3.9 of 57 Ratings
A 45-year-old male presents with increasing left groin pain. He has a history of bilateral hip avascular necrosis and underwent bilateral hip resurfacing arthroplasties 3 years ago. He is a recreational runner and recently ran a 10-kilometer race several weeks ago. Figure A demonstrates an AP radiograph of his pelvis. Serum testing demonstrated a cobalt level of 10 mcg/L (reference 0.8 - 5.1 mcg/L) and chromium level of 7 mcg/L (reference 0.5 - 2.5 mcg/L). What is the likely cause of the patient's symptoms?
Prosthetic joint infection
Increased activity-related wear
Femoral neck stress fracture
Select Answer to see Preferred Response
A 40-year-old male presents with chronic severe and progressively worsening right hip pain which has been intractable to conservative management. He has a history of avascular necrosis of the femoral head with subsequent collapse and development of severe osteoarthritis. After discussion of his surgical options, he elects to proceed with the procedure shown in Figure A. He presents to the emergency department 2 months later with severe groin pain and inability to bear weight. Radiographs obtained at this time are shown in Figure B. Each of the following has been shown to increase the risk for development of this complication post-operatively EXCEPT:
History of avascular necrosis with cystic bone loss
Notching of the superior aspect of the femur
Varus placement of the femoral component
Incomplete seating of the femoral implant
Excessive inclination of the acetabular component
An active 40-year-old male undergoes hip surgery for arthritis. A post-operative radiograph is provided in Figure A. Each of the following are complications associated with this procedure EXCEPT:
Deep vein thrombosis
Femoral neck fracture
Which of the following is the most common reason for reoperation following hip resurfacing in the first 6 months following the operation?
Aseptic loosening of the acetabular component
Aseptic loosening of the femoral component
Fracture of the femoral neck
Fracture of the acetabulum
Which of the following complications is the primary reason for early reoperation following the procedure shown in Figure A?
Edge loading leading to rapid polyethylene wear
Groin pain from accelerated acetabular erosion
All of the following are absolute or relative contraindication to hip resurfacing arthroplasty EXCEPT?
1.5 cm femoral head bone cysts
Femoral neck bone stock deficiency
Age less than 50-years-old
When discussing metal on metal hip resurfacing versus metal on polyethylene total hip replacement, the surgeon should inform the patient that all of the following are disadvantages of hip resurfacing EXCEPT?
Higher dislocation rate
Higher periprosthetic fracture rate
Increased serum metal ion levels
Higher rates of osteonecrosis
Larger incision and surgical dissection
Which of the following is the most common cause of early revision surgery (<20 weeks) following a hip resurfacing arthroplasty?
Rupture of abductors