Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
Swedish Hip Arthroplasty Register, Gothenburg, Sweden
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Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
Swedish Hip Arthroplasty Register, Gothenburg, Sweden
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Swedish Hip Arthroplasty Register, Gothenburg, Sweden
Department of Orthopaedics, Prince Philip Hospital, HDUHB, Wales
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Finnish Arthroplasty Register, Helsinki, Finland
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Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
Swedish Hip Arthroplasty Register, Gothenburg, Sweden
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Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
Swedish Hip Arthroplasty Register, Gothenburg, Sweden
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Introduction Total hip arthroplasty (THA) currently comprises a variety of head sizes and bearing types. The size of femoral head used in THA gradually increased from 22 mm in the 1960s to 28 mm in the 1990s, and thereafter to 32 mm in the mid
Region Västra Götaland, Sahlgrenska University Hospital, Department of Orthopaedics, Gothenburg, Sweden
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Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark
Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
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Region Västra Götaland, Sahlgrenska University Hospital, Department of Orthopaedics, Gothenburg, Sweden
The Swedish Hip Arthroplasty Register, Gothenburg, Sweden
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standard in many countries. 4 Introduction of metal-on-metal articulations, ceramic-on-ceramic and, above all later on, highly cross-linked polyethylene opened the possibility for the use of bigger head sizes, but recent studies have suggested limited
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of the cup. Bearing surfaces and femoral head size selection THA bearing surfaces are susceptible to edge loading, and an abnormal hip–spine relationship increases its occurrence significantly. Posterior edge loading can occur during hip
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system provides a greater effective head size and improved head-to-neck ratio ( Fig. 5 ). Dual mobility is therefore expected to improve the ROM to impingement and joint stability. Laboratory studies have confirmed this assumption and have emphasised the
Division of Orthopaedics and Trauma Surgery, Cantonal Hospital Winterthur, Winterthur, Switzerland
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Faculty of Medicine, University of Berne, Berne, Switzerland
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stainless steel due to wear issues and finally in 1974 by aluminium oxide ceramic heads ( 17 , 19 ). Nevertheless, no long-term advantages could be shown regarding the rotating neck ( 20 ). However, as the head sizes of 32 mm were innovative at that time
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. Evaluating surgical and implant-related factors, cemented, cementless, hybrid fixation and head size proved not to be risk factors (due to confounding factors). For healthcare factors, low volume hospitals and low volume surgeons were risk factors for
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polyethylene (PE), metal-on-metal (MoM) hard-on-hard articulations started to become popular to enable larger head sizes. Opposite to PE bearings, the amount of wear in MoM bearings decreases with head size – as long as they are lubricated properly. This was
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al. ( 49 ) reported a survival rate of 97% in males and 80% in females at 10 years. The majority of failures had a head size of 46 mm or less (64%), but this was not found to be statistically significant. Samuel et al. ( 38 ) also reported that
IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
Fondazione Livio Sciutto Onlus, Campus Savona – Università degli Studi di Genova, Savona, Italy
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Department of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands
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Fondazione Livio Sciutto Onlus, Campus Savona – Università degli Studi di Genova, Savona, Italy
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for special cases such as metal-on-metal (MoM) THA or small head size ( 5 , 12 , 13 ). Concerning the quality of evidence behind them, these guidelines were not evidence based but drafted from expert consensus. Therefore, the level of recommendation
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Department of Biomechanical Engineering, University of Twente, Enschede, The Netherlands
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Dept. of Orthopaedics, Radboud University Medical Center, Nijmegen, The Netherlands
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Dept. of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands
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opportunity for researchers to assess how implant characteristics like type of articulation, femoral head size, stem shape or stem surface affect prosthesis survival. Prostheses can be grouped according to a specific generic characteristic present in several