Functional Impairment in Aseptic Loosening of Total Hip Arthroplasty: The Role of Defect Severity, Osteolysis Burden, and Fixation Type
References
- Koutalos A, Varitimidis S, Malizos K, Karachalios T. Revision total hip arthroplasty for aseptic loosening compared with primary total hip arthroplasty for osteoarthritis: long-term clinical, functional and quality of life outcome data. Hip Int. 2023;33(5):889-898. doi:10.1177/11207000221115354.
- Kuroda Y, Hayashi S, Hashimoto S, Matsumoto T, Takayama K, Kuroda R. Predictors of health-related quality of life after revision total hip arthroplasty for aseptic loosening. Indian J Orthop. 2020;54(4):463-468. doi:10.1007/s43465-020-00057-y.
- Aghayev E, Teuscher R, Neukamp M, Lee EJ, Melloh M, Eggli S, et al. The course of radio-graphic loosening, pain and functional outcome around the first revision of a total hip arthroplasty. BMC Musculoskelet Disord. 2013;14:167. doi:10.1186/1471-2474-14-167.
- Anil U, Singh V, Schwarzkopf R. Diagnosis and detection of subtle aseptic loosening in total hip arthroplasty. J Arthroplasty. 2022;37(8):1494-1500. doi:10.1016/j.arth.2022.02.060.
- Bragina S. Modern possibilities with early laboratory diagnosis of periprosthetic osteolysis predating aseptic loosening in total hip arthroplasty (literature review). Genij Ortop. 2020;26(2):261-265. doi:10.18019/1028-4427-2020-26-2-261-265.
- He A, Zhang Y, Lu C, Cao L, Liu J, Zhong Z. Imaging study of aseptic loosening of the acetabular cup after cementless total hip arthroplasty: a retrospective study. BMC Musculoskelet Disord. 2025;26:1. doi:10.1186/s12891-025-08607-x.
- Li G, Zhang J, Huang Y. Factors associated with aseptic loosening after primary total hip arthroplasty: a systematic review and meta-analysis. World J Orthop. 2026;17(1):114482. doi:10.5312/wjo.v17.i1.114482.
- Macinnes SJ, Gordon A, Wilkinson JM. Risk factors for aseptic loosening following total hip arthroplasty. In: Recent Advances in Arthroplasty. InTech; 2012. doi:10.5772/26975.
- Sandberg O, Carlsson S, Harbom E, Cappelen V, Tholén S, Olivecrona H, et al. Inducible displacement CT increases the diagnostic accuracy of aseptic loosening in primary total hip arthroplasty. Acta Orthop. 2022;93:831-836. doi:10.2340/17453674.2022.5240.
- Schwaiger BJ, Gassert FT, Suren C, Gersing AS, Haller B, Pfeiffer D, et al. Diagnostic accuracy of MRI with metal artifact reduction for the detection of periprosthetic joint infection and aseptic loosening of total hip arthroplasty. Eur J Radiol. 2020;131:109253. doi:10.1016/j. ejrad.2020.109253.
- Apostu D, Lucaciu O, Berce C, Lucaciu D, Cosma D. Current methods of preventing aseptic loosening and improving osseointegration of titanium implants in cementless total hip arthroplasty: a review. J Int Med Res. 2018;46(6):2104-2119. doi:10.1177/0300060517732697.
- Ayekoloye C, Qa’oud M, Radi M, León S, Kuzyk P, Safir O, et al. Review of complications, functional outcome, and long-term survival following conversion of hip fusion to total hip arthroplasty. Bone Joint J. 2021;103-B(7 Supple B):129-134. doi:10.1302/0301-620X.103B7. BJJ-2020-2382.R1.
- Baroni S, Oliviero S, Viceconti M, Curreli C. In silico model for aseptic loosening prediction in cementless hip stems: a design of experiments. J Biomech Eng. 2025;147:1-24. doi:10.1115/1.4070009.
- Cherian JJ, Jauregui JJ, Banerjee S, Pierce TP, Mont MA. What host factors affect aseptic loosening after THA and TKA? Clin Orthop Relat Res. 2015;473(8):2700-2709. doi:10.1007/s11999-015-4220-2.
- Chiarlone F, Zanirato A, Cavagnaro L, Alessio-Mazzola M, Felli L, Burastero G. Acetabular custom-made implants for severe acetabular bone defect in revision total hip arthroplasty: a systematic review of the literature. Arch Orthop Trauma Surg. 2020;140(3):415-424. doi:10.1007/s00402-020-03334-5.
- Del Buono A, Denaro V, Maffulli N. Genetic susceptibility to aseptic loosening following total hip arthroplasty: a systematic review. Br Med Bull. 2012;101:39-55. doi:10.1093/bmb/ldr011.
- El-Warrak AO, Olmstead M, Rechenberg B, Auer JA. A review of aseptic loosening in total hip arthroplasty. Vet Comp Orthop Traumatol. 2001;14(3):115-124. doi:10.1055/s-0038-1632685.
- Gallo J, Konttinen YT, Goodman SB, Thyssen JP, Gibon E, Pajarinen J, et al. Aseptic loosening of total hip arthroplasty as a result of local failure of tissue homeostasis. In: Recent Advances in Arthroplasty. InTech; 2012:319-362. doi:10.5772/25817.
- Gallo J, Vaculová J, Goodman SB, Konttinen YT, Thyssen JP. Contributions of human tissue analysis to understanding the mechanisms of loosening and osteolysis in total hip replacement. Acta Biomater. 2014;10(6):2354-2366. doi:10.1016/j.actbio.2014.02.003.
- Goh EL, Boughton OR, Donnelly TD, Murphy CG, Cashman J, Green C. Do joint-preserving hip procedures compromise subsequent total hip arthroplasty? A meta-analysis of complications, functional outcome and survivorship. SICOT J. 2024;10:18. doi:10.1051/sicotj/2024018.
- Hanif M, Arshad N, Habib Y, Shami A, Rehman O, Rehman M, et al. Effect of cementing technique on aseptic stem loosening in cemented primary total hip arthroplasty: a systematic review and meta-analysis. Ann Med Surg. 2023;85(6):2884-2895. doi:10.1097/MS9.0000000000000734.
- Iannotti JP, Balderston RA, Booth RE, Roth-man RH, Cohn JC, Pickens GT. Aseptic loosening after total hip arthroplasty. Incidence, clinical significance, and etiology. J Arthroplasty. 1986;1(2):99-107. doi:10.1016/s0883-5403(86)80047-x.
- Innocenti M, Smulders K, Willems JH, Goosen JHM, van Hellemondt G. Patient-reported outcome measures, complication rates, and re-revision rates are not associated with the indication for revision total hip arthroplasty: a prospective evaluation of 647 consecutive patients. Bone Joint J. 2022;104-B(7):859-866. doi:10.1302/0301-620X.104B7.BJJ-2021-1739.R1.
- Jud L, Rüedi N, Dimitriou D, Hoch A, Zingg PO. High femoral offset as a risk factor for aseptic femoral component loosening in cementless primary total hip arthroplasty. Int Orthop. 2024;48(5):1217-1224. doi:10.1007/s00264-024-06116-5.
- Kienzle A, Walter S, von Roth P, Fuchs M, Winkler T, Müller M. High rates of aseptic loosening after revision total knee arthroplasty for periprosthetic joint infection. JBJS Open Access. 2020;5(3):e20.00026. doi:10.2106/JBJS. OA.20.00026.
- Kochbati R, Rbai H, Jlailia M, Makhlouf H, Bouguira A, Daghfous M. Predictive factors of aseptic loosening of cemented total hip prostheses. Pan Afr Med J. 2016;24:260.
- Moret CS, Masri SE, Schelker BL, Friederich NF, Hirschmann MT. Unexpected early loosening of rectangular straight femoral Zweymüller stems with an alumina-reduced surface after total hip arthroplasty—a prospective, double-blind, randomized controlled trial. J Orthop Traumatol. 2024;25:9. doi:10.1186/s10195-023-00743-1.
- Boas FE, Fleischmann D. Evaluation of two iterative techniques for reducing metal artifacts in computed tomography. Radiology. 2011;259(3):894-902. doi:10.1148/radiol.11101782.
- Papagiannis S, Tatani I, Kyriakopoulos G, Kokkalis Z, Megas P, Stathopoulos C, et al. Alterations in small non-coding microRNAs (miRNAs) and the potential role in the development of aseptic loosening after total hip replacement: study protocol for an observational, cross-sectional study. Cureus. 2024;16:e72179. doi:10.7759/cureus.72179.
- Papagiannis S, Kokkalis Z, Kyriakopoulos G, Petropoulou A, Tatani I, Kotsia C, et al. Alterations in circulating miRNAs and their potential role in aseptic loosening after total hip replacement: an observational, cross-sectional study. J Pers Med. 2025;15(11):508. doi:10.3390/jpm15110508.
- Peddada KV, Welcome BM, Parker MN, Delma C, Holland CT, Giordani M, et al. Aseptic loosening in single-stage revision arthroplasty for periprosthetic joint infection. J Orthop Exp Innov. 2022. doi:10.60118/001c.32652.
- Pegios VF, Kenanidis E, Tsotsolis S, Potoupnis M, Tsiridis E. Bisphosphonates’ use and risk of aseptic loosening following total hip arthroplasty: a systematic review. EFORT Open Rev. 2023;8(11):798-808. doi:10.1530/EOR-22-0121.
- Ricciardi G, Siracusano L, Micale E, Addorisio V, Ballato M, Donadio D, et al. Aseptic loosening in total hip arthroplasty: pathophysiology, biomarkers, and preventive treatment strategies. Appl Sci. 2025;15(16):9156. doi:10.3390/app15169156.
- Röder C, Vogel R, Burri L, Dietrich D, Staub LP. Total hip arthroplasty: leg length inequality impairs functional outcomes and patient satisfaction. BMC Musculoskelet Disord. 2012;13:95. doi:10.1186/1471-2474-13-95.
- Rysinska A, Sköldenberg O, Garland A, Rolfson O, Aspberg S, Eisler T, et al. Aseptic loosening after total hip arthroplasty and the risk of cardiovascular disease: a nested case-control study. PLoS One. 2018;13(11):e0204391. doi:10.1371/journal.pone.0204391.
- Sitorus IB, Dilogo IH. Functional and radiological outcome of revision total hip arthroplasty in the Indonesian National Referral Hospital. Hip Knee J. 2022;3(1). doi:10.46355/hipknee. v3i1.116.
- Bhaskaran T, Kp R, K R, Ahuja V. Functional outcome of cemented total hip arthroplasty by Moore’s approach. Int J Orthop Sci. 2025;11(1). doi:10.22271/ortho.2025.v11.i1a.3698.
- Thejeel B, Endo Y. Imaging of total hip arthroplasty: part II — imaging of component dislocation, loosening, infection, and soft tissue injury. Clin Imaging. 2022;92:72-82. doi:10.1016/j. clinimag.2022.09.011.
- Valles G. Biomarkers in focus: addressing wear and aseptic loosening in patients with total hip arthroplasty. Orthop Proc. 2025;107-B(Suppl 6). doi:10.1302/1358-992X.2025.6.086.
- Abolghasemian M. Aseptic loosening in hip arthroplasty (a brief review). Iran J Orthop Surg. 2015;13:36-42.
- Al-Abboodi H. Evaluation of aseptic loosening of primary hip arthroplasty. Karbala J Med. 2020;16:30-37. doi:10.47723/kcmj.v16i1.187.
Language: English
Page range: 125 - 136
Published on: Jun 30, 2026
Published by: Macedonian Academy of Sciences and Arts
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© 2026 Darko Talevski, Jasminka Nancheva, Jasmin Ciriviri, Zoran Nestorovski, Zorica Vangelovska, Dusko Ciriviri, Kuzman Stefanovski, Jovanova Aleksandra, published by Macedonian Academy of Sciences and Arts
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