I am very familiar with microport products and I have recently implanted them. With regard to confirming the correct implant size, the surgeon is always the last stop. However, all members of the team should work together. If there is a labeling issue on the package, there will be a large share of liability attributed to the manufacturer. This should be very clear. There is a product label on the packaging that is part of the medical record. If the patient has been revised there is a laser etching on the head confirming the size (if it’s metal). If it was a ceramic head it was made by BIOLOX which makes all ceramic heads currently used in the US.
Most protocols for best practice have the representative show the packaging to the surgeon who confirms the correct size. The circulating nurse then opens the packages and also confirms the size and records it in the medical record with implant stickers. The scrub should then read out the marking on the implant and the present the final implant to the surgeon so that he/she can see the marking finally confirming the size. With a familiar team, there may be a level of trust between the surgeon and the other members so that procedure may be somewhat abbreviated. But the final responsibility will always fall on the surgeon. If an implant was labeled as one size and packaged as the wrong size, there is a significant liability to the manufacturer. We trust that a 36mm is a 36mm if it’s labeled on the package and implant as a 36mm- if that’s the case, it’s very interesting and exceedingly rare. Stability of the hip joint is very dependent on the positioning and sizing of the joint. If there was a mismatched head/cup combo it would have no hope for success. The cup liners in total hip come in different sizes that are matched to the head. A 36mm liner matched to a 32mm head would be obvious and would not be stable intraoperatively. The post-films would also be askew.