Fifty-nine revisions that were done for aseptic acetabular loosening
after 6,128 total hip arthroplasties for degenerative arthritis or
traumatic arthritis were studied. These revisions were in forty-four
(approximately 1 per cent) of 4,576 hips that had a twenty-two-millimeter
femoral-head component, in two of 520 that had a twenty-eight-millimeter
femoral-head component, and in thirteen (approximately 2.5 per cent) of 487
that had a thirty-two-millimeter femoral-head component. Therefore, the
thirty-two-millimeter femoral component was associated with the highest
rate of acetabular revision (p less than 0.001). The dimensions of the
acetabular wall were thinner in the hips that had the thirty-two-millimeter
component than in those that had the twenty-two-millimeter component (p
less than 0.05). Multivariate analysis demonstrated a significantly
increased risk of acetabular loosening in men and in patients who were less
than sixty years old.