Review Question - QID 7724

Action	Numeric Key	Letter Key	Function Key
Choose 1	1
Choose 2	2
Choose 3	3
Choose 4	4
Choose 5	5
Submit Response			Enter
Previous Question			Left Arrow
Next Question		N	Right Arrow
Open/Close Bookmode		C
Open Image			Spacebar

THA Aseptic Loosening QID: 7724 (SAE11OS.136)

QID 7724 (Type "7724" in App Search)

Figure 136 is the radiograph of a 68-year-old man who reports persistent pain after undergoing total hip arthroplasty. Examination reveals equal limb lengths and there is minimal discomfort with straight-leg raise or hip rotation. When asked to ambulate, however, he has discomfort with the first few steps, and then can walk more comfortably. C-reactive protein and erythrocyte sedimentation rates are normal. Management should now consist of

Type & Select Correct Answer

Type in at least one full word to see suggestions list

an indium scan.

27/749

a three-phase bone scan.

26%

198/749

revision of the femoral component with a cemented stem.

10%

76/749

revision of the femoral component with a cementless stem.

57%

427/749

cortical strut allografting of the femoral stress fracture.

10/749

Select Answer to see Preferred Response

Review TC In New Tab

The patient has a 100% radiolucent line around the femoral component as well as a distal pedestal indicating loosening of the femoral component. With these findings, there is no need to do further workup for loosening with a bone scan. Infection is unlikely with the normal laboratory findings so an indium scan is not necessary. Allograft for the femur may improve pain with a stress fracture but not in the setting of a loose femoral component. Revision of the femoral component with a cementless stem after removing the fibrous endosteal tissue and the distal pedestal is associated with the best results. Cemented revision stems in this setting are associated with early failure.

Rating

Please Rate Question Quality

1.7

(32)