Which statement correctly differentiates primary from revision arthroplasty and identifies a common indication for primary?

• A. In revision arthroplasty, the procedure is typically the first joint replacement.
• B. Primary is the first joint replacement; revision is a subsequent procedure due to wear, loosening, infection, instability, or fracture.
• C. Primary uses cement in all cases; revision uses cementless components in all cases.
• D. Primary is performed for infection; revision is for osteoarthritis.

Answer: (B)

Primary arthroplasty is the first joint replacement performed to relieve pain and restore function, while revision arthroplasty is a subsequent procedure aimed at addressing problems with a prior implant. The best statement captures this distinction by defining primary as the initial replacement and revision as a later operation due to issues such as wear with loosening, infection, instability, or fracture. A common reason to perform a primary arthroplasty is osteoarthritis, though other conditions like rheumatoid arthritis or avascular necrosis can also lead to a first replacement.

The other ideas are not accurate: not all primary replacements use cement and not all revisions use cementless components; cementation choices depend on multiple patient- and implant-specific factors. Infection is not an indication for a primary replacement; it typically prompts a revision procedure.