of Evidence: Level II.
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 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 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".