THA Other Complications

(OBQ13.121) A 55-year-old patient returns for followup 2 years after a left ceramic-on-ceramic total hip arthroplasty. He has no pain or symptoms of instability. The video in Figure V shows him ascending stairs. All of the following factors may contribute to this phenomenon EXCEPT Tested Concept

(OBQ13.20) A 38-year-old female patient presents to your office three years after a hip resurfacing. She complains of worsening left hip discomfort for the last 6 months. Her ESR is 12 (normal 0-20) and CRP is 1.2 (0-5). A radiograph and axial and coronal MRI scans are shown in Figures A, B, and C. What is the most likely diagnosis? Tested Concept

(OBQ12.234) A 67-year-old female complains of anterior groin pain one year following a primary, uncemented total hip arthroplasty. The pain is exacerbated when she tries to climb stairs or get up from a seated position. She denies any recent fevers or chills. On physical exam, the pain is reproduced with resisted seated hip flexion. Laboratory analysis, including WBC, ESR, and CRP are within normal limits. Radiographs reveal that the components are appropriately positioned without evidence of loosening or fracture. Which of the following is the most appropriate at this time? Tested Concept

(OBQ12.164) A 45-year-old man has had the gait disturbance shown in Video A ever since a total hip replacement two years ago. Since then he has undergone physical therapy and nerve exploration without any clinical improvement. Extensive AFO bracing was attempted but was not tolerated by the patient. A recent ankle radiograph is shown in Figure A. The Silfverskiold test reveals dorsiflexion of 20 degrees with knee flexion, and 10 degrees with full knee extension. The results of muscle testing using a Cybex dynamometer are shown in Figure B. What is the most appropriate next step in in treatment. Tested Concept

(SAE07HK.85) A 62-year-old patient is seen for routine follow-up after undergoing cementless total hip arthroplasty 2 years ago. The patient reports limited range of motion that severely affects daily activities. A radiograph is shown in Figure 51. Management should now consist of Tested Concept

(SAE07HK.80) Figure 49 shows a histologic section of the lung in a patient who died during total hip arthroplasty. What unexpected finding is seen in the pulmonary capillaries? Tested Concept

(SAE07HK.47) A 58-year-old patient who underwent bilateral hip arthroplasty 12 years ago now reports pain in his hips and difficulty with ambulation to the point where he now uses crutches. A radiograph of the hip and pelvis is shown in Figure 26. What is the best treatment option for this patient? Tested Concept

(SAE07HK.41) Figure 23 shows failure of the femoral stem in a patient. What is the most likely reason for the failure? Tested Concept

(SAE07HK.3) A metal-on-metal bearing used for total hip arthroplasty shows which of the following properties? Tested Concept

(OBQ06.141) The preoperative pelvic radiograph of a 63-year-old female with osteoarthritis is shown in Figure A. She undergoes an uncomplicated total hip replacement. Six weeks post-operatively she complains that her right leg is longer than her left, and an AP pelvic radiograph is obtained which is shown in Figure B. Physical exam shows normal post-operative range of motion and strength in both hips. What is the most likely etiology for this patients gait impairment? Tested Concept