Review Question - QID 7657

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THA Revision QID: 7657 (SAE11OS.69)

QID 7657 (Type "7657" in App Search)

A patient reports startup pain 3 months after undergoing a primary total hip arthroplasty. Figures 69a and 69b show postoperative radiographs at 6 weeks and 3 months, respectively. Laboratory studies reveal a normal CBC count, C-reactive protein, and erythrocyte sedimentation rate. Which of the following options is most appropriate?

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Continued observation

33/529

Revision of the femoral component

76%

402/529

Hip aspiration for cell count and culture

12%

62/529

Physical therapy for quadriceps strengthening

24/529

Resection arthroplasty, antibiotic spacer, and intravenous antibiotics

1/529

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The patient has a loose femoral component, which has subsided at least 1 cm. The stem is undersized which is a risk factor for subsidence, especially with tapered stems. Continued observation is not indicated. Revision total hip arthroplasty is the best option. With a normal erythrocyte sedimentation rate and C-reactive protein, further workup and treatment for infection is not indicated.

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