[Aseptic loosening of cemented, total hip alloplasty]

The cemented low-friction arthroplasty of the hip (THR) has emerged as one of the most successful operations. About 3.500 THR's are inserted every year in Denmark, the clinical success rate at ten years being 90-95 percent. The most frequent long-term complication remains aseptic loosening of the prosthesis. This mechanism of failure is still a matter of discussion and it seems that aseptic loosening is a rather complex and multifactorial process. Our review deals with the various hypotheses with special reference to particulate debris generated at the prosthesis' surfaces and its active biological role in inducing aseptic loosening.