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A patient with a severe nickel allergy and degenerative joint disease of the hip would be best served by which of the following prosthetic options?
Cemented titanium stem, ceramic (alumina) head, and press-fit titanium cup
Cemented cobalt-chrome stem, ceramic (alumina) head, and press-fit cobalt-chrome cup
Press-fit titanium stem, cobalt-chrome head, and press-fit titanium cup
Press-fit titanium stem, titanium head, and press-fit titanium cup
Press-fit titanium stem, ceramic (alumina) head, and cementless titanium cup
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Compared to metal-on-polyethylene total hip bearing surfaces, the debris particles generated by metal-on-metal articulations are
larger and less numerous.
larger and more numerous.
smaller and less numerous.
smaller and more numerous.
With the increasing availability of total hip arthroplasty (THA) to younger patients with hip osteoarthritis, there has been increased use of alternative bearing surfaces. Compared to a ceramic-on-ceramic articulation, which of the following is a specific advantage of a metal-on-metal bearing surface?
Increased fracture toughness
Decreased surface roughness
Lower coefficient of friction
Based on the type of articulation shown in Figure 32, wear is not affected by which of the following factors?
Radial mismatch of the femoral head to the acetabular component
Sphericity of the bearings
Surface finish of the articulation
Carbon content of the metal-on-metal bearing
An 80-year-old man has a Charnley all-polyethylene acetabular shell shown in Figure A. When defining failure as revision for any reason, what is the failure rate at 35 years for this type of prosthesis?
Less than 10%
20% to 30%
40% to 50%
50% to 75%
Greater than 75%
What surgeon is credited for designing the prosthesis seen in Figure A?
Sir Harry Platt
Austin T. Moore
Charles Frederick Thackray
A patient undergoes the procedure depicted in Figures A and B with standard components (non-gender specific). Which of the following outcomes most appropriately describes the difference in females compared to males for this procedure?
Greater implant survivorship
Decreased WOMAC scores
Increased rate of extensor mechanism rupture
Increased postoperative pain
Increased component osteoloysis
A 56-year-old gentleman presents to your office one year after undergoing total hip arthroplasty with the implant seen in Figure A. He is concerned about the potential complications given the recent media attention his implant has received. He is currently asymptomatic. Which of the following statements is accurate regarding his prosthesis and future care?
He should have bi-annual LFTs measured, as metal ions are metabolized by the liver.
His risk of developing cancer is dramatically increased.
There is no correlation between activity level and serum levels of metal ions.
His prosthesis design is safe in women of child-bearing age as the ions cannot be transmitted via pregnancy.
His prosthesis design puts him at an increased risk for dislocation.
All of the following are true for a patient who underwent a metal-on-metal total hip arthroplasty (THA) EXCEPT?
they will have production of ionically charged wear particles
there is a higher cancer risk than with metal-on-polyethylene THA
they will have elevated levels of cobalt and chromium in the serum
they will have elevated levels of cobalt and chromium in the urine
there is a higher frictional torque than with ceramic on ceramic THA