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We conducted a radiographic assessment of 180 flanged modular titanium alloy Capital femoral hip replacements. Six significant factors associated with failure are identified. The mean followup period was 7.9 years (2.1-16 years) and there were 26 (14%) radiographic failures irrespective of whether these were symptomatic or led to revision. Failure, if it is going to occur, is initiated early, within an average of 1.4 years, and becomes clinically evident very quickly; the remainder appear to sustain more likelihood of stable survival. This is the longest published follow-up and it suggests that the survival is better than indicated in some other series. If the identified prejudicial aspects of surgical technique had not been present, it follows that the results would have been better. Comparison with other published series is attempted.