Pathogenesis of bone loss after total hip arthroplasty

Orthop Clin North Am. 1998 Apr;29(2):173-86. doi: 10.1016/s0030-5898(05)70316-3.


Bone loss with or without evidence of aseptic loosening is a long term complication after total hip arthroplasty (THA). It occurs with all materials and in all prosthetic systems in use or that have been used to date. Bone loss after THA can be a serious problem in revision surgery because bone deficiencies may limit reconstructive options, increase the difficulty of surgery, and necessitate autogenous or allogenic bone grafting. There are three factors adversely affecting maintenance of bone mass after THA: (1) bone loss secondary to particulate debris; (2) adaptive bone remodeling and stress shielding secondary to size, material properties, and surface characteristics of contemporary prostheses; and (3) bone loss as a consequence of natural aging. This chapter reviews the mechanisms of the primary causes of bone loss after THA.

Publication types

  • Review

MeSH terms

  • Aging / physiology
  • Alloys / adverse effects
  • Alloys / chemistry
  • Arthroplasty, Replacement, Hip / adverse effects*
  • Biocompatible Materials / adverse effects
  • Biocompatible Materials / chemistry
  • Bone Remodeling
  • Bone Resorption / etiology*
  • Bone Resorption / physiopathology
  • Bone Resorption / surgery
  • Bone Transplantation
  • Hip Prosthesis / adverse effects
  • Humans
  • Osteoporosis / etiology
  • Osteoporosis / physiopathology
  • Polyethylenes / adverse effects
  • Polyethylenes / chemistry
  • Prosthesis Design
  • Prosthesis Failure
  • Reoperation
  • Stress, Mechanical
  • Surface Properties
  • Transplantation, Autologous
  • Transplantation, Homologous


  • Alloys
  • Biocompatible Materials
  • Polyethylenes