## 1 Introduction  
Total hip arthroplasty (THA), commonly referred to as total hip replacement, is a surgical procedure that replaces diseased or damaged hip joints with prosthetic implants. It has become the gold standard for treating degenerative hip conditions, effectively restoring function and alleviating pain when conservative treatments fail. Osteoarthritis, a degenerative joint disease characterized by the breakdown of cartilage, stands as a primary indication for THA, primarily in older adults with chronic hip pain and limited range of motion. Rheumatid arthritis, an autoimmune condition affecting the synovial membrane, can lead to joint destruction and necessitate surgical intervention to improve quality of life. Avascular necrosis, stemming from compromised blood supply to the hip joint, poses another crucial indication, often exacerbated by factors such as trauma or long-term corticosteroid use. Additionally, post-traumatic arthritis resulting from fractures or injuries to the hip joint may necessitate arthroplasty for restoration of function. In some cases, congenital abnormalities or developmental dysplasia of the hip may contribute to the need for surgical intervention. As hip arthroplasty continues to evolve, its application extends beyond these primary disorders, embracing a diverse spectrum of conditions and improving the lives of a wide range of patient demographics. Although THA is a widely practiced and effective orthopedic procedure, complications such as mechanical failure, aseptic loosening, dislocation, and instability remain concerns, often necessitating revision surgery. Additionally, patient-specific factors, including age, gender, and comorbidities, can influence surgical outcomes. Addressing these challenges requires improved preoperative planning and implant fixation strategies [1; 2; 3; 4; 5]. Many procedures can be performed with a \"press-fit\" application, typically in younger, more active patients with sufficient bone quality. The interface between the bony pelvis and the porous surface of the acetabular cup implant allows for bone ingrowth over time, enhancing fixation stability and promoting the long-term integration of the implant (Figure 1). However, while a certain amount of friction is necessary to promote bony ingrowth at the interface between the pelvis and the acetabular cup, too much movement can prevent this process and cause loosening over time [6; 7]. In cases of suboptimal bone quality, cup size issues, or other patient factors, the implant requires further fixation into the bony pelvis using various screw configurations, as demonstrated in Figure 2[8]. Figure 1: Bone in acetabular cup fixation. Illustration demonstrating bone ingrowth between bony pelvis and porous surface of metal acetabular cup implant. Ingrowth enhances fixation stability and long-term integration of implant, reducing risk for failure from loosening. Screw fixation presents challenges, particularly in avoiding critical anatomical structures, such as arteries, veins, and nerves [9; 10; 11; 12]. For hip implants that do not meet the requirements for a press-fit application, determining the proper amount and location of the screws falls upon the operating surgeon's discretion and preference. Many studies addressing this problem have compared surgical approaches, reviewed common causes of implant failure, and highlighted postoperative patient outcomes [13; 14; 15; 16; 17; 18; 19; 20; 21]. Computational modeling has become an increasingly valuable tool in assessing THA success. While motion analysis can quantify functional improvements, it does not provide insights into biomechanical optimization. Finite element analysis (FEA), in contrast, allows for precise simulations of stress distribution and implant stability, enabling surgeons to refine implant positioning and fixation strategies [22]. There are little to no studies focusing on predictive modeling methods to optimize the initial surgery and to prevent the need for revision surgery.