Factors associated with early loosening of cemented total hip prostheses

Patient data and radiograms from a series of 237 consecutive total hip replacements were evaluated by means of a computer programme in an attempt to study factors correlated with early loosening. We found that the loosening rate was significantly influenced by several factors. The CAD-prosthesis (Computer Assisted Design, Howmedica) was found to be superior to the Charnley-Müller-prosthesis. The viscosity of the cement seemed to be an important factor in that low viscosity was positively correlated to loosening whereas high viscosity showed a negative correlation. Several technical details in the performance of the operations as well as loosening correlated with the surgeon. Males who preoperatively had fairly unrestricted physical activity and high body weight were more prone to early loosening. No correlation was found with the diagnosis, previous hip surgery, age, osteoporosis or cortisone treatment preoperatively. We wish to underline the importance of a thorough technique and suggest that total hip replacement should be performed by specialized surgeons.