Complications
A 68-year-old man presents with progressive right hip pain 12 years after primary total hip arthroplasty. He had been doing well for the first decade but has noted increasing startup pain and groin discomfort over the past 2 years. Radiographs show progressive radiolucent lines around the acetabular component and focal osteolytic lesions in DeLee-Charnley zones 1 and 2. Inflammatory markers are normal, and aspiration shows negative cultures. The surgeon discusses the mechanism of aseptic loosening and the role of wear debris. Regarding aseptic loosening in total joint arthroplasty:
Mark each as TRUE or FALSE
Polyethylene wear debris is phagocytosed by macrophages, triggering release of pro-inflammatory cyto...
Particle size between 0.2 and 10 MICROMETERS is most biologically active as it is optimal for macrop...
Highly cross-linked polyethylene (HXLPE) has INCREASED wear debris generation compared to convention...
Wear debris-activated macrophages upregulate RANKL expression, which binds RANK on osteoclast precur...
Radiographic signs of loosening include PROGRESSIVE radiolucent lines (widening over serial radiogra...
Answer the questions to see explanations
Click T (True) or F (False) for each option