Chapter 8 - Osteolysis and Implant Loosening

A detailed infographic showing the biological and mechanical processes of osteolysis and implant loosening, with illustrations of macrophages, UHMWPE, and wear particle interactions.

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

13 Questions3 MinutesCreated by ExploringBones42

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

Chapter 8 - Osteolysis and Implant Loosening

Osteolysis and Implant Loosening Quiz

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