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©The Author(s) 2026. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Jan 18, 2026; 17(1): 114482
Published online Jan 18, 2026. doi: 10.5312/wjo.v17.i1.114482
Published online Jan 18, 2026. doi: 10.5312/wjo.v17.i1.114482
Factors associated with aseptic loosening after primary total hip arthroplasty: A systematic review and meta-analysis
Guo-Qing Li, Department of Orthopedics, Beijing Jishuitan Hospital, Capital Medical Uni
Ji Zhang, Yong Huang, Department of Orthopedics, National Center for Orthopaedics, Beijing Jishuitan Hospital, Capital Medical University, Beijing 100035, China
Author contributions: Li GQ contributed to investigation, methodology, writing-original draft, editing; Zhang J contributed to review; Huang Y contributed to writing-review.
Supported by the National Natural Science Foundation of China, No. 82402789; Beijing Jishuitan Hospital Youcai Plan, No. KYYC202402; Beijing Jishuitan Research Funding, No. HL202402; and Beijing Natural Science Foundation, No. L232062, and No. L222063.
Conflict-of-interest statement: All authors declare that they have no conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Check-list.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Guo-Qing Li, MD, Principal Investigator, Senior Scientist, Department of Orthopedics, Beijing Jishuitan Hospital, Capital Medical University, No. 31 Xinjiekou East Street, Xicheng District, Beijing 100035, China. guoqingli@pku.edu.cn
Received: September 22, 2025
Revised: October 21, 2025
Accepted: December 1, 2025
Published online: January 18, 2026
Processing time: 111 Days and 6.6 Hours
Revised: October 21, 2025
Accepted: December 1, 2025
Published online: January 18, 2026
Processing time: 111 Days and 6.6 Hours
Core Tip
Core Tip: Aseptic loosening is the main cause of failure in primary total hip arthroplasty, yet the key risk factors remain unclear. Our meta-analysis of 20 studies clarifies this: Modifiable factors like high body mass index, comorbidity burden, and prosthesis choice significantly increase risk, while surgical expertise is protective. This evidence enables surgeons to identify high-risk patients and prioritize modifiable factors, paving the way for personalized prevention strategies and improved implant longevity.