Total Hip Acetabular Component Position Affects Component Loosening Rates

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.