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It utilizes a general form of the elasticity operator alongside a revised fracture propagation condition based on the critical value of the energy release rate.
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There were no revisions for stem loosening but 2 stems were revised for fracture — both with a defective cement mantle proximally.
One hip was revised after fracture of the alumina femoral head 6.25 years after surgery.
They were managed by revising the fracture area, removing fibrous and necrotic tissues, and increasing the stabilisation by changing the ineffective stabilizing elements.
Intraoperative biopsies and joint aspirations were positive in 5 cases; 3 of them had been revised for failed fracture arthroplasty.
Method We analyzed morphological and immunophenotypic changes in the periprosthetic soft tissues and femoral heads of 52 revised MoM arthroplasties (fracture in 21, pseudotumor in 13, component loosening in 9, and other causes in 9 cases).
All except three of our patients were diagnosed with ARMD indicating that there was lack of hips with unresponsive synovium (e.g. patients revised for periprosthetic fracture or implant loosening).
This fracture was revised with a longer IM nail bypassing the fracture line.
A year later the right hip was revised because of a fracture of the ceramic head.
One fracture was revised with a GK femoral nail and the others with LGN.
In 1 hip, the stem was revised following a periprosthetic fracture with adequate trauma 12 years postoperatively.
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Since I tried Ludwig back in 2017, I have been constantly using it in both editing and translation. Ever since, I suggest it to my translators at ProSciEditing.

Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com