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Infection
0%
15/4405
Acetabular component loosening
8%
340/4405
Femoral component loosening
3%
133/4405
Dislocation
86%
3810/4405
Periprosthetic fracture
1%
63/4405
Select Answer to see Preferred Response
The patient has eccentric polyethylene wear secondary to component malpositioning. He is at highest risk for dislocation. Late dislocation following total hip arthroplasty(THA) can occur and has a high recurrence rate, thereafter. Risk factors include eccentric polyethylene, THA at an early age, neurologic decline or associated neurologic conditions (i.e. Parkinson's disease), or associated trauma. Parvizi et al. noted in this instructional course lecture that eccentric, excessive polyethylene wear is one of the most common reasons for late, recurrent dislocation. Revision is recommended. Pulido et al. in this review, reiterated that polyethylene wear can lead to increased inflammation, capsular distention, and instability, increasing risk for dislocation. von Knoch et al. reviewing over 500 dislocated hips, also noted that eccentric wear was one of major causes linked to late dislocation. Figure A. exhibits a left total hip arthroplasty with eccentric wear. Incorrect answers: Answer 1. This patient is not at increased risk for infection. Answers 2 and 3. While this patient is at increased risk for loosening, the risk of dislocation due to eccentric wear. Answer 5. This patient is not at increased risk for fracture.
4.3
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