International Orthopaedics

, Volume 41, Issue 4, pp 715–722 | Cite as

Early aseptic loosening of cementless monoblock acetabular components

  • Simo S. A. Miettinen
  • Tatu J. MäkinenEmail author
  • Inari Laaksonen
  • Keijo Mäkelä
  • Heini Huhtala
  • Jukka Kettunen
  • Ville Remes
Original Paper



Early aseptic loosening of cementless monoblock acetabular components is a rare complication of total hip arthroplasty (THA) and hip resurfacing arthroplasty (HRA). The purpose of this study was to evaluate the incidence and risk factors for early aseptic loosening of the cementless monoblock acetabular components.


This retrospective analysis consisted of 4,043 cementless hip devices (3,209 THAs and 834 HRAs). We identified 41 patients with early aseptic loosening of the acetabular component. A control group of 123 patients without acetabular component loosening was randomly selected. The demographic data and risk factors for loosening of the acetabular component were evaluated. The mean follow-up time was 4.6 years (range, 1.7–7.8). The end-point was acetabular revision.


The incidence of early acetabular component loosening was 1.0 %. Mean time to revision was 1.2 years (SD 1.6, range 0.0–5.4). There was significantly more Dorr type A and C acetabular morphology in patients with early loosening (P = 0.014). The loosened components were implanted to more vertical (P < 0.001) and less anteverted (P = 0.001) position than those of the control group. Presence of acetabular dysplasia or acetabular component type did not associate to early loosening.


Acetabular morphology (Dorr type A and C) and component positioning vertically and less anteverted were more common in patients with early aseptic loosening of cementless acetabular components. Suboptimal cup position most likely reflects challenges to obtain sufficient stability during surgery. We hypothesize that errors in surgical technique are the main reason for early loosening of monoblock acetabular components.


Acetabular morphology Aseptic loosening Case–control study Cup positioning Hip arthroplasty 


Compliance with ethical standards


This study was funded by the Finnish Arthroplasty Society, Finnish Research Foundation for Orthopaedics and Traumatology, Research Foundation of Kuopio University Hospital, the Jane and Aatos Erkko Foundation, Finnish Cultural Foundation, North Savo Regional Fund, and The Finnish Medical Foundation Duodecim.

Conflict of interest and funding

The authors state there are no conflicts of interest.

Supplementary material

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Copyright information

© SICOT aisbl 2016

Authors and Affiliations

  • Simo S. A. Miettinen
    • 1
  • Tatu J. Mäkinen
    • 2
    Email author
  • Inari Laaksonen
    • 3
  • Keijo Mäkelä
    • 3
  • Heini Huhtala
    • 4
  • Jukka Kettunen
    • 1
  • Ville Remes
    • 2
    • 5
  1. 1.Department of Orthopaedics, Traumatology and Hand SurgeryKuopio University HospitalKuopioFinland
  2. 2.Department of Orthopaedics and TraumatologyHelsinki University Hospital and University of HelsinkiVantaaFinland
  3. 3.Department of Orthopaedics and TraumatologyTurku University Central HospitalTurkuFinland
  4. 4.School of Health SciencesUniversity of TampereTampereFinland
  5. 5.Pihlajalinna OyHelsinkiFinland

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