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soft tissue reactions and hypersensitivity to metal-on-metal bearings, such bearings are best avoided. 4 Possibly related to their favourable wear properties, ceramic bearings present an excellent choice for selected patients in future. However
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might partially be explained by further improvements during the last decades, e.g. standardized and optimized surgery techniques, which have become widely performed ( 28 ). Improved materials, such as new generation ceramic bearings and highly
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normally functioning Oxford UKA (Phase-1 and 2) bearings demonstrated a mean wear of 0.01 mm/year. 85 , 86 Such a low rate will not cause in vivo penetration or alter alignment (±1° degree varus per 1 mm wear). 85 However, several factors can accelerate
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size, bearings materials), and proper reconstruction of hip rotation centre are equally important. 63 – 67 All these issues can affect both clinical outcomes and complication rates in THA. The kinematic alignment technique for THA aims to restore
Department of Orthopaedic Surgery, Vejle Hospital, Vejle, Denmark
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Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Lund University, Skåne University Hospital, Department of Orthopedics, Malmö, Sweden
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Department of Clinical Medicine, University of Bergen, Bergen, Norway
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Department of Clinical Medicine, University of Bergen, Bergen, Norway
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Department of Orthopaedics and Traumatology, Turku University Hospital, Turku, Finland
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Department of Surgery, Epworth HealthCare, University of Melbourne, Melbourne, Australia
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Centre for Hip Surgery, Wrightington Hospital, Wrightington, Wigan and Leigh NHS Trust, Lancashire, United Kingdom
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Orthopaedic Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark
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not prevent the problems with MoM bearings but it did identify the failure at an early stage and reported this to the Medicines and Healthcare Products Regulatory Agency. This resulted in regulatory action and a significant change in practice. It was
Department of Microbial Diseases, UCL Eastman Dental Institute, University College London, London, UK
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MSK Lab, Imperial College London, London, UK
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implant materials demonstrating reduced bacterial adhesion and slower biofilm development. 42 Clinically there has been evidence of an anti-infective effect of ceramic bearings compared to polyethylene; in an infected total hip arthroplasty retrieval
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loosening? According to the recommendations provided by the multidisciplinary consensus statement on the use and monitoring of metal-on-metal (MoM) bearings for THA and hip resurfacing, radiographs should be performed in all patients during follow
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been treated very successfully with total hip replacement surgery. In 2005, a new design was introduced in which metal bearings were used with the claim that they would improve the life span of the implant and that, because of the size of the bearings
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-on-ceramic ( 5 ) bearings; (iv) fatigue fracture of highly cross-linked polyethylene ( 6 ); (v) squeaking of ceramic-on-ceramic bearings ( 7 ) and ceramic fracture ( 8 ); (vi) worse patient-reported outcomes ( 9 ); (vii) iliopsoas tendinitis ( 10 ); (viii) leg
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-on-metal bearings, compared to those with metal-on-plastic articulations, there was no difference in the prevalence of metal hypersensitivity between the two groups 25 with Hjorth et al reporting no association between the formation of pseudotumours and serum metal
