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* 1. What Is the PRINCIPAL Reason for Revision (Choose ONLY ONE)?

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* 2. What are the SECONDARY Reason(s) for Revision (Choose ALL that apply)?

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* 3. Where is the location of the loosening?

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* 4. Was there associated polyethylene wear?

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* 5. Was there Soft Tissue Insufficiency?

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* 6. Was there Abductor Insufficiency?

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* 7. Was there Capsular Insufficiency?

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* 8. What was the INDEX bearing combination?

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* 9. Did the PREVIOUS femoral head have a skirt/collar?

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* 10. What is the location of Osteolysis?

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* 11. Is there presence of Metallosis / Metalic Debris?

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* 12. Is there presence of Pseudotumor?

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* 13. Is there trunnion corosion?

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* 14. What is the intraoperative tissue assessment?

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* 15. Please indicate the Special Techniques performed on the Acetabulum (Choose ALL that apply)

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* 16. Please indicate the Special Techniques performed on the Femur (Choose ALL that apply)

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* 17. What was the ACETABULAR BONE LOSS CLASSIFICATION (Paprosky Class)?

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* 18. What type of skin closure was used (Choose ALL that apply)?

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* 19. What was the dressing used?

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