EP149 Hip mosaicplasty provides good-to-excellent clinical scores at 10 years in patients with small femoral osteochondral lesions
Bibliographic record
Abstract
Abstract Purpose To report on the outcomes at ≥7 years of patients with osteochondral lesions of the femoral head that underwent hip mosaicplasty. Methods A consecutive series of patients that received hip mosaicplasty through minimally invasive direct anterior approach was identified. The cohort comprised 17 men and 7 women (24 hips) aged 28.7±7.4 years with body mass index of 23.3±2.8kg/m2. At a follow-up of ≥7years, an independent clinician noted complications and reoperations, and assessed the modified Harris hip score (mHHS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Descriptive statistics were used to summarise the data. Two subgroup analyses were performed: (i) lesion size <2cm2 versus lesion size ≥2cm2, and (ii) conversion to THA versus no THA conversion. Results Three patients were lost to follow-up and 6 patients (25%) were converted to THA at 5.1±3.5 years (range, 2–12). At a follow-up of 9.5±1.9 years (range, 7–14), the remaining 15 patients reported mHHS of 87.2±10.1 and WOMAC of 84.1±12.3. Compared to patients with lesion size <2cm2, patients with lesion size ≥2cm2 tended to have greater proportion of THA conversion (57% vs 12%), lower postoperative mHHS (78.5±14.9 vs 89.4±8.0), and lower postoperative WOMAC (57.9±11.5 vs 41.2±16.9). Compared to patients that did not require THA conversion, patients that required THA tended to have greater proportion of women (50% vs 22%), greater proportion of femoroacetabular impingement (67% vs 39%), and greater lesion size (2.3±0.9cm2 vs 1.4±0.5cm2). Conclusions Hip mosaicplasty at the femoral head using osteochondral autografts from the ipsilateral head provides good-to-excellent clinical scores at a mean follow-up of 10 years, although 25% of patients required THA at 5.1±3.5 years after mosaicplasty. Interestingly, greater lesion size seemed to be associated with worse postoperative outcomes and greater rates of conversion to THA, suggesting that mosaicplasty may not be effective for lesions ≥2cm2.
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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 | 0.000 |
| Bibliometrics | 0.001 | 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".