Differences in Perioperative Outcomes Between Conversion Total Hip Arthroplasty After Previous Proximal Femur Fracture and Primary Total Hip Arthroplasty
Bibliographic record
Abstract
Background This study compares outcomes between conversion total hip arthroplasty (THA) after proximal femur fracture (PFF) fixation and primary THA for osteoarthritis and examines whether fracture type affects results. Methods This is a retrospective review of prospectively collected data from a single academic center. Eighty-seven consecutive patients underwent conversion THA following surgical fixation of a PFF with a minimum 2-year follow-up. These patients were matched 1:1 with patients who underwent a primary THA for osteoarthritis, by the same arthroplasty surgeons, using propensity score technique. Outcomes measures included length of stay, complications, reoperation rates, and Oxford Hip Score (OHS). Subgroup analysis involved comparing outcome measures between patients who required conversion THA following an intracapsular and extracapsular PFF. Results The mean follow-up was 5.6 years (range, 2.3-13.1). Patients in the conversion THA group required longer length of stay (8.1 vs 1.4 days, P < .001). There was no difference in complication rate (12.6% vs 16.1%, P = .491), reoperative rate (12.6% vs 5.7%, P = .243), or OHS (40.1 vs 37.2; P = .052) at final follow-up. There was no difference in outcomes between controls and conversion THA for a previous intracapsular PFF. Reoperation rate was significantly higher (18.2% vs 5.7%, P = .039) and OHS significantly lower (32.3 vs 40.0, P < .001) for conversion THA following extracapsular PFF. Conclusions Conversion THA after extracapsular PPF is associated with higher reoperation rates and poorer functional outcomes than primary THA for osteoarthritis. In contract, intracapsular PPF show comparable results, underscoring the need to consider fracture type in treatment planning.
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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 | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| 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 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".