A 65-year-old patient presents with increasing pain and instability in their left knee, 10 years after a primary total knee arthroplasty. The provided radiographs are shown.

Aseptic loosening with significant osteolysis and bone loss.

Following the diagnosis of aseptic loosening, the candidate expresses concern about the state of the collateral ligaments, particularly the MCL, and the extensive bone loss. The patient is planned for revision surgery.

Unlinked Constrained Condylar (VVC)

The patient, described as "reasonably young," has extensive bone loss around the failed total knee replacement. The surgeon is planning the revision procedure.

Restoration of bone stock using structural or morselized bone graft, potentially with metaphyseal sleeves.

The lateral radiograph of the failed total knee replacement clearly demonstrates anterior femoral cortical notching.

It suggests a technical error during primary implantation, increasing the risk of periprosthetic fracture.

The candidate initially suggests that the radiographs are "suggestive of infection until proven otherwise," despite the examiner later confirming aseptic loosening.

Elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP).

The examiner asks about the advantages of PCL substituting (PS) over PCL retaining (CR) designs.

Provides a degree of varus-valgus constraint and improved anterior-posterior stability via the cam-post mechanism.

The patient has extensive bone loss, concerns about collateral ligament integrity, and calcified soft tissues. The surgeon is planning a single-stage revision.

Meticulous soft tissue management and careful consideration of wound closure due to calcification.

The radiographs demonstrate calcification of soft tissues, including the popliteal vessels.

It increases the risk of intraoperative vascular injury and postoperative wound complications.

The patient is described as "reasonably young" with extensive bone loss, and the examiner emphasizes the importance of long-term planning.

Preserving and restoring bone stock to facilitate potential future revisions.

ABOS Part I Orthopaedic Review: TKA Revision & Hallux Valgus Surgical Management | Part 21607

14 Apr 2026 1 min read 1 Views

Key Takeaway

This ABOS Part I Orthopaedic Review module provides 20 advanced MCQs for ABOS Part I and AAOS OITE exams. It covers critical topics in Total Knee Arthroplasty (TKA) Revision, such as aseptic loosening and bone loss, and comprehensive Hallux Valgus surgical management, including osteotomies and complication strategies, derived from high-yield clinical cases.

ABOS Part I Comprehensive Review - Batch 104

This module contains 20 advanced orthopedic multiple-choice questions developed to mirror the American Board of Orthopaedic Surgery (ABOS) Part I and AAOS OITE examinations. Questions are derived directly from high-yield clinical teaching cases.

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ABOS Part I Orthopaedic Deformity Correction, Limb Reconstruction & Gait Analysis Review | Part 21914

ABOS Part I Orthopaedic Review: TKA Revision & Hallux Valgus Surgical Management | Part 21607

Key Takeaway

ABOS Part I Comprehensive Review - Batch 104

Module Results

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Chapter Index

ABOS Part I Orthopaedic Deformity Correction, Limb Reconstruction & Gait Analysis Review | Part 21914

ABOS Part I Orthopaedic Review: TKA Revision & Hallux Valgus Surgical Management | Part 21607

Key Takeaway

ABOS Part I Comprehensive Review - Batch 104

⚠️ Unanswered Questions

Module Results

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Chapter Index