Periprosthetic Femur Fractures Managed by Revision Arthroplasty
Bibliographic record
Abstract
Background Periprosthetic femoral fractures (PFFs) are a growing indication for revision total hip arthroplasty (THA), particularly in elderly patients with complex comorbidities. Surgical management is challenging, with significant morbidity and mortality. This study evaluates outcomes following revision arthroplasty for PFFs at a tertiary trauma centre in the United Kingdom . Methods A retrospective review was conducted of 24 patients who underwent revision arthroplasty for PFFs between February 2021 and January 2022. Data collected included patient demographics, fracture classification, implant history, surgical details, and complications. Follow-up data were extracted from electronic health records up to February 2025. The primary outcome was the need for further revision; secondary outcomes included mortality and postoperative complications. Results The cohort had a mean age of 78.3 years (IQR: 16), with most injuries resulting from low-energy trauma. Vancouver B-type fractures were the most common, and three patients sustained interprosthetic fractures. Surgical strategies included modular fluted stems (n=13), femoral replacement prostheses (n=7), and cemented stems (n=4). Complications included one infection managed with suppressive antibiotics, two recurrent dislocations, and two cases of leg length discrepancy. One patient required further revision for instability. Twelve patients died during follow-up: two within 30 days, three within one year, and seven after one year. Thirteen patients were followed remotely due to frailty or relocation. Conclusion Revision arthroplasty for PFFs involves technically demanding procedures with significant risks. Despite the complexity, outcomes were in line with published data. Multidisciplinary care, timely surgical intervention, and individualised implant selection remain critical to optimise outcomes in this high-risk population.
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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 | 0.000 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 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".