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The internal shell endoprothesis for the hip joint after Wagner has considerably limited the indications for the implantation of ceramic endoprotheses to patients under 60 years, because less bone substance has to be sacrificed. Furthermore there are indications for ceramic endoprotheses in cases of substance defects of the femoral head and neck, to some extent also in cases of dysplasia and protrusio acetabuli, and by loosening traditional total hip endoprotheses.
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