Predictors of immobility following surgery for periprosthetic hip fractures
Bibliographic record
Abstract
BACKGROUND: Periprosthetic femoral fractures (PPF) following total hip arthroplasty (THA) are a growing clinical challenge, particularly in the elderly. Postoperative mobility is a key determinant of outcome, yet little is known about how surgical treatment and weight-bearing protocols influence functional recovery in this population. METHODS: We conducted a retrospective cohort study of 186 patients aged ≥ 65 years treated surgically for Vancouver type B or C PPF between January 2017 and August 2023 at a level 1 trauma center. Patients underwent either open reduction and internal fixation (ORIF) or revision arthroplasty. Postoperative weight-bearing protocols were categorized as full weight bearing (FWB) or partial weight bearing (PWB). The primary outcome was mobility status at hospital discharge. Binary logistic regression was used to identify independent risk factors for immobility. RESULTS: Of the 186 patients included (mean age 82.4 ± 7.4 years), 64.5% were mobilized with FWB. In the ORIF group, patients allowed FWB were significantly older (85.5 ± 7.4 vs. 80.2 ± 6.3 years, p < 0.001). No significant differences in mobility, complication rates, revision surgery, or in-hospital mortality were observed between weight-bearing regimens, regardless of the type of surgery. Logistic regression identified intraoperative blood transfusion (OR = 3.17) and higher ASA scores (ASA III: OR = 9.10; ASA IV: OR = 32.03) as independent predictors of postoperative immobility. Neither the postoperative weight-bearing protocol nor the surgical procedure had a significant impact on mobility outcomes. CONCLUSION: This study examines postoperative weight-bearing strategies on clinical outcomes in patients with periprosthetic hip fractures and simultaneously identifies independent risk factors associated with postoperative immobility. Our findings suggest that mobility outcomes are more influenced by patient-related factors than by surgical procedure. Our findings support the safe implementation of full weight-bearing protocols in elderly patients following periprosthetic femoral fractures, regardless of the type of surgical intervention.
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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 | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| 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 | 0.000 |
| 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".