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The JBJS Quiz of the Month is a collection of 10 relevant questions from each orthopaedic subspecialty. The questions are drawn from JBJS Clinical Classroom, which houses over 4,500 questions and 3,100 learning resources. Take the Quiz to see how you score against your peers!

NOTE: This quiz does not earn users CME credits. The questions must be answered within Clinical Classroom to earn CME credits.

A 52-year-old male patient underwent an uncomplicated total hip arthroplasty for primary osteoarthritis 8 years ago with a cementless acetabular component and a cementless femoral stem with a modular femoral neck and a ceramic-on-polyethylene bearing surface. He now presents with progressive groin pain over the past 6 months. His C-reactive protein level and erythrocyte sedimentation rate are within normal ranges. He has elevated serum cobalt and chromium levels, and his magnetic resonance imaging shows evidence of a pseudotumor. Which of the following is the best operative option for this patient?
    • Revision of the femoral stem
      • The patient’s modular-neck femoral stem has likely corroded, causing increased metal ion levels and a pseudotumor. It should be revised with a nonmodular femoral stem.

 

    • Exchange of the ceramic head to a metal head
      • The patient’s pseudotumor is likely due to the modular femoral neck causing corrosion and metallosis. Exchanging the ceramic head for a metal one will not address this.

 

    • Exchange of the modular neck and head liner
      • Modular neck exchange would not solve the problem of corrosion and pseudotumor formation; the entire femoral component should be revised.

 

    • Acetabular cup revision
      • If the acetabular component is well-fixed and well-positioned, it does not need to be revised.

     

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