Chapter 8 - Osteolysis and Implant Loosening
Osteolysis and Implant Loosening Quiz
Test your knowledge on osteolysis, foreign-body reactions, and the mechanisms behind implant loosening! This quiz covers concepts related to wear particles, inflammatory responses, and advanced materials used in orthopedic implants.
- Multiple-choice questions
- Detailed answers and explanations provided
- Great for students and professionals in the field
A foreign-body reaction is mediated by a cascade that results from: 1) Associated injury, 2) Local haematoma formation , 3) Recruitment of host inflammatory cells, 4) Acute-to-chronic inflammation and 5) -----. What is (5)?
Activation of adaptive immune responses
Fibrosis/Granuloma formation
Neovascularisation of damaged tissue
'Cement disease' was initially named following a decription of the lysis derived from macrophages around loose implants. It was initially thought to be due to cement particles produced around an implant from ----- and poor cement technique
Abnormal motion
Fragmentation of cement under load
Firbous tissue formation
What size of particles are involved in a macrophage-driven response to wear?
0.02-1 micrometre
0.2-10 micrometre
2-100 micrometre
Ultra-high-molecular-weight-polyethylene (UHMWPE) contains long chains of ----- monomer units
200-600k
2-6 million
20-60 million
Wear at the hip consists mainly of adhesive and ----- mechanisms
Third body wear
Backside wear
Abrasive
In addition to macrophages which cell type are indicated in wear response to smaller (~50nm) range, often characterised in an ALVAL response?
Lymphocytes
Neutrophils
Eosinophils
A proinflammatory cascase is modulated by TNF-alpha, MCP1 and -----, leading to osteoclast differentiation
PGE
TNF beta
Lymphotoxin-a
Osteoclast differentiation and activation is mediated and activated by TNF-alpha and -----
NF-kB cascade
TNF beta
RANKL
Particle production + inflammatory cascades can potentially be targeted with ----- and antioxidants (such as ascorbic acid and N-acetylcysteine)
NSAIDS
Bisphosphonates
Statins
Ceramic bearings have the lowest wear rates of any bearing combination, with a wear rate of < ----- micrometres/year
0.5-2.5
0.05-0.25
5-25
Advances in radiation, annealing techniques and adjuncts such as ----- reduce free radical formation and improve the mechanical and fatigue properties of UHMWPE
Vitamin C
Vitamin D
Vitamin E
Cadeveric mouse models have shown extensive bone destruction, ----- and bone loss in response to polyethylene particles packed in the subperiosteal space
Scoring
Ridging
Pitting
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