Please confirm topic selection

Are you sure you want to trigger topic in your Anconeus AI algorithm?

Please confirm action

You are done for today with this topic.

Would you like to start learning session with this topic items scheduled for future?

Review Question - QID 534

In scope icon L 2 C
QID 534 (Type "534" in App Search)
A 85-year-old man who underwent hemiarthroplasty 5 years ago now complains of thigh pain for the past four months. Laboratory studies show a normal white blood cell count (WBC), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). An aspiration of the hip is performed and is negative for infection. A radiograph is shown in Figure A. Which of the following is the best management option for the femoral implant?
  • A

Bone scan to look for loosening

10%

292/2788

Touch down weight bearing and physical therapy

1%

29/2788

Revision with a tumor prosthesis

2%

69/2788

Revision of femoral component with metaphyseal cement fixation of the stem

14%

383/2788

Revision to a cementless femoral component with diaphyseal press-fit fixation of the stem

72%

1999/2788

  • A

Select Answer to see Preferred Response

bookmode logo Review TC In New Tab

The radiograph shows lucency around the femoral stem cement mantle consistent with loosening. There is bone loss in the proximal femur. Diaphyseal fixation is the best option from the choices available. Revision to a cementless femoral stem is the most appropriate management.

Paprosky et al. described their results of revision to cementless femoral components and report 95% survivorship with a minimum of 10 years follow up.

Haydon et al showed that despite historical literature discouraging the use of cemented femurs for revision, in their experience cemented femoral revision had 91% survivorship when the cause was aseptic loosening. They found early generation cementing techniques, poor cement mantle, poor bone quality, age of less than 60, and male gender to be risk factors for failure in cemented revisions.

REFERENCES (2)
Authors
Rating
Please Rate Question Quality

2.8

  • star icon star icon star icon
  • star icon star icon star icon
  • star icon star icon star icon
  • star icon star icon star icon
  • star icon star icon star icon

(42)

Attach Treatment Poll
Treatment poll is required to gain more useful feedback from members.
Please enter Question Text
Please enter at least 2 unique options
Please enter at least 2 unique options
Please enter at least 2 unique options