What is the typical management for aseptic loosening in hip arthroplasty?

• A. Debridement
• B. Antibiotics
• C. Observation
• D. Revision

Answer: (D)

Aseptic loosening means the prosthesis has lost stable fixation due to wear debris and accompanying bone loss, not infection. Because the fixation has failed, simply cleaning or giving antibiotics won’t restore stability or function. The typical treatment is a revision hip arthroplasty: remove the loosened components and replace them with a new prosthesis, often using techniques to address bone loss (such as a longer stem, augments, or bone grafting) to re-establish stable fixation and proper biomechanics. Debridement is aimed at infection and won’t correct mechanical loosening, antibiotics are for infection, and observation doesn’t remedy the instability once loosening is established.