Predisposition of Hip Prosthesis Component Positioning on Dislocation Risk: Biomechanical Considerations Based on Finite Element Method Analysis

Abstract

Background/Objectives: Total hip arthroplasty (THA) is a widely accepted and effective intervention for advanced degenerative hip disease. However, prosthetic dislocation remains one of the most common postoperative complications. This study aimed to evaluate the biomechanical consequences of implant positioning variations and their influence on prosthetic stability. Methods: A three-dimensional finite element model (FEM) of the pelvis and hip joint was developed using SolidWorks Professional 2025, based on CT imaging of an anatomically normal adult. Multiple implant configurations were simulated, varying acetabular cup inclination and anteversion angles, femoral stem depth, and femoral offset. Muscle force vectors replicating single-leg stance conditions were applied according to biomechanical reference data. The mechanical performance of each configuration was quantified using the safety factor (SF), defined as the ratio of allowable material stress to calculated stress in the model. Results: The configuration with 45° cup inclination, 15° anteversion, standard femoral offset, and optimal stem depth demonstrated the highest SF values (9–12), indicating a low risk of mechanical failure or dislocation. In contrast, malpositioned implants—particularly those with low or high anteversion, excessive offset, or shallow stem insertion—resulted in a marked decrease in SF values (2–5), especially in the anterosuperior and posterosuperior quadrants of the acetabular interface. Conclusions: The findings underscore the critical importance of precise implant alignment in THA. Even moderate deviations from optimal positioning can substantially compromise biomechanical stability and increase the risk of dislocation. These results support the need for individualized preoperative planning and the use of assistive technologies during surgery to enhance implant placement accuracy and improve clinical outcomes.