Instability of total hip prostheses at rotational stress. A roentgen stereophotogrammetric study

Roentgen stereophotogrammetric analysis (RSA) has been carried out on 24 total hip prostheses (24 patients), which were all painful at weightbearing. The examinations were made with the hip at distraction, compression, external and internal rotation. One acetabular component showed instability only at distraction-compression and one showed instability only at rotation. Four femoral components showed instability at distraction-compression and at rotation, six only at rotation, but none showed instability only at distraction-compression. Thus rotational provocation demonstrated instability in all unstable femoral components; rotational stress must be of importance in mechanical loosening of the femoral component.