Evidence map›Paper›PMID 34636979›Full record

ArticleArchives of orthopaedic and trauma surgery2023

Femoral defects in revision hip arthroplasty: a therapy-oriented classification.

Max Jaenisch, Hendrik Kohlhof, Adnan Kasapovic, Martin Gathen, Thomas Martin Randau, Koroush Kabir, Philip Peter Roessler, Geert Pagenstert, Dieter Christian Wirtz

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Archives of orthopaedic and trauma surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
  4. Handmade spacers for two-stage exchange at the hip.Operative Orthopadie und Traumatologie · 2023
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Max Jaenisch *Department of Orthopedics and Trauma Surgery, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany. max.jaenisch@ukbonn.de.ORCID http://orcid.org/0000-0001-5998-0224
Hendrik Kohlhof *Department of Orthopedics and Trauma Surgery, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany.
Adnan KasapovicDepartment of Orthopedics and Trauma Surgery, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany.
Martin GathenDepartment of Orthopedics and Trauma Surgery, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany.
Thomas Martin RandauDepartment of Orthopedics and Trauma Surgery, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany.
Koroush KabirDepartment of Orthopedics and Trauma Surgery, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany.
Philip Peter RoesslerDepartment of Orthopedics and Trauma Surgery, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany.
Geert PagenstertCLARAHOF Clinic of Orthopaedic Surgery, University of Basel, Clarahofweg 19a, 4058, Basel, Switzerland.
Dieter Christian WirtzDepartment of Orthopedics and Trauma Surgery, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe complex field of femoral defects in revision hip arthroplasty displays a lack of standardized, intuitive pre- and intraoperative assessment. To address this issue, the femoral defect classification (FDC) is introduced to offer a reliable, reproducible and an intuitive classification system with a clear therapeutic guideline. MATERIALS AND

methodsThe FDC is based on the integrity of the main femoral segments which determine function and structural support. It focuses on the femoral neck, the metaphysis consisting of the greater and lesser trochanter, and the femoral diaphysis. The four main categories determine the location of the defect while subcategories a, b and c are being used to classify the extent of damage in each location. In total, 218 preoperative radiographs were retrospectively graded according to FDC and compared to intraoperatively encountered bone defects. To account for inter-rater and intra-rater agreement, 5 different observers evaluated 80 randomized cases at different points in time.

resultsA Cohens kappa of 0.832 ± 0.028 could be evaluated, accounting for excellent agreement between preoperative radiographs and intraoperative findings. To account for inter-rater reliability, 80 patients have been evaluated by 5 different observers. Testing for inter-rater reliability, a Fleiss Kappa of 0.688 could be evaluated falling into the good agreement range. When testing for intra-rater reliability, Cohens Kappa of each of the 5 raters has been analyzed and the mean was evaluated at 0.856 accounting for excellent agreement.

conclusionThe FDC is a reliable and reproducible classification system. It combines intuitive use and structured design and allows for consistent preoperative planning and intraoperative guidance. A therapeutic algorithm has been created according to current literature and expert opinion. Due to the combination of the FDC with the recently introduced Acetabular Defect Classification (ADC) a structured approach to the entire field of hip revision arthroplasty is now available.

Indexed as

Arthroplasty, Replacement, HipHip ProsthesisFemurHumansRadiographyReoperationReproducibility of ResultsRetrospective StudiesArthroplastyBone defectFemoralHipRevision

Identifiers

PMID34636979
PMCPMC9957875

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.