Influence of head size and sex on the five-year survival of ceramic-on-ceramic hip resurfacing
Bibliographic record
Abstract
Aims: Ceramic-on-ceramic hip resurfacing (CoCHR) has been introduced to mitigate the risk of adverse tissue reactions associated with metal-on-metal hip resurfacing (MoMHR), particularly in females and smaller component sizes. This study evaluated: the survival of the ReCerf hybrid CoCHR up to five years; the impact of sex and component size on revision; and improvement in functional outcomes as measured by the Oxford Hip Score (OHS) and the University of California, Los Angeles Activity Scale (UCLA). Methods: An international retrospective study included 604 consecutive patients (336 males, 268 females; mean age 50.1 years (20 to 80)) who underwent CoCHR from September 2018 to January 2023. Kaplan-Meier analysis assessed up to five-year survival, with log-rank tests comparing outcomes by sex and femoral head size. Cox proportional hazards regression quantified revision risk. Results: Mean follow-up was 4.04 years (1.44 to 6.35). Survival in 128 hips which had five-year follow-up was 98.0% (95% CI 96.3 to 99.0): 97.6% for males (95% CI 94.7 to 98.9), 98.5% for females (95% CI 96.0 to 99.4), 98.5% for femoral head sizes < 50 mm (95% CI 96.1 to 99.4), and 97.5% for head sizes ≥ 50 mm (95% CI 94.6 to 98.8). Females had a revision hazard ratio (HR) of 0.79 (95% CI 0.14 to 4.26; p = 0.780) and an increase in head diameter by 1 mm of 1.01 (95% CI 0.83 to 1.23; p = 0.890), demonstrating no significant impact of sex or head size on revision incidence. Significant improvements in OHS and UCLA scores were observed for all patients (preoperative OHS 22.3 (SD 8.4) and postoperative OHS 45.0 (SD 4.1); preoperative UCLA 4.96 (SD 2.2) and postoperative UCLA 7.97 (SD 1.7)). Conclusion: CoCHR demonstrated excellent patient-reported outcome improvement and survival up to five years, irrespective of sex or implant size, comparing favourably to MoMHR. Longer-term follow-up is required to confirm these outcomes.
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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 | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 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 | 0.001 |
| 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 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".