Today's THR systems have been developed in conjunction with feedback from clinical practice, i.e. by evolution. In the 70s and 80s ceramic stems, monolithic cups, monoblock components, and skirted heads were used. Today, modular hip systems are offered, designed for ceramic heads, which articulate against ceramic or PE cups. The surgeon has the option of choosing a combination suitable to the specific situation. About 70 cups with ceramic inserts have been developed. More than 200,000 ceramic inserts have been used since the mid 80s.
The article discusses which combinations of head and cup inserts have been approved by government agencies and which combinations are not recommended
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