Clinical Orthopaedics and Related Research · 1988 · 301 citations · 0 references
MedicineOrthopaedic SurgeryOrthopedic SurgeryJoint Replacement SurgeryOrthopedic BiomechanicsOrthopedicsArthroplasty BiomechanicsComplications Of ArthroplastyHip ArthroplastyJoint Load DistributionJoint LoadingKnee ArthroplastyAcetabular Component PositioningAcetabular LooseningFemoral Component DesignFemoral Component PositioningFemoral LooseningFollow-up StudiesPreoperative Patient SelectionProsthesis Design
Loosening is the most common long-term problem following total hip arthroplasty. Many factors, including patient selection, cement technique, femoral component placement, and prosthesis design reportedly affect the incidence of loosening. Theoretically, the location of the hip center of rotation substantially affects the load on the hip, and superior and lateral hip center location will result in higher loads than medial and inferior placement. Long-term follow-up studies (average, 9.1 years after surgery) using logistical regression analysis demonstrate significantly higher rates of femoral loosening with acetabular components placed in a superior and lateral (i.e., nonanatomic) position, compared with acetabular components placed in a nearly anatomic position.