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Trial registered on ANZCTR
Registration number
ACTRN12609000678291
Ethics application status
Approved
Date submitted
5/08/2009
Date registered
10/08/2009
Date last updated
24/07/2013
Type of registration
Retrospectively registered
Titles & IDs
Public title
The effect of femoral head size on dislocation following total hip replacement
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Scientific title
The effect of a large 36 mm vs standard 28 mm articulation in a total hip prosthesis on the incidence of dislocation one year following total hip replacement
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Secondary ID [1]
282899
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Nil known
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
dislocation following total hip replacement
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Condition category
Condition code
Musculoskeletal
239759
239759
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0
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Osteoarthritis
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Musculoskeletal
239760
239760
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0
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Other muscular and skeletal disorders
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Surgery
239761
239761
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0
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Surgical techniques
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Total hip replacement using a 36 mm metal on highly cross-linked polyethylene articulation. This is a surgical procedure where the femoral head is removed and replaced by a metal prosthetic femoral head (which in this situation has a diameter of 36 mm), which is attached to a femoral stem inserted into the femur. The head then articulates with a plastic (highly cross-linked polyethylene) liner in a metal acetabular shell, which is inserted into the acetabulum. The duration of the operation is between about 45 minutes and 4 hours, depending on the complexity of the operation.
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Intervention code [1]
237074
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Treatment: Surgery
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Comparator / control treatment
Total hip replacement using a 28 mm metal on highly cross-linked polyethylene articulation. This is a surgical procedure where the femoral head is removed and replaced by a metal prosthetic femoral head (which in this situation has a diameter of 28 mm), which is attached to a femoral stem inserted into the femur. The head then articulates with a plastic (highly cross-linked polyethylene) liner in a metal acetabular shell, which is inserted into the acetabulum. The duration of the operation is between about 45 minutes and 4 hours, depending on the complexity of the operation.
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Control group
Active
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Outcomes
Primary outcome [1]
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Dislocation of the total hip prosthesis.
Patients complete a Hip Instability Questionnaire, which asks whether they have experienced a number of symptoms of instability or a dislocation. A Hospital Visit Questionnaire is also completed, which documents every admission or attendance to the Emergency Room of a hospital.
A radiograph of the dislocated hip is required for confirmation of dislocation.
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Assessment method [1]
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Timepoint [1]
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one year following total hip replacement
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Secondary outcome [1]
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Polyethylene wear, which is measured from standard radiographs, using PolyWare, a computer-based analysis program for measuring wear.
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Assessment method [1]
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Timepoint [1]
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two years following total hip replacement
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Secondary outcome [2]
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Acetabular cup migration, which is measured from standard radiographs, using Einbild Roentgen Analyse (EBRA), a computer-based analysis program for measuring acetabular cup migration.
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Assessment method [2]
257077
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Timepoint [2]
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two years following total hip replacement
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Eligibility
Key inclusion criteria
undergoing primary total hip replacement involving a metal on polyethylene articulation, through a posterior surgical approach, for osteoarthritis, rheumatoid or other inflammatory arthritis, or previous fracture/dislocation/surgery to the hip; or
undergoing revision total hip replacement (involving a metal on polyethylene articulation) of a hemiarthroplasty or revision of a total hip replacement
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Minimum age
50
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
age <60 years (revisions: <50),
neuromuscular disease,
abnormal abductor mechanism,
abnormal acetabulum (primaries only),
revision for instability or infection (revisions only)
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
A listing of all possible combinations of allocations in blocks of 2 to 8 was prepared (eg for a block of 4: 28,28,36,36; 36,36,28,28, 36,28,36,28 etc) and each combination was allocated a number. Then a random number generator was used to choose the combination sequence for the block sizes required in each stratum.
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
Patients are stratified for a number of factors that may affect primary and secondary outcomes (eg age, diagnosis).
Blocked randomisation is then undertaken within strata, with patients being randomised to receive a total hip prosthesis with either a 28 mm or 36 mm articulation.
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Phase
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Active, not recruiting
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Date of first participant enrolment
Anticipated
1/09/2001
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Actual
24/09/2001
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Date of last participant enrolment
Anticipated
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Actual
8/06/2007
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
650
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW,SA,VIC
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Recruitment outside Australia
Country [1]
1934
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United Kingdom
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State/province [1]
1934
0
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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National Health Medical Research Council (NHMRC)
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Address [1]
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Level 1,
16 Marcus Clarke St
Canberra ACT 2601
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Country [1]
237453
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Australia
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Funding source category [2]
237454
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Commercial sector/Industry
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Name [2]
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Zimmer
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Address [2]
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1800 W Center St
Warsaw IN 46580
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Country [2]
237454
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United States of America
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Funding source category [3]
237455
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University
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Name [3]
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University of Adelaide
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Address [3]
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North Tce
Adelaide SA 5005
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Country [3]
237455
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Australia
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Funding source category [4]
237456
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Hospital
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Name [4]
237456
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Royal Adelaide Hospital
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Address [4]
237456
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North Tce
Adelaide SA 5000
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Country [4]
237456
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Australia
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Funding source category [5]
237457
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Other Collaborative groups
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Name [5]
237457
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Australian Orthopaedic Association
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Address [5]
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Ground Floor
William Bland Centre
229 Macquarie St
Sydney NSW 2000
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Country [5]
237457
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Australia
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Primary sponsor type
Individual
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Name
Prof Donald Howie
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Address
Department of Orthopaedics and Trauma
Level 4, Bice Building
Royal Adelaide Hospital
North Tce
Adelaide SA 5000
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Country
Australia
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Secondary sponsor category [1]
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Individual
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Name [1]
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Dr Oksana Holubowycz
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Address [1]
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Department of Orthopaedics and Trauma
Level 4, Bice Building
Royal Adelaide Hospital
North Tce
Adelaide SA 5000
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Country [1]
236942
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
239580
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Royal Adelaide Hospital Human Research Ethics Committee
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Ethics committee address [1]
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Royal Adelaide Hospital North Tce Adelaide SA 5000
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
239580
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Approval date [1]
239580
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Ethics approval number [1]
239580
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Summary
Brief summary
This randomised controlled trial aims to determine whether a total hip replacement with a larger 36 mm diameter prosthetic femoral head significantly reduces the incidence of dislocation one year following total hip replacement, compared to total hip replacement with a standard 28 mm diameter prosthetic femoral head. The effect of the larger femoral head on both polyethylene wear and acetabular cup migration is also being assessed.
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Trial website
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Trial related presentations / publications
Howie DW, Holubowycz OT, Middleton R, The Large Articulation Study Group. Large femoral heads decrease the incidence of dislocation after total hip arthroplasty. A randomized controlled trial. J Bone Joint Surg Am. 2012;94:1095-102.
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Public notes
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Contacts
Principal investigator
Name
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Prof Donald Howie
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Address
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Department of Orthopaedics and Trauma
Level 4, Bice Building,
Royal Adelaide Hospital
North Tce
Adelaide SA 5000
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Country
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Australia
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Phone
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+61 8 8222 5563
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Dr Oksana Holubowycz
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Address
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Department of Orthopaedics and Trauma
Level 4, Bice Building
Royal Adelaide Hospital
North Tce
Adelaide SA 5000
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Country
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Australia
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Phone
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+61 8 8222 5760
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Fax
13259
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Email
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[email protected]
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Contact person for scientific queries
Name
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Dr Oksana Holubowycz
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Address
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Department of Orthopaedics and Trauma
Level 4, Bice Building
Royal Adelaide Hospital
North Tce
Adelaide SA 5000
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Country
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Australia
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Phone
4187
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+61 8 8222 5760
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Fax
4187
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Dimensions AI
Large Femoral Heads Decrease the Incidence of Dislocation After Total Hip Arthroplasty
2012
https://doi.org/10.2106/jbjs.k.00570
N.B. These documents automatically identified may not have been verified by the study sponsor.
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