Review Question - QID 8398

Figures 60a through 60c show the intraoperative photograph, anteroposterior radiograph, and axial MRI scan of a 63-year-old man who had right groin pain 18 months after undergoing an uncemented right total hip replacement using a modular femoral neck implant and a metal-on-polyethylene bearing. His laboratory studies revealed an erythrocyte sedimentation rate of 8 mm/h (reference range, 0-20 mm/h) and C-reactive protein level of 5.4 mg/L (reference range, 0.08-3.1 mg/L). A preoperative aspiration revealed cultures that were negative for infection. A cell could not be obtained for evaluation because the cells were "degenerative." At the time of surgery the joint fluid was turbid in appearance; the periarticular tissues appeared avascular and tan/beige in color. An intraoperative frozen section was negative for acute inflammation. The implants were solidly fixed to bone. The cause of this patient's symptoms and the intraoperative findings most likely are attributable to