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Tribology in Total Hip Arthroplasty pp 25–40Cite as

Ceramic Hip Replacements: Wear Behavior Affects the Outcome – A Tribological and Clinical Approach

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Abstract

The goal of this chapter is to show that ceramic bearings in total hip arthroplasty (THA) significantly reduce the revision rate caused by wear induced osteolysis and the following complications. Another important goal is to stress the fact that zirconia platelet toughened alumina (ZTA) due to their enhanced material properties allow for more challenging designs in hip arthroplasty compared to traditional alumina. Larger femoral ball head diameters coming along with smaller inserts require a thin wall thickness which is not possible to achieve with ceramic material made of pure alumina. Clinical experience with ceramic THA bearing couples is presented, together with possible complications.

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References

  1. Back, et al.: Early results of primary Birmingham hip resurfacings. JBJS (Br) 87-B, 324–329 (2005)

    Google Scholar 

  2. Bishop, et al.: Friction moments of large metal-on-metal hip joint bearings and other modern designs. Med. Eng. Phys. 30, 1057–1064 (2008)

    Article  PubMed  CAS  Google Scholar 

  3. Bizot, et al.: Press-fit metal-backed alumina sockets: a minimum five-year follow-up study. Clin. Orthop. Relat. Res. 379, 134–142 (2000)

    Article  PubMed  Google Scholar 

  4. Bono, et al.: Severe polyethylene wear in total hip arthroplasty. Observations from retrieved AML PLUS hip implants with an ACS polyethylene liner. J. Arthroplasty 9(2), 19–25 (1994)

    Article  Google Scholar 

  5. Dahl et al.: Less wear with 28 mm aluminum oxide heads against conventional PE -A 10 year RSA study, 60th annual meeting of the Norwegian Orthopaedic Society, Oslo. 24–26 (2007)

    Google Scholar 

  6. Campbell, et al.: Biologic and tribologic considerations of alternative bearing surfaces. Clin. Orthop. Relat. Res. 418(1), 98–111 (2004)

    Article  PubMed  Google Scholar 

  7. Capello, et al.: Ceramic-on-ceramic total hip arthroplasty: update. J. Arthroplasty 23(7), 39–43 (2008)

    Article  PubMed  Google Scholar 

  8. Clarke, et al.: How do alternative bearing surfaces influence wear behavior? J. Am. Acad. Orthop. Surg. 16, 86–93 (2008)

    Google Scholar 

  9. Clarke, et al.: Hip-simulator wear studies of an alumina-matrix composite (AMC) ceramic compared to retrieval studies of AMC balls with 1–7 years follow-up. Wear 267, 702–709 (2009)

    Article  CAS  Google Scholar 

  10. Dowson, et al.: A hip joint simulator study of the performance of metal-on-metal joints, simulator study of MOM hips. Part II:Design. J Arthroplasty 19(8), Suppl.3, 124–130 (2004)

    PubMed  Google Scholar 

  11. Ecker, T., et al.: Squeaking in total hip replacement: no cause for concern. Orthopedics 31(9), 1–3 (2008)

    Article  Google Scholar 

  12. Eickmann, et al.: Squeaking and neck-socket impingement in a ceramic total hip arthroplasty. Bioceramics 15, 849–852 (2003)

    Google Scholar 

  13. Essner, et al.: Hip simulator wear comparison of metal-on-metal, ceramic-on-ceramic and crosslinked UHMWPE bearings. Wear 259, 992–995 (2005)

    Article  CAS  Google Scholar 

  14. Fisher, et al.: Long term wear of ceramic on ceramic hips. In: Lazennec, J.Y., Dietrich, M. (eds.) Bioceramics and Alternative Bearings in Joint Arthroplasty, Steinkopff-Verlag Darmstadt, 45–46 (2004)

    Chapter  Google Scholar 

  15. Greenwald, et al.: Alternative bearing surfaces: the good, the bad, and the ugly. J. Bone Joint Surg. Am. 83, 68–72 (2001)

    PubMed  Google Scholar 

  16. Hamadouche, et al.: Cementless bulk alumina socket: preliminary results at six years. J. Arthroplasty 14, 701–707 (1999)

    Article  PubMed  CAS  Google Scholar 

  17. Hamadouche, et al.: Alumina-on-alumina total hip arthroplasty: a minimum 18.5-year follow-up study. J. Bone Joint Surg. 84B, 69–77 (2002)

    Google Scholar 

  18. Hannink, et al.: Transformation toughening in zirconia-containing ceramics. J. Am. Ceram. Soc. 83(3), 461–487 (2000)

    Article  CAS  Google Scholar 

  19. Huo, et al.: What’s new in hip arthroplasty. J. Bone Joint Surg. Am. 88, 2100 (2006)

    Article  PubMed  Google Scholar 

  20. Keurentjes, et al.: High incidence of squeaking in THAs with alumina ceramic-on-ceramic bearings. Clin. Orthop. Relat. Res. 466, 1438–1443 (2008)

    Article  PubMed  CAS  Google Scholar 

  21. Kuntz, et al.: Current state of the art of the ceramic composite material BIOLOX® delta. In: Mendes, G, Lago, B. (eds.) Strength of Materials, Nova Science Publishers Inc., 133–155 (2009)

    Google Scholar 

  22. Kusaba, et al.: Abrieb von Hüftexplantat-Kugelköpfen aus Aluminiumoxidkeramik und Kobalt-Chrom im Vergleich. Deutscher Kongress für Orthopädie, Abstract, Berlin (2004)

    Google Scholar 

  23. Kusaba et al.: Alumina on alumina bearing with uncemented implant for dysplastic hips aged sixty or below: A five years minimum follow-up study to advantage the bearing property from a viewpoint of the surgeon. Abstract OSA04-03, ISTA 2008

    Google Scholar 

  24. Lewinnek, et al.: Dislocations after total hip-replacement arthroplasties. J. Bone Joint Surg. 60, 217–220 (1978)

    PubMed  CAS  Google Scholar 

  25. Lewis, et al.: Prospective randomized trial comparing alumina ceramic-on-ceramic with ceramic-on-conventional polyethylene bearings in total hip arthroplasty. J. Arthroplasty 25(3), 392–397 (2010)

    Article  PubMed  Google Scholar 

  26. Lusty, et al.: Third-generation alumina-on-alumina ceramic bearings in cementless total hip arthroplasty. J. Bone Joint Surg. Am. 89, 2676–2683 (2007)

    Article  PubMed  CAS  Google Scholar 

  27. Lusty, et al.: Minimising squeaking and edge loading when implanting a ceramic-on-ceramic hip arthroplasty. Touch briefings, European Musculoskeletal Review. 1, 73–75 (2007)

    Google Scholar 

  28. Magnissalis, et al.: Wear of retrieved ceramic THA components: four matched pairs retrieved after 5–13 years in service. J. Biomed. Mater. Res. 58, 593–598 (2001)

    Article  PubMed  CAS  Google Scholar 

  29. Morlock, et al.: Mismatched wear couple zirconium oxide and aluminum oxide in total hip arthroplasty. J. Arthroplasty 16, 1071–1074 (2001)

    Article  PubMed  CAS  Google Scholar 

  30. Murphy et al.: Clinical experience with the ceramic on ceramic articulation in THR in the USA. Abstract SA02–02, ISTA, Seoul, 2008

    Google Scholar 

  31. Nevelos, et al.: Analysis of retrieved alumina ceramic components from Mittelmeier total hip prostheses. Biomaterials 20, 1833–1840 (1999)

    Article  PubMed  CAS  Google Scholar 

  32. Nizard, et al.: Ten-year survivorship of cemented ceramic-ceramic total hip prosthesis. Clin. Orthop. Relat. Res. 282, 53–63 (1992)

    PubMed  Google Scholar 

  33. Nizard, et al.: Alumina pairing in total hip replacement. J. Bone Joint Surg. Br. 87-B(6), 755–758 (2005)

    Article  Google Scholar 

  34. Olyslaegers, et al.: Wear in conventional and highly cross-linked polyethylene cups. J. Arthroplasty 23(4), 489–494 (2008)

    Article  PubMed  Google Scholar 

  35. Oonishi, et al.: Alumina hip joints characterized by run-in wear and steady-state wear to 14 million cycles in hip-simulator model. J. Biomed. Mater. Res. 70, 523–532 (2004)

    Article  Google Scholar 

  36. Pandorf, T.: Wear of large ceramic bearings. In: Chang, J.D., Billau, K. (eds.) Bioceramics and Alternative Bearings in Joint Arthroplasty, Steinkopff-Verlag Darmstadt, 91–97 (2007)

    Chapter  Google Scholar 

  37. Pokorny, et al.: The noisy hip – Is it only a ceramic issue? In: Cobb, J. (ed.) Modern Trends in THA Bearings. Material and Clinical Performance, Springer-Verlag Berlin Heidelberg, 85–90 (2010)

    Google Scholar 

  38. Prudhommeaux, et al.: Wear of alumina-on-alumina total hip arthroplasties at a mean 11-year follow up. Clin. Orthop. Relat. Res. 379, 113–122 (2000)

    Article  PubMed  Google Scholar 

  39. Restrepo, et al.: The noisy ceramic hip: is component malpositioning the cause? J. Arthroplasty 23(5), 643–649 (2008)

    Article  PubMed  Google Scholar 

  40. Restrepo, et al.: The effect of stem design on the prevalence of squeaking following ceramic-on-ceramic bearing total hip arthroplasty. J. Bone Joint Surg. Am. 92, 550–557 (2010)

    Article  PubMed  Google Scholar 

  41. Rosneck, et al.: A rare complication of ceramic-on-ceramic bearings in total hip arthroplasty. J. Arthroplasty 23(2), 311–313 (2008)

    Article  PubMed  Google Scholar 

  42. Sedel, et al.: Alumina–alumina hip replacement. J. Bone Joint Surg. Br. 72, 639–658 (1990)

    Google Scholar 

  43. Sedel, L.: Evolution of alumina-on-alumina implants: a review. Clin. Orthop. Relat. Res. 379, 48–54 (2000)

    Article  PubMed  Google Scholar 

  44. Simon, J., Dayan, A., Ergas, E., et al.: Catastrophic failure of the acetabular component in a ceramic-polyethylene bearing total hip arthroplasty. J. Arthroplasty 13, 108 (1998)

    Article  PubMed  CAS  Google Scholar 

  45. Skinner: Ceramic bearing surfaces. Clin. Orthop. Relat. Res. 369, 83–91 (1999)

    Article  PubMed  Google Scholar 

  46. Steppacher et al.: Outcome of ceramic-ceramic total hip arthroplastry at two to ten years in patients with developmental dysplasia of the hip. Abstract OSAA04-02, ISTA, Seoul, 2008

    Google Scholar 

  47. Toni, et al.: Early diagnosis of ceramic liner fracture. Guidelines based on a twelve-year clinical experience. J. Bone Joint Surg. Am. 88, 55–63 (2006)

    Article  PubMed  Google Scholar 

  48. Toni, et al.: Osteolysis and ceramic-on-ceramic hip prostheses: “fact or fairy tale?”. In: Cobb, J. (ed.) Modern Trends in THA Bearings. Material and Clinical Performance, Springer-Verlag Berlin Heidelberg, 55–60 (2010)

    Google Scholar 

  49. Walter, et al.: Edge loading in third generation alumina ceramic-on-ceramic bearings: stripe wear. J. Arthroplasty 19, 402–413 (2004)

    Article  PubMed  Google Scholar 

  50. Walter, et al.: Squeaking in ceramic-on-ceramic hips: the importance of acetabular component orientation. J. Arthroplasty 22, 496–503 (2007)

    Article  PubMed  Google Scholar 

  51. Widmer, KH.: “Safe Zone” in der HTEP: das zu erreichende Ziel. Leading Opinions 2, 6–8 (2010)

    Google Scholar 

  52. Wollmerstedt, et al.: Aktivitätsmessung von Patienten mit Hüfttotalendoprothesen. Der Orthopäde 35, 1237–1245 (2006)

    Article  PubMed  CAS  Google Scholar 

  53. Zichner, et al.: In-vivo-Verschleiß der Gleitpaarungen Keramik-Polyetyhlen gegen Metall-Polyethylen. [In vivo wear of ceramics-polyethylene in comparison with metal-polyethylene]. Der Orthopäde 26, 129–134 (1997)

    PubMed  CAS  Google Scholar 

  54. Fisher, et al.: Tribology of alternative bearings. Clin. Orthop. Relat. Res. 453, 25–34 (2006)

    Article  PubMed  Google Scholar 

  55. Baldini et al.: Wear and tissue reaction in retrieved ceramic-on-ceramic THA. PF66, EFORT 2009

    Google Scholar 

  56. Capello, et al.: Ceramic-on-ceramic total hip arthroplasty:update. J. Arthroplasty 23, 39–43 (2008)

    Article  PubMed  Google Scholar 

  57. Murphy, et al.: Two-to 9-year clinical results of alumina ceramic-on-ceramic THA. Clin. Orthop. Relat. Res. 453, 97–102 (2006)

    Article  PubMed  Google Scholar 

  58. Mesko, et al.: Ceramic-on-ceramic hip outcome at a 5- to 10 year interval. has lived up to its expectations? In: Cobb, J.P. (ed.) Modern Trends in THA Bearings Material and Clinical Performance, Springer-Verlag Berlin Heidelberg, 209–217 (2010)

    Google Scholar 

  59. Ihle, et al.: Keramik- und Metallköpfe im Dauertest – eine Langzeitanalyse des PE-Abriebs nach 20 Jahren. [Ceramic vs CoCrMo femoral heads in combination with Polyethylene cups. Long term wear analysis at 20 years.]. Orthopädische Praxis 46(5), 221–230 (2009)

    Google Scholar 

  60. Descamps et al.: Comparative study of polyethylene wear in THR: 28 mm diameter ceramic versus metallic head:a fifteen years result. Abstract F67, EFORT, 2008

    Google Scholar 

  61. Dorlot, et al.: Wear analysis of retrieved alumina heads and sockets of hip prostheses. J Biomed Mater Res. 23 (A3 Suppl), 299–310 (1989)

    Article  PubMed  CAS  Google Scholar 

  62. Boehler, et al.: Long-term results of uncemented alumina acetabular implants. J. Bone Joint Surg. Br. 76, 53–59 (1994)

    PubMed  CAS  Google Scholar 

  63. Prudhommeaux, et al.: Wear of alumina-on-alumina total hip arthroplasties at a mean 11-year follow up. Clin. Orthop. Relat. Res. 379, 113–122 (2000)

    Article  PubMed  Google Scholar 

  64. Hernigou, et al.: Ceramic-ceramic bearing decreases osteolysis: a 20-year study versus ceramic-polyethylene on the contralateral hip. Clin. Orthop. Relat. Res. 467(9), 2274–2280 (2009)

    Article  PubMed  Google Scholar 

  65. Thomas, et al.: Orthopädisch-chirurgische Implantate und Allergien. Orthopade 1, 1–14 (2008)

    Google Scholar 

  66. Raman et al.: Functional and clinical outcome of cementless primary arthroplasty of the hip using large diameter cermic bearing couples. Paper F244, EFORT 2010

    Google Scholar 

  67. Kim, Y.H., et al.: Cementless total hip arthroplasty with ceramic-on-ceramic bearing in patients younger than 45 years with femoral-head osteonecrosis. Int. Orthop. 34(8), ­1123–1127 (2010)

    Article  PubMed  Google Scholar 

  68. Kim, Y.H.: The results of a proximally-coated cementless femoral component in total hip replacement. J. Bone Joint Surg. Br. 90, 299–305 (2008)

    Article  PubMed  Google Scholar 

  69. Urban, et al.: Ceramic-on-polyethylene bearing surfaces in total hip arthroplasty: Seventeen to twenty-one-year results. J. Bone Joint Surg. Am. 83, 1688–1694 (2001)

    PubMed  Google Scholar 

  70. Weber, et al.: Polyäthylen-Verschleiß und Spätlockerung der Totalprothese des Hüftgelenkes [Polyethylene wear and late loosening in total hip replacement]. Der Orthopäde 18, 370–376 (1989)

    PubMed  CAS  Google Scholar 

  71. Zagra et al.: Ceramic-ceramic coupling with big heads: clinical outcome. Eur J Orthop Surg Traumatol 17(3), 247–251 (2007)

    Google Scholar 

  72. Dalla Pria, et al.: Evolution for diameter features and results. In: Chang, J.D., Billau, K. (eds.) Bioceramics and Alternative Bearings in Joint Arthroplasty, Steinkopff-Verlag Darmstadt, 99–105 (2007)

    Google Scholar 

  73. Zagra et al.: Ceramic-on-ceramic coupling with 36mm heads. P428, EFORT 2008

    Google Scholar 

  74. Giacometti-Ceroni, et al.: Alumina-on-alumina coupling with 36 mm heads. In: Zippel, H., Dietrich, M. (eds.) Bioceramics in Joint Arthroplasty, Steinkopff-Verlag, Darmstadt, 183 (2003)

    Google Scholar 

  75. Eskelinen, et al.: Total hip arthroplasty for primary osteoarthrosis in younger patients in the Finnish arthroplasty register. 4,661 primary replacements followed for 0-22 years. Acta Orthop. 76, 28–41 (2005)

    Article  PubMed  Google Scholar 

  76. Schmalzried, et al.: The John Charnley Award. Wear is a function of use, not time. Clin. Orthop. Relat. Res. 381, 36–46 (2000)

    Article  PubMed  Google Scholar 

  77. Schmalzried, T.P.: Quantitative assessment of walking activity after total hip or knee replacement. J. Bone Joint Surg. Am. 80, 54–59 (1998)

    Article  PubMed  CAS  Google Scholar 

  78. The Swedish National Hip Register. Annual Report 2008

    Google Scholar 

  79. Clarke, et al.: Wear performance of 36 mm BIOLOX® forte/delta Hip combinations compared in simulated “severe” micro-separation test mode. In: Chang, J.D, Billau, K. (eds.) Bioceramics and Alternative Bearings in Joint Arthroplasty, Steinkopff-Verlag Darmstadt, 33–43 (2007)

    Chapter  Google Scholar 

  80. Stewart, et al.: Long-term wear of ceramic-matrix composite material for hip prostheses under severe swing phase microsimulation. J. Biomed. Mater. Res. Appl. Biomater 66B, ­567–573 (2003)

    Article  CAS  Google Scholar 

  81. Kinkel S.: Wollmerstedt N et al., Patient Activity after Total Hip Arthroplasty Declines with Advancing Age. Clin. Orthop. Relat. Res. published online, 27 February 2009

    Google Scholar 

  82. Wollmerstedt, et al.: The daily activity questionnaire. J. Arthroplasty 25(3), 475–480 (2010)

    Article  PubMed  Google Scholar 

  83. Harris, W.H.: The problem is osteolysis. Clin. Orthop. Relat. Res. 311, 46 (1995)

    PubMed  Google Scholar 

  84. Schmalzried, et al.: Wear in total hip and knee replacements. J. Bone Joint Surg. Am. 81, 115 (1999)

    PubMed  CAS  Google Scholar 

  85. Kobayashi, et al.: Factors affecting aseptic failure of fixation after primary Charnley total hip arthroplasty. Multivariate survival analysis. J. Bone Joint Surg. Am. 79, 1618 (1997)

    PubMed  CAS  Google Scholar 

  86. Harris, W.H.: Wear and periprosthetic osteolysis. Clin. Orthop. Relat. Res. 393, 66–70 (2001)

    Article  PubMed  Google Scholar 

  87. Phillips, et al.: Incidence rates of dislocation, pulmonary embolism, and deep infection during the first six months after elective total hip replacement. J. Bone Joint Surg. Am. 85, 20–26 (2003)

    Article  PubMed  Google Scholar 

  88. Von Knoch, et al.: Late dislocation after total hip arthroplasty. J. Bone Joint Surg. Am. 84, 1949–1953 (2002)

    Google Scholar 

  89. Mason, J.B.: The new demands by patients in the modern era of total joint arthroplasty: a point of view. Clin. Orthop. Relat. Res. 446, 146–152 (2008)

    Article  Google Scholar 

  90. Jasty, et al.: Wear of polyethylene acetabular components in total hip arthroplasty. An analysis of one hundred and twenty-eight components retrieved at autopsy or revision operations. J. Bone Joint Surg. Am. 79(3), 349–358 (1997)

    Article  PubMed  CAS  Google Scholar 

  91. Kesteris, et al.: Polyethylene wear in Scanhip arthroplasty with a 22 or 32 mm head: 62 matched patients followed for 7–9 years. Acta Orthop. Scand. 67(2), 125–127 (1996)

    Article  PubMed  CAS  Google Scholar 

  92. Eggli, et al.: Comparison of polyethylene wear with femoral heads of 22 mm and 32 mm. A prospective, randomized study. J. Bone Joint Surg. Br. 84(3), 447–451 (2002)

    Article  PubMed  CAS  Google Scholar 

  93. Tarasevicius, et al.: Femoral head diameter affects the revision rate in total hip arthroplasty. An analysis of 1,720 hip replacements with 9–21 years of follow-up. Acta Orthop. Scand. 77(5), 706–709 (2006)

    Article  Google Scholar 

  94. Saikko, et al.: Low wear and friction in alumina/alumina total hip joint; a hip simulator study. Acta Orthop. Scand. 69, 443–448 (1998)

    Article  PubMed  CAS  Google Scholar 

  95. Güttler, T.: Experience with BIOLOX®option revision heads. In: Benazzo, F, Falez, F, Dietrich, M. (eds.) Bioceramics and Alternative Bearings in Joint Arthroplasty, Steinkopff-Verlag, Darmstadt, 149–154 (2006)

    Chapter  Google Scholar 

  96. Knahr, et al.: Revision strategies in total hip arthroplasty with respect to articulation materials. In: Benazzo, F, Falez F, Dietrich, M. (eds.) Bioceramics and Alternative Bearings in Joint Arthroplasty, Steinkopff-Verlag Darmstadt, 163–168 (2006)

    Chapter  Google Scholar 

  97. Knahr et al.: Strategies for head and inlay exchange in revision hip arthroplasty. In: Chang, J.D, Billau, K. (eds.) Bioceramics and Alternative Bearings in Joint Arthroplasty, Steinkopff-Verlag Darmstadt, 275–280 (2007)

    Google Scholar 

  98. Walter, W.K.: Australian experience with ceramic systems. In: D’Antonio, J.A, Dietrich, M (eds.) Bioceramics and Alternative Bearings in Joint Arthroplasty, Steinkopff-Verlag Darmstadt, 113–115 (2005)

    Google Scholar 

  99. D’Antonio, et al.: Alumina ceramics bearings for total hip arthroplasty. Clin. Orthop. Relat. Res. 436, 164–171 (2005)

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Service Center Development, CeramTec GmbH, CeramTec Platz 1–9, 73207, Plochingen, Germany

    Meinhard Kuntz

  2. Medical Products Division, CeramTec GmbH, CeramTec Platz 1–9, 73207, Plochingen, Germany

    Sylvia Usbeck & Thomas Pandorf

  3. Medical Products Division, CeramTec North America, 533 Princeton Cove, Memphis, TN, 38117, USA

    Ricardo Heros

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  1. Meinhard Kuntz
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  2. Sylvia Usbeck
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  3. Thomas Pandorf
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  4. Ricardo Heros
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Correspondence to Meinhard Kuntz .

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  1. , 2nd Orthopaedic Department, Orthopaedic Hospital Vienna-Speising, Speisinger Straße 109, Vienna, 1130, Austria

    Karl Knahr

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Kuntz, M., Usbeck, S., Pandorf, T., Heros, R. (2011). Ceramic Hip Replacements: Wear Behavior Affects the Outcome – A Tribological and Clinical Approach. In: Knahr, K. (eds) Tribology in Total Hip Arthroplasty. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-19429-0_3

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