history of cemented hip replacement term 2011/history of... · “wear and surface cracking in...
TRANSCRIPT
His
tory
of
cem
en
ted
hip
rep
lace
me
nt
His
tory
is
imp
ort
an
t
•th
ose
wh
o c
an
no
t re
me
mb
er
the
pa
st a
re
con
de
mn
ed
to
re
pe
at
it.
Sa
nta
ya
na
.
Jud
et
Pro
sth
esi
s
Ye
ar:
19
50
Jour
nal o
f Roy
al s
ocie
ty o
f Med
icin
e 19
98.
Kam
anqu
M, A
cta
Ort
hop
Bel
gica
2002
.
Sca
les
JT, Z
arek
JM. B
iom
echa
nica
l pr
oble
ms
of th
e or
igin
al J
udet
pros
thes
is. B
MJ
1954
;1:1
007-
13
Sm
ith
-Pe
ters
on
mo
uld
art
hro
pla
sty
Land
ham
. 200
6. J
R S
oc M
ed.
20 y
ears
= 8
1%, a
nd
30 y
ears
59%
48 y
ears
ago
in a
wom
an a
dmitt
ed to
A
&E
at t
he a
ge o
f 74
Fir
st s
ucc
ess
ful
hip
re
pla
cem
en
ts
by P
hil
ip W
ile
s
Rin
g M
OM
pro
sth
esi
s M
cKe
e
Fa
rra
r a
nd
Rin
g
Joh
n C
ha
rnle
y’s
Low
Fri
ctio
n
Art
hro
pla
sty
“atte
mpt
s to
lu
bric
ate
any
artif
icia
l jo
int
mus
t be
ba
sed
on
the
idea
of
us
ing
boun
dary
lubr
icat
ion.
The
sub
stan
ce w
hich
se
ems
idea
lly s
uite
d fo
r th
is p
urpo
se is
PT
FE
be
caus
e no
t on
ly
has
this
a
low
co
effic
ient
of
fric
tion
(0.0
4–0.
05)
but
it is
a
subs
tanc
e w
hich
is re
adily
tole
rate
dby
ani
mal
tis
sues
by
virtu
e of
its
che
mic
al
iner
tnes
s.”
Charnley said in 1959
AN
D C
EM
EN
T
Me
tal
on
po
lye
thyle
ne
hip
rep
lace
me
nt
Me
tal
on
Po
ly C
em
en
ted
Hip
s
•Lo
w f
rict
ion
an
d w
ea
r.
•U
HM
WP
E
–N
atu
re (
com
po
site
).
–S
teri
lisa
tio
n.
–B
iolo
gic
al re
act
ion
s.
•S
tem
de
sig
ns
–C
ha
rnle
y s
tem
s.
–E
xete
r S
tem
s.
–C
ste
ms.
•A
ceta
bu
lar
cup
s
•C
em
en
t
–In
tro
du
ctio
n t
o h
ip
art
hro
pla
sty
.
–B
iom
ech
an
ica
l p
rop
ert
ies.
–C
em
en
t d
ise
ase
.
–F
ren
ch p
ara
do
x.
–A
va
ila
ble
ce
me
nts
.
Ch
arn
ley
•T
efl
on
(P
TF
E)
–T
he
mo
st s
lip
pe
ry m
ate
ria
l.
•F
ive
de
sig
n c
ha
ng
es
occ
urr
ed
.
•F
irst
: D
ou
ble
cu
p a
rth
rop
last
y u
sin
g P
TF
E.
Ch
arn
ley d
esi
gn
s co
nti
nu
ed
•S
eco
nd
to
fo
rth
: U
se o
f m
eta
llic
he
ad
s a
ga
inst
PT
FE
.
Fif
th d
esi
gn
wit
h P
TF
E
•2
2.2
25
mm
fe
mo
ral
ste
mm
ed
an
d
cem
en
ted
fe
mo
ral
com
po
ne
nt
an
d P
TF
E
cup
.
•P
ub
lish
ed
his
re
sult
s in
Lan
cet
19
61
.
•H
e c
laim
ed
ne
gli
gib
le
we
ar
at
10
mo
nth
s fr
om
rad
iog
rap
hs.
Fa
bri
cati
on
of
the
co
mp
on
en
ts
Fa
bri
cati
on
Co
ntd
.
Re
pla
cem
en
t o
f P
TF
E
Gla
ss a
nd
pro
pe
reit
yfi
lle
d =
Flu
oro
sin
t
Fa
ilu
re o
f P
TF
E (
TE
FLO
N)
•C
ha
rnle
y J
. T
he
Ma
n a
nd
th
e H
ip.
Ne
w Y
ork
,
NY
: S
pri
ng
er;
•1
99
0:1
20
–1
43
.
•5
. C
ove
ntr
y M
B,
No
lan
DR
, B
eck
en
ba
ug
hR
D.
‘De
lay
ed
’p
rop
Ma
y 1
96
2 –
Th
e i
ntr
od
uct
ion
of
UH
MW
PE
•M
r V
C B
inn
s.
•“W
he
n s
ho
wn
th
e m
ate
ria
l, C
ha
rnle
y d
ug
his
thu
mb
-na
il i
nto
it
an
d w
alk
ed
ou
t, t
ell
ing
Cra
ve
n h
e w
as
wa
stin
g h
is t
ime
”
•A
fte
r ru
nn
ing
da
y a
nd
nig
ht
for
thre
e w
ee
ks,
th
is
ne
w m
ate
ria
l, w
hic
h v
ery
fe
w p
eo
ple
eve
n i
n
en
gin
ee
rin
g c
ircl
es
ha
d h
ea
rd a
bo
ut
at
tha
t ti
me
, h
ad
no
t w
orn
as
mu
ch a
s P
TF
E w
ou
ld h
ave
wo
rn in
24
ho
urs
un
de
r th
e s
am
e c
on
dit
ion
s. T
he
re w
as
no
do
ub
t a
bo
ut
it,
“we
we
re o
n.”
Th
e U
HM
WP
E c
up
Ch
arn
ley
an
d C
up
ic,
19
73
.CO
RR
.
•In
tro
du
ced
wir
e m
ark
er
in 1
96
3.
•M
ea
sure
s d
ista
nce
be
twe
en
th
e w
ire
an
d
fem
ora
l h
ea
d in
th
e w
eig
ht
be
ari
ng
an
d n
on
-
we
igh
t b
ea
rin
g r
eg
ion
s –
an
d t
he
n d
ivid
e b
y 2
.
•A
ccu
racy
of
on
ly 0
.5m
m.
•T
he
co
ho
rt o
f th
e p
ap
er:
18
5 a
rth
rop
last
ies
in
17
0 p
ati
en
ts.
Ma
ny
ha
d d
ied
an
d m
ost
we
re
un
ab
le t
o c
om
e t
o t
he
cli
nic
fo
r a
sse
ssm
en
t so
on
ly 1
06
co
uld
be
ass
ess
ed
.
Ste
rili
sati
on
of
UH
MW
PE
Po
lye
thyle
ne
Ste
rili
sati
on
•1
96
0’s
: G
am
ma
ra
dia
tio
n i
n a
ir.
•1
99
0’s
: R
en
ew
ed
in
tere
st d
ue
to p
oly
ost
eo
lysi
s.
•D
ua
l ro
le o
f G
am
ma
ra
dia
tio
n.
Cro
ss lin
kin
g a
nd
oxi
da
tio
n
com
pe
tin
g r
ea
ctio
ns.
•F
ree
ra
dic
als
pe
rsis
ts f
or
ye
ars
.
•C
ha
ng
es
in p
ack
ag
ing
syst
em
s.
Jaha
nM
S. J
Bio
med
Mat
er R
es 1
991
Aug
;25(
8):1
005-
17.
Ste
rili
zati
on
Tim
eli
ne
of
ea
rly
UH
MW
PE
de
ve
lop
me
nt
in T
HA
Cu
rre
nt
wo
rk:
Op
tim
iza
tio
n o
f M
icro
stru
ctu
re
for
imp
rov
ed
we
ar
an
d f
ati
gu
e r
esi
sta
nce
•Im
pro
ve
we
ar
an
dfa
tig
ue
re
sist
an
ce b
y c
om
bin
ing
te
chn
olo
gie
s :
–F
or
be
tte
r w
ea
r �
cro
ssli
nk
th
e
am
orp
ho
us
reg
ion
usi
ng
ra
dia
tio
n
–F
or
be
tte
r fa
tig
ue
�e
nh
an
ce t
he
cr
yst
all
init
yo
f th
e m
ate
ria
l u
sin
g
hig
h p
ress
ure
Crosslinking
Crystalline Lamellae
Cro
ssli
nk
ed
PE
UH
MW
PE
UH
MW
PE
XLP
EX
LPE
XLP
E
�F
or th
is r
easo
n,
each
mat
eria
l nee
ds
to b
e co
nsid
ered
se
para
tely
EF
FE
CT
S O
F C
RO
SS
LIN
KIN
G
•C
ross
lin
kin
g�
de
cre
ase
d m
od
ulu
s, d
ecr
ea
sed
ha
rdn
ess
, d
ecr
ea
sed
fa
tig
ue
re
sist
an
ce,
incr
ea
sed
we
ar
resi
sta
nce
•H
igh
Pre
ssu
re t
rea
tme
nt �
incr
ea
sed
mo
du
lus*
*,
incr
ea
sed
fa
tig
ue
re
sist
an
ce,
incr
ea
sed
ult
ima
te s
tre
ss,
incr
ea
sed
ha
rdn
ess
, in
cre
ase
d l
am
ell
ar
size
•C
ou
ple
d e
ffe
ct e
nh
an
ces
fati
gu
e a
nd
we
ar
•*
*A
lim
ita
tio
n i
s th
at
the
in
cre
ase
d m
od
ulu
s w
ill
dri
ve
up
co
nta
ct s
tre
sse
s
Mix
ed
Cli
nic
al
Pe
rfo
rma
nce
•C
lin
ica
l P
erf
orm
an
ce o
f a
Hig
hly
Cro
ssli
nk
ed
at
Tw
o y
ea
rs i
n T
ota
l H
ip
Art
hro
pla
sty
: A
Ra
nd
om
ize
d P
rosp
ect
ive
Tri
al.
Ma
rte
ll J
M,
Ve
rne
rJJ
, In
cav
o
SJ.
J A
rth
rop
last
y 2
00
3. 5
0%
re
du
ctio
n i
n w
ea
r•
Hig
hly
cro
ss-l
ink
ed
po
lye
thy
len
e i
n c
em
en
ted
TH
A:
ran
do
miz
ed
stu
dy
of
61
h
ips.
Dig
as
G,
Ka
rrh
olm
J, T
ha
nn
er
J, M
alc
ha
uH
, H
erb
ert
sP
. C
lin
Ort
ho
p.
20
03
50
% r
ed
uct
ion
in
we
ar
wit
h h
igh
ly c
ross
lin
ke
dU
HM
WP
E
•L.
Bra
dfo
rd-C
oll
on
s, D
.A.
Ba
ke
r, J
. G
rah
am
, A
. C
ha
wa
n,
M.D
. R
ies,
L.
Pru
itt,
“W
ea
r a
nd
Su
rfa
ce C
rack
ing
in
Ea
rly
Re
trie
ve
d H
igh
ly C
ross
lin
ke
dD
ura
sul
Ace
tab
ula
r Li
ne
rs,”
Jou
rna
l o
f B
on
e a
nd
Jo
int
Su
rge
ry 8
6:1
27
1-1
28
2 (2
00
4).
Su
rfa
ce d
am
ag
e o
bse
rve
d i
n a
ll i
mp
lan
ts•
L. B
rad
ford
, R
. K
url
an
d,
M.
Sa
nk
ara
n,
H.
Kim
, L.
Pru
itt,
M.
Rie
s,
“Ea
rly
Fa
ilu
re d
ue
to
Ost
eo
lysi
sin
Hig
hly
Cro
ss-l
ink
ed
UH
MW
PE
:
A C
ase
Re
po
rt,”
Jou
rna
l o
f B
on
e a
nd
Jo
int
Su
rge
ry 8
6:1
27
1-1
28
2 (
20
04
).
Bo
ne
lo
ss d
ue
to
ost
eo
lysi
s
Ch
arn
ley S
tem
de
sig
ns
•1
96
9 f
irst
ch
an
ge
d t
o
va
nq
ua
she
en
ed
fin
ish
fo
r
surf
ace
ha
rdn
ess
.
•2
nd
ge
ne
rati
on
19
73
–
rou
nd
cro
ss s
ect
ion
.
•3
rdg
en
era
tio
n –
Co
bra
fla
ng
ed
.
•1
98
4:
cha
ng
ed
th
e h
ea
d
ne
ck r
ati
o,
red
uci
ng
ne
ck
fro
m 1
2.5
to
10
mm
.
Po
lym
eth
yl
Me
tha
cry
late
PM
MA
•R
eact
ion
prod
uced
by
liqui
d ┼
solid
.
•Liq
uid
cont
ains
mon
omer
and
initi
ator
.
•E
xoth
erm
ic r
eact
ion.
•Som
e in
itial
exp
ansi
on a
nd th
en v
olum
e sh
rinka
ge.
•Fin
al v
olum
e is
3-5
% in
crea
se in
siz
e.
Pol
ymer
izat
ion
-M
MA
rad
ical
plu
s M
MA
:rep
eate
d m
any,
m
any
times
Me
cha
nic
al
Me
cha
nic
al
pro
pe
rtie
sp
rop
ert
ies
of
of
cem
en
tce
me
nt
Ce
me
nt
Ce
me
nt
isisa
a
vis
coe
last
icv
isco
ela
stic
bri
ttle
bri
ttle
ma
teri
al
ma
teri
al
cha
ract
eri
zed
cha
ract
eri
zed
by
b
y
rela
tiv
ely
rela
tiv
ely
hig
hh
igh
com
pre
ssiv
e
com
pre
ssiv
e s
tre
ng
thst
ren
gth
resi
sta
nce
resi
sta
nce
bu
t b
ut
we
ak
ne
ssw
ea
kn
ess
in t
en
sio
n a
nd
in
te
nsi
on
an
d b
en
din
gb
en
din
g
Acr
yli
cA
cry
lic
bo
ne
bo
ne
cem
en
tsce
me
nts
: : m
ech
an
ica
lm
ech
an
ica
la
nd
a
nd
ph
ysi
cal
ph
ysi
cal
pro
pe
rtie
sp
rop
ert
ies
Ort
ho
pO
rth
op
Cli
n
Cli
n N
ort
hN
ort
hA
m 2
00
5;
36
: 2
9A
m 2
00
5;
36
: 2
9-- 3
9
39
Ku
eh
nK
ue
hn
KD
an
d
KD
an
d c
oll
coll
Compressive
Compressive strength
strength
90
90 Mpa
Mpa
Shear
Shearstrength
strength
50
50 Mpa
Mpa
Tensile
Tensilestrength
strength
25
25 Mpa
Mpa
Me
cha
nic
al
Me
cha
nic
al
ba
sis
ba
sis
of
ste
m
of
ste
m c
em
en
ted
cem
en
ted
fixa
tio
nfi
xati
on
Bo
ne
Bo
ne
, , ce
me
nt
cem
en
ta
nd
ste
m
an
d s
tem
ma
ke
ma
ke
a c
om
po
site
str
uct
ure
a c
om
po
site
str
uct
ure
--A
ll m
en
tio
ne
d m
ate
ria
ls h
av
e d
iffe
ren
t E
All
me
nti
on
ed
ma
teri
als
ha
ve
dif
fere
nt
E-- M
od
uli
Mo
du
li
Co
rte
x:
Co
rte
x:
12
1
2 --
18
18
Gp
aG
pa
PM
MA
:P
MM
A:
1.8
1.8
G
pa
Gp
a
Sta
inle
ss S
tee
lS
tain
less
Ste
el
25
0
2
50
G
pa
Gp
a
--E
ach
of
the
se m
ate
ria
ls h
ad
d
iffe
ren
t st
rain
s u
nd
er
cycl
ic a
xi
Ea
ch o
f th
ese
ma
teri
als
ha
d d
iffe
ren
t st
rain
s u
nd
er
cycl
ic a
xi a
l a
nd
a
l a
nd
to
rsio
na
lto
rsio
na
l
loa
d t
ha
t in
du
ce
loa
d t
ha
t in
du
ce m
icro
mo
tio
nm
icro
mo
tio
na
t th
e i
nte
rfa
ces
at
the
in
terf
ace
s
--M
icro
mo
tio
nM
icro
mo
tio
np
rim
ary
occ
urs
at
the
ste
mp
rim
ary
occ
urs
at
the
ste
m-- c
em
en
t in
terf
ace
cem
en
t in
terf
ace
--M
icro
mo
tio
nM
icro
mo
tio
nca
n o
nly
be
pa
rtia
lly
ab
sorb
ed
by
ce
me
nt
ela
stic
ity
can
on
ly b
e p
art
iall
y a
bso
rbe
d b
y c
em
en
t e
last
icit
y
--M
icro
mo
tio
nM
icro
mo
tio
nis
se
ttle
d b
y t
he
ste
m w
hic
h i
s th
e s
tiff
est
co
mp
on
en
t
is s
ett
led
by
th
e s
tem
wh
ich
is
the
sti
ffe
st c
om
po
ne
nt
Imp
rove
me
nt
in c
em
en
tati
on
tech
niq
ue
No
sign
ifica
nt d
iffer
ence
bet
wee
n se
cond
-an
d th
ird-g
ener
atio
n te
chni
ques
has
bee
n w
ell e
stab
lishe
d (6
).
The
cem
ent–
pros
thes
is in
terf
ace
does
not
see
m to
be
influ
ence
d by
cem
ent t
imin
g w
hen
usin
g sm
ooth
ste
ms
(1).
Exe
ter
Ste
m
•1
96
9 i
n E
xete
r.
•A
vo
id t
roch
an
teri
c
ost
eo
tom
y a
nd
la
cks
coll
ar.
•F
irst
ch
an
ge
in
19
76
du
e t
o
fra
ctu
res
of
fem
ora
l st
em
–
to m
att
fin
ish
ed
.
•1
98
6 r
etu
rn t
o p
oli
she
d s
tem
.
•1
98
8 m
od
ula
rity
of
ste
m.
Taper slip VS
Composite beam
Taper-slip system
Exeter
Flanged
Charnley
Harris Precoat
Composite-beam
system
CPT, C-stem
Eff
ort
s to
E
ffo
rts
to i
mp
rove
imp
rove
cem
en
ted
cem
en
ted
art
hro
pla
sty
art
hro
pla
sty
1.
1.
Imp
rov
eIm
pro
ve
me
cha
nic
al
me
cha
nic
al
pro
pe
rtie
sp
rop
ert
ies
of
of
cem
en
tce
me
nt
2.
2.
Incr
ea
seIn
cre
ase
cem
en
tce
me
nt
lay
er
lay
er
thic
kn
ess
thic
kn
ess
3.
3.
Imp
rov
eIm
pro
ve
cem
en
tin
gce
me
nti
ng
tech
niq
ue
te
chn
iqu
e
4.
4.
Imp
rov
eIm
pro
ve
bo
ne
bo
ne
-- ce
me
nt
cem
en
tin
terf
ace
inte
rfa
ce
5.
5.
Mo
dif
yM
od
ify
ste
m d
esi
gn
to
st
em
de
sig
n t
o d
ecr
ea
sed
ecr
ea
sest
ress
es
stre
sse
s su
pp
ort
ed
sup
po
rte
db
y
by
ce
me
nt
cem
en
t
6.
6.
Loo
k f
or
a
Loo
k f
or
a s
eco
nd
ary
seco
nd
ary
fix
ati
on
fi
xa
tio
n t
hro
ug
hth
rou
gh
a d
ista
l a
dis
tal
mig
rati
on
m
igra
tio
n \\
sub
sid
en
cesu
bsi
de
nce
7.
7.
Incr
ea
seIn
cre
ase
lin
kli
nk
be
twe
en
be
twe
en
ste
m a
nd
st
em
an
d c
em
en
tce
me
nt
thro
ug
hth
rou
gh
a
a
rou
gh
su
rfa
cero
ug
h s
urf
ace
Imp
rove
ce
me
nt
bo
ne
an
d s
tem
in
terf
ace
s
Ra
ng
e o
f si
zes
to g
et
the
be
st
fit
in t
he
fe
mo
ral
can
al
Impo
rtan
ce o
f Im
port
ance
of
supe
rosu
pero
-- med
ial
med
ial
cem
ent
cem
ent m
antle
man
tle
Com
posi
te-b
eam
sy
stem
OR
T
aper
Slip
OS
TE
OLY
SIS
•W
ille
rta
nd
Se
mli
tsch
19
77
we
ar
de
bri
s w
ith
in m
acr
op
ha
ge
s o
f th
e
pe
rip
rost
he
tic
tiss
ue
.
•M
irra
et
al.
1
97
6 f
ou
nd
PM
MA
pa
rtic
les
in t
he
fib
rou
s st
rom
a
aro
un
d h
ip p
rost
he
ses.
•G
old
rin
ge
t a
l. 1
98
3 c
oll
ag
en
ase
an
d p
rost
ag
lan
din
E2
(P
GE
2.
•K
im e
t a
l. f
ew
dif
fere
nce
s e
xist
ed
fa
ile
d c
em
en
ted
an
d
un
cem
en
ted
hip
co
mp
on
en
ts,
imp
lyin
g s
imil
ar
me
cha
nis
ms
of
ase
pti
c lo
ose
nin
g.
•K
im 1
99
4:
UH
MW
PE
-h
igh
le
ve
ls o
f co
lla
ge
na
sea
nd
IL-
1
Pa
rtic
le d
yn
am
ics
•1
97
6-7
7:
We
ar
de
bri
s is
cle
are
d f
rom
th
e j
oin
t
spa
ce b
y m
acr
op
ha
ge
ph
ag
ocy
tosi
sa
nd
tra
nsp
ort
ed
via
th
e ly
mp
ha
tic
syst
em
to
th
e
reti
culo
en
do
the
lia
l
syst
em
.
•1
99
0:
Gra
nu
lati
on
tis
sue
is
form
ed
at
the
pe
rip
rost
he
tic
inte
rfa
ce,
wh
ich
co
mp
rom
ise
s
bo
ny
an
cho
rs a
nd
re
sult
s in
im
pla
nt
loo
sen
ing
.
•W
ille
rte
t a
l. a
nd
la
ter
Sch
ma
lzri
ed
et
al.
1
99
4:
the
co
nce
pt
of
the
‘‘e
ffe
ctiv
e j
oin
t sp
ace
’’
•Li
ne
ar
an
d f
oca
l o
ste
oly
sis.
UH
MW
PE
de
bri
s
Sca
nnin
g el
ectr
omic
rogr
aph
of U
HM
WP
E
(ultr
ahig
h-m
olec
ular
-wei
ght
poly
ethy
lene
) pa
rtic
les
isol
ated
from
faile
d to
tal h
ip
arth
ropl
astie
s.
CD
3 im
mun
osta
ined
T c
ells
(re
d ar
row
s)
and
fore
ign
body
gia
nt c
ell (
gree
n ar
row
) lo
caliz
ed w
ith U
HM
WP
E w
ear
debr
is(y
ello
w a
rrow
s) fr
om a
his
toric
al, g
amm
a-ai
r st
erili
zed
UH
MW
PE
hip
rep
lace
men
t re
vise
d 14
.2 y
ears
pos
t-im
plan
tatio
n. 2
00K
mag
nific
atio
n.S
cale
inte
rval
rep
rese
nts
10 K
m.
Imp
ing
em
en
t a
s a
ca
use
of
cup
loo
sen
ing
•W
rob
lew
ski
BM
: J
Art
hro
pla
sty
20
09
.
–1
2.5
mm
(9
72
) a
nd
10
mm
(2
61
) n
eck
dia
me
ter
fem
ora
l p
rost
he
sis.
–Lo
ose
nin
g o
ccu
rre
d a
t 2
mm
he
ad
pe
ne
tra
tio
n i
n
12
.5m
m n
eck
dia
me
ter
pro
sth
esi
s g
rou
p;
an
d n
ot
un
til
4m
m o
f cu
p p
en
etr
ati
on
in
10
mm
gro
up
.
Lon
g-t
erm
su
rviv
al
of
Ch
arn
ley L
FA
18
%
42
%
70
%
Imp
ort
an
ce o
f p
ati
en
t se
lect
ion
Co
ncl
usi
on
Go
od
re
sult
s o
f C
ha
rnle
y L
FA
•C
ha
rnle
y 1
97
9:
–0
.21
% r
ev
isio
n r
ate
(2
3 r
evis
ion
s)
–1
0,9
13
lo
w-f
rict
ion
art
hro
pla
stie
s (L
FA
) (1
96
6 –
19
76
)
–2
–1
2 y
ea
r fo
llo
w-u
p.
•W
rob
lew
ski
19
98
: 9
4%
•G
arr
ellic
k1
99
9:
93
.2%
•F
en
de
r 1
99
9:
revis
ion
ra
tes
of
alm
ost
10
% a
t 5
ye
ars
.
•C
ha
rnle
y J
. Lo
w F
rict
ion
Art
hro
pla
sty
of
the
Hip
: 1
97
9.
•W
rob
lew
ski
BM
. C
OR
R 2
11
:30
–3
5,
19
86
.
•G
are
llic
kG
, J
Art
hro
14
(4):
41
4–
42
5,
19
99
.
•F
en
de
r D
,. J
Bo
ne
Jo
int
Su
rg (
Br)
, 8
1:5
77
, 1
99
9.
Co
ncl
usi
on
•A
his
tory
of
tria
l a
nd
err
or.
•M
an
y d
ed
ica
ted
pe
op
le.
•P
oly
eth
yle
ne
an
d c
em
en
t a
re t
he
we
ak
est
lin
ks.
•R
ese
arc
h w
ork
s.
•R
esu
lts
ke
ep
im
pro
vin
g.
Th
an
k y
ou