Revision Arthroplasty in Vancouver B1 Periprosthetic Hip Fractures
Bibliographic record
Abstract
Introduction: Periprosthetic hip fractures (PHF) represent an important complication after hip arthroplasty. The management of Vancouver B1 fractures remains elusive. While most stems may present radiographically as stable, stem fixation may in fact be compromised. Choosing plate osteosynthesis as a treatment in this type of fractures, trusting radiographic studies alone may lead to implant failure. Methods: We reviewed 10 years of our institution ́s clinical records (20112021) and found a total of 161 PHF. Twenty five cases of B1 periprosthetic fractures were included in our study, after their presenting radiographs were blindly reviewed. All PHFs were submitted to arthrotomy, dislocation and stability assessment. Stable implants were submitted to plate osteosynthesis, and unstable implants were submitted to revision arthroplasty. Demographic information, duration of surgery, blood loss, inpatient complications, functional outcomes, and outpatient outcomes and complications were recorded. Mean time of followup was 47 months. Results: Seventytwo percent of of initially classified B1 type fractures presented with a loose stem and required revision arthroplasty. Time until supported ambulation was lower in the revision arthroplasty group (p= 0.01) while surgical time, blood loss after surgery, and inpatient complications presented similar results in both groups. Negative outpatient outcomes showed similar rates in both groups. Conclusion: Most radiographically wellfixed implants were in fact unstable. Stability assessment using radiographic studies alone proves insufficient and may lead to inadequate osteosynthesis treatment. As such, inoperative stability testing in all B1 type fractures is paramount. Revision arthroplasty permitted early ambulation and showed no greater complications when comparing with osteosynthesis.
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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 | 0.003 |
| 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 | 0.001 |
| 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".