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Reconstruction Quiz

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1 / 50

In total hip arthroplasty, which of the following techniques will lead to improved stability by increasing the abductor tension?

2 / 50

All of the following are risk factors for wear-related failure in total knee arthroplasty when using a polyethylene liner that underwent sterilization via gamma irradiation in air EXCEPT?

3 / 50

You are caring for a 18-year-old boy with severe hip arthritis and pain from a missed slipped capital femoral epiphysis. You decide that a hip arthrodesis is the best treatment option. What is the optimum position for a hip arthrodesis to maximize function and prevent complications?

4 / 50

Internal rotation of the femoral component in primary total knee arthroplasty may lead to which of the following?

5 / 50

All of the following are risk factors for developing a sciatic nerve palsy following total hip arthroplasty EXCEPT:

6 / 50

A 45-year-old woman is scheduled to undergo a TKA. Which of the following implant designs theoretically reduces poylethylene wear and reduces boneimplant-interface stress?

7 / 50

Highly cross-linked ultra high molecular weight polyethylene has which of the following characteristics?

8 / 50

During insertion of a cementless femoral stem, a nondisplaced fracture is noticed along the femoral calcar. Which of the following is the most appropriate next step in surgical management?

9 / 50

Which of the following characteristics of stromelysin is incorrect?

10 / 50

Which of the following statements regarding the use of continuous passive motion (CPM) devices following total knee arthroplasty is true?

11 / 50

All of the following are risk factors for post-operative total knee arthroplasty periprosthetic supracondylar femur fractures EXCEPT:

12 / 50

All of the following interventions help restore anatomic limb length following total hip arthroplasty EXCEPT:

13 / 50

A 41-year-old male has steroid-induced avascular necrosis of the hip and decides to undergo metal on polyethylene total hip arthroplasty. His 80-year-old, sedentary father had a total hip replacement 5 years ago. With comparison to his father, the patient should be informed of the following risk?

14 / 50

A new biomaterial has been designed for hard on soft bearings in total hip arthroplasty. The implant company claims this new material has a lower wear rate and greater toughness than highly cross linked polyethylene. Which of the following studies would most accurately evaluate wear between the two materials?

15 / 50

After insertion of trial components in a total knee replacement, the surgeon finds that he is unable to fully extend the knee and that the tibial tray lifts-off in flexion greater than 90 degrees. What intervention should be taken to acheive a knee that is balanced in flexion and extension?

16 / 50

The figure below is a photograph of a femoral head removed during revision of a ceramic on ceramic total hip arthroplasty. Which of the following is the most likely indication for this revision total hip arthroplasty?
Question Image

17 / 50

A 73 year-old female underwent total knee arthroplasty 10 years ago. She sustained a proximal tibial shaft periprosthetic fracture after a ground level fall. Radiographs show that the fracture involves the tibial component’s stem with loosening of the tibial component. Which of the following is the most appropriate treatment?

18 / 50

A 65-year-old male complains of continued groin pain 18 months following total hip arthroplasty. The pain is worse with activity, specifically with hip extension during gait. Hip radiographs show no fracture or loosening of the components. Lab values including ESR and CRP are within normal limits, and a hip aspiration yields a nucleated cell count of 500 and no growth on culture. Which of the following is most likely to determine the nature of the continued pain?

19 / 50

Which of the following findings is a prerequisite for a high tibial valgus osteotomy for medial compartment osteoarthritis?

20 / 50

What is the primary wear mechanism of polyethylene components in total knee arthroplasty ?

21 / 50

A 40-year-old man complains of increasing groin pain. Radiographs show femoral head avascular necrosis with subchondral lucency but without femoral head collapse. Which of the following medical treatments have been shown to decrease the risk of subsequent femoral head collapse?

22 / 50

A minimal-incision technique with an incision no more than 10 centimeters has which of the following advantages compared to a standard incision for a total hip replacement?

23 / 50

Which of the following factors is most likely to increase the risk of hip dislocation after a total hip arthroplasty (THA)?

24 / 50

What preoperative knee deformity puts a patient at most risk for a postoperative peroneal nerve palsy after total knee arthroplasty?

25 / 50

A patient who has previously undergone a lateral closing wedge tibial osteotomy 10 years prior is scheduled for a total knee arthroplasty (TKA). Which of the following factors is most likely to be present and may complicate the arthroplasty?

26 / 50

A 65-year-old female has severe knee arthritis with a significant flexion contracture and valgus deformity. Postoperatively in the recovery room after a total knee replacement, she is unable to dorsiflex her toes. Management should include?

27 / 50

With regards to unicompartmental knee arthroplasty, all of the following are true EXCEPT:

28 / 50

A 66-year-old male is undergoing a total knee arthroplasty using a fixed bearing posterior stabilized component. During intraoperative trialing of the components it is noted that the flexion gap is loose, and extension gap is appropriate. If this is not corrected, what post-operative complication is this patient at risk of having?

29 / 50

The use of vancomycin impregnated bone cement during total knee arthroplasty is most strongly recommended for which of the following patients?

30 / 50

Which of the following describes the mechanical axis of the limb in template preparation for a total knee arthroplasty?

31 / 50

What is the range of pore size of cementless porous implants to allow for optimal bony ingrowth?

32 / 50

A design surgeon has created a new polyethlyene acetabular liner for total hip arthroplasty. Early clinical outcomes are comparable to conventional total hip arthroplasty. At 4 year follow-up, radioisometric analysis reveals 0.05 mm of annual wear in the surgeon’s trial patients. Which of the following statements can be made from this data?

33 / 50

When placing acetabular screws to supplement cementless acetabular fixation in total hip arthroplasty, placing screws in which zone poses the highest risk to damaging the external iliac vasculature?

34 / 50

During revision total hip arthroplasty (THA), adjunctive motor-evoked potentials (MEPs) and electromyography (EMG) are utilized to monitor the sciatic and peroneal nerves. During the procedure, a conduction abnormality arises in the sciatic nerve. Which of the following actions would decrease tension on the sciatic nerve?

35 / 50

All of the following are true for a patient who underwent a metal-on-metal total hip arthroplasty (THA) EXCEPT?

36 / 50

A 45-year-old male, with a history of avascular necrosis, undergoes a total hip arthroplasty using a metal-on-metal bearing. Which of the following statements regarding the use of metal-on-metal bearings is true?

37 / 50

Risk factors for a motor nerve palsy following primary total hip arthroplasty include all of the following EXCEPT?

38 / 50

A 78-year-old female undergoes total hip arthroplasty through a minimally invasive surgical approach. During insertion of a metaphyseal fixation stem with a cementless press-fit technique, a crack in the calcar is identified. The stem is removed, two cable wires are passed around the calcar, and the same stem is reinserted. Which of the following statements is true?

39 / 50

A 65-year-old male presents with a painful right total knee arthroplasty, which was performed ten years ago. CRP is 15 mg/L. Knee aspiration reveals 2,100 WBC’s with 78% PMN’s. Which of the following is the best management option?

40 / 50

With respect to management of osteoarthritis of the knee with osteotomy which one of the following statements is true?

41 / 50

During total knee replacement with the trial components in place, the knee acheives full extension but experiences tightness in flexion with a range to only 90 degrees. What is the most appropriate action?

42 / 50

Which of the following treatment options does not have Grade A recommendations supporting its utilization by the American Academy of Orthopaedic Surgeons (AAOS) Guidelines for Treatment of Knee Arthritis (OA)?

43 / 50

All of the following are absolute or relative contraindication to hip resurfacing arthroplasty EXCEPT?

44 / 50

During total hip arthroplasty, which of the following techniques increases range of motion prior to impingement?

45 / 50

All of the following are contraindications for a medial unicompartmental knee replacement EXCEPT?

46 / 50

All of the following are contraindications to medial unicondylar knee arthroplasty EXCEPT:

47 / 50

What percentage of patients with complete peroneal nerve palsy after total hip arthroplasty will never recover full strength?

48 / 50

When discussing metal on metal hip resurfacing versus metal on polyethylene total hip replacement, the surgeon should inform the patient that all of the following are disadvatages of hip resurfacing EXCEPT?

49 / 50

A 65-year-old male who had a total knee arthroplasty 8 years ago comes into the office with worsening knee pain. The orthopaedic surgeon is concerned about infection and aspirates the knee. Which of the following are the lowest laboratory values from a synovial aspirate suggestive of infection?

50 / 50

Which of the following investigations is the most specific scanning method to detect infection in a total joint replacement?

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