Wear and Osteolysis Flashcards

1
Q

What are the steps involved in osteolysis d/t wear debris?

A

1) particulate debris formation
2) macrophage activated osteolysis
3) prosthesis micromotion
4) particulate debris dissemination

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2
Q

What is the most accurate and precise technique to evaluate polyethylene wear?

A

Radiostereometric analysis; uses radiopaque tantalum beads planted in the bone

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3
Q

What is the most important factor determining the amount of wear particles generated in a THA?

A

Head size; increased volumetric wear

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4
Q

When comparing conventional polyethylene liners to the newer highly cross-linked polyethylene liners, what is true?

A

Highly cross-linked poly has reduced wear and number of wear particles, but has inferior mechanical properties

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5
Q

What effect does head size have on wear rates of highly cross-linked poly?

A

None; wear rates are similar for head sizes 22-46mm

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6
Q

What causes stripe wear in ceramic on ceramic bearings?

A

Instability related to head lift off during gait

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7
Q

Which type of inflammatory cell is involved in the biological response to metal-on-metal particulate debris?

A

Lymphocytes

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8
Q

What molecules are associated with macrophage induced osteolysis surrounding orthopaedic implants?

A

1) TNF- alpha
2) TGF-beta
3) osteoclast activating factor
4) oxide radicals
5) hydrogen peroxide
6) acid phosphatase
7) interleukins (Il-1, IL-6)
8) prostaglandins

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9
Q

Osteoprotegrin (OPG) binds to what structure to inhibit particle-induced osteolysis?

A

RANKL; OPG binds to RANK-ligand so that it cannot bind to RANK and stimulate osteoclast activation

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10
Q

What urine test is indicative of type 1 collagen breakdown and can be utilized as a marker of bone turnover?

A

N-telopeptide

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11
Q

What two things are a/w higher metal ion levels in MoM hips?

A

smaller implant diameter and acetabular cup abduction angle >55 degrees are associated with elevated serum metal ion levels

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