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Georgios Tsikandylakis Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
Region Västra Götaland, Sahlgrenska University Hospital, Department of Orthopaedics, Gothenburg, Sweden

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Soren Overgaard The Danish Hip Arthroplasty Register, Aarhus, Denmark
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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Luigi Zagra Hip Department, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy

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Johan Kärrholm Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
Region Västra Götaland, Sahlgrenska University Hospital, Department of Orthopaedics, Gothenburg, Sweden
The Swedish Hip Arthroplasty Register, Gothenburg, Sweden

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a CoC articulation. None of the hips developed osteolysis. Lee et al followed 72 patients (86 THAs) with contemporary delta ceramic bearings for a minimum of five years in patients younger than 30 years. 52 Eight hips exhibited squeaking or

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Dongmei Wu School of Medicine, University of St. Andrews, St. Andrews, Fife, United Kingdom

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Rohan M Bhalekar ExplantLab, The Biosphere, Newcastle Helix, Newcastle-upon-Tyne, United Kingdom

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Jordan S Marsh School of Medicine, University of St. Andrews, St. Andrews, Fife, United Kingdom

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David J Langton ExplantLab, The Biosphere, Newcastle Helix, Newcastle-upon-Tyne, United Kingdom

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Alan J Stewart School of Medicine, University of St. Andrews, St. Andrews, Fife, United Kingdom

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, approximately 35% of hip arthroplasty (HA) procedures involved MoM implants, and over 1 million MoM HAs have been performed worldwide so far ( 2 , 3 ). However, the usage of CoCr alloys in MoM bearings is related to the initiation of a series of complications

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Luigi Zagra Hip Department, IRCCS Istituto Ortopedico Galeazzi, Italy

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Enrico Gallazzi Hip Department, IRCCS Istituto Ortopedico Galeazzi, Italy

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.5% for THA performed. 6 While THA is a successful procedure in most cases, failures are still recorded. Overall, excluding metal-on-metal (MoM) bearings from the analysis, failures due to articulating materials represent around 5% of the total

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Philippe Hernigou Hôpital Henri Mondor, University of Paris-Est, France

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François Roubineau Hôpital Henri Mondor, University of Paris-Est, France

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Charlie Bouthors Hôpital Henri Mondor, University of Paris-Est, France

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Charles-Henri Flouzat-Lachaniette Hôpital Henri Mondor, University of Paris-Est, France

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superior wettability and hydrophilic surfaces aid in lubrication. Furthermore, the most recent studies have demonstrated new long-term advantages with current ceramic-bearing couples. However, the most important current concerns about CoC bearings are

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Luigi Zagra Hip Department, IRCCS Istituto Ortopedico Galeazzi, Milan Italy

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various hip implant bearings. 26 RCTs show similar short- to mid-term survivorship among ceramic-on-ceramic (CoC), ceramic-on-highly cross-linked polyethylene (XPE) and metal-on-XPE in patients younger than 65 years. 27 Standard polyethylene (PE

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Carsten Perka Center for Musculoskeletal Surgery, Charité Medical University Center, Berlin, Germany

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Maziar Mohaddes Hässleholms Hospital, Region Skåne, Hässleholm, Sweden
Orthopedics, Faculty of Medicine, Department of Clinical Sciences, Lund University, Malmö, Sweden

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Luigi Zagra Hip Department, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy

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Axel Ekkernkamp BG Klinikum Unfallkrankenhaus Berlin gGmbH, Berlin, Germany
BG Kliniken – Klinikverbund der gesetzlichen Unfallversicherung gGmbH, Berlin, Germany

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Niklas Keller Harding Center for Risk Literacy, University of Potsdam, Faculty of Health Sciences, Potsdam, Germany

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Dirk Stengel BG Kliniken – Klinikverbund der gesetzlichen Unfallversicherung gGmbH, Berlin, Germany

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)), less than 35 000 patients were enrolled in RCTs between 2000 and 2020 to study new developments or modifications like cementless fixation, short stems, novel bearings, etc., in a causal fashion ( 16 , 17 ). In such a situation, it is inevitable to

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Georgios Tsikandylakis Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden
Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
Swedish Hip Arthroplasty Register, Gothenburg, Sweden

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Maziar Mohaddes Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden
Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
Swedish Hip Arthroplasty Register, Gothenburg, Sweden

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Peter Cnudde Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
Swedish Hip Arthroplasty Register, Gothenburg, Sweden
Department of Orthopaedics, Prince Philip Hospital, HDUHB, Wales

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Antti Eskelinen Coxa Hospital for Joint Replacement, Tampere, Finland
Finnish Arthroplasty Register, Helsinki, Finland

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Johan Kärrholm Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden
Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
Swedish Hip Arthroplasty Register, Gothenburg, Sweden

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Ola Rolfson Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden
Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
Swedish Hip Arthroplasty Register, Gothenburg, Sweden

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review, the use of 28 mm or greater head diameter in THA with metal-on-XLPE (MoXLPE), ceramic-on-XLPE (CoXLPE) and ceramic-on-ceramic (CoC) bearings is analyzed with respect to range of movement, dislocation, functional outcomes, wear, taper corrosion and

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J R W Crutsen Department of Orthopaedic Surgery, VieCuri Medical Center, Venlo, the Netherlands

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M C Koper Department of Orthopaedic Surgery, Reinier HAGA Orthopaedic Center, Zoetermeer, the Netherlands

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J Jelsma Department of Orthopaedic Surgery and Traumatology, Zuyderland Medical Center, Sittard-Geleen-Heerlen, the Netherlands

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M Heymans Zuyderland Academy, Centre of Knowledge and Information (KIC), Zuyderland Medical Centre, Sittard-Geleen, the Netherlands

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I C Heyligers Department of Orthopaedic Surgery and Traumatology, Zuyderland Medical Center, Sittard-Geleen-Heerlen, the Netherlands
School of Health Professions Education (SHE), Maastricht University, Maastricht, the Netherlands

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B Grimm Luxembourg Institute Health, Human Motion, Orthopaedics, Sports Medicine, Digital Methods (HOSD), Luxembourg, Luxembourg

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N M C Mathijssen Department of Orthopaedic Surgery, Reinier HAGA Orthopaedic Center, Zoetermeer, the Netherlands

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M G M Schotanus Department of Orthopaedic Surgery and Traumatology, Zuyderland Medical Center, Sittard-Geleen-Heerlen, the Netherlands
School of Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands

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cobalt concentrations are often seen after implantation of metal-on-metal (MoM) hip bearings ( 7 ). This can be due to the release of ions from the metal (cobalt–chromium) surface either directly (corrosion) or during sliding under load, which may create

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Didier Hannouche Department of Orthopaedic Surgery and Traumatology, Geneva University Hospital, Switzerland

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Matthieu Zingg Department of Orthopaedic Surgery and Traumatology, Geneva University Hospital, Switzerland

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Hermes Miozzari Department of Orthopaedic Surgery and Traumatology, Geneva University Hospital, Switzerland

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Remy Nizard Department of Orthopaedic Surgery, AP-HP, Hôpital Lariboisière, Paris University, Paris, France

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Anne Lübbeke Department of Orthopaedic Surgery and Traumatology, Geneva University Hospital, Switzerland

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zirconium. 8 , 9 In this review, the long-term clinical results with third-generation pure Al-Al bearings and their complications will be presented and compared with other available ceramics. A brief history of Al ceramics in orthopaedics Al is

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Theofilos Karachalios School of Health Sciences, Faculty of Medicine, University of Thessalia, University General Hospital of Larissa, Mezourlo Region, 41110 Larissa, Greece

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George Komnos Orthopaedic Department, University General Hospital of Larissa, Greece

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Antonios Koutalos Orthopaedic Department, University General Hospital of Larissa, Greece

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in vivo . 11 Hard-on-hard bearings, such as ceramic-on-ceramic (CoC), with survival rates of approximately 97% at ten years, or metal-on-metal (MoM), with survival rates of approximately 90% at ten years (in the best reports), were initially

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