Enhance your orthopedic knowledge and prepare for exams with our online MCQs bank. Our interactive platform offers a diverse range of questions to test your skills and identify areas for improvement. Start practicing today and boost your confidence in your orthopedic knowledge!
Interactive MCQs
Question 51
Which of the following is not a significant risk factor for the development of heterotopic ossification?
Hypertrophic osteoarthritis
Ankylosing spondylitis
Posttraumatic arthritis
Previous osteonecrosis
Previous formation of heterotopic ossification
Correct answer: d. Previous osteonecrosis
Submit Response
Question 52
Long stemmed tibial components for revision total knee arthroplasty are not cemented for which of the following reasons?
Extensive stress shielding
Difficulty in removal
Infection risk
Asymmetric wear
Hypotension with insertion
Correct answer: a. Extensive stress shielding
Submit Response
Question 53
Unicompartmental arthroplasty is contraindicated in which patient?
A patient with osteonecrosis of medial condyle
A patient with osteoarthritis of medial condyle
A patient with rheumatoid arthritis concentrated in the medial compartment
A patient with posttraumatic arthritis of the medial tibial plateau
A patient with prior patellectomy with medial compartment osteoarthritis
Correct answer: c. A patient with rheumatoid arthritis concentrated in the medial compartment
Submit Response
Question 54
If a metal-backed tibial component is used for total knee arthroplasty, what is the minimum thickness of polyethylene to be used to prevent accelerated wear?
4 mm to 6 mm
10 mm to 12 mm
8 mm to 10 mm
Whatever polyethylene thickness balances the knee correctly
12 mm to 14 mm
Correct answer: c. 8 mm to 10 mm
Submit Response
Question 55
Which of the following is not a contraindication for high tibial osteotomy to treat medial compartment arthritis?
Obesity
Age greater than 65
Rheumatoid arthritis
Prior medial and lateral menisectomy
A young patient unwilling to stop high activity occupation
Correct answer: e. A young patient unwilling to stop high activity occupation
Submit Response
Question 56
In preoperative evaluation for total knee arthroplasty, a patient is seen to have three previous incisions over the anterior knee. Two are longitudinal, 2.5 cm apart over the anterior aspect of the patella. One is transverse. All incisions are healed. Which incision should be used to decrease the likelihood of skin necrosis?
The medial most longitudinal incision
The lateral most longitudinal incision
The transverse incision as the skin will slough with either of the previous longitudinal incisions
A new midline incision between the two longitudinal incisions
The longitudinal incision that will allow for best exposure
Correct answer: b. The lateral most longitudinal incision
Submit Response
Question 57
A patient who underwent a posterior stabilized total knee arthroplasty 10 months ago has new complaints of knee pain and popping. This pain was exacerbated with climbing stairs and rising from a chair. An audible and palpable clunk is heard with terminal extension. Range of motion is from 0º to 110º, and there is no evidence of instability with examination. A pop is felt with active extension in the terminal 15º to 30º of motion. The best treatment is:
Revision arthroplasty
Nonsteroidal anti-inflammatory medicines
Revision to a condylar constrained type prosthesis
Arthroscopic debridement or open revision of the patellar component
Plate fixation (Dynamic Condylar Screw or fixed angle blade) with retention of femoral component
Correct answer: d. Arthroscopic debridement or open revision of the patellar component
Submit Response
Question 58
A patient has a displaced supracondylar femur fracture 6 cm proximal to a well-fixed, posterior stabilized component. This knee was asymptomatic prior to fracture. Treatment should include which of the following?
Cast bracing
Traction
Revision to a long stemmed femoral component
Retrograde nail fixation with retention of femoral component
Plate fixation (Dynamic Condylar Screw or fixed angle blade) with retention of femoral component
Correct answer: e. Plate fixation (Dynamic Condylar Screw or fixed angle blade) with retention of femoral component
Submit Response
Question 59
Resection of too little distal femur will have what effect on the "flexion/extension gap" with regard to ligamentous balancing?
Increase flexion gap (loose in flexion)
Increase extension gap (recurvatum)
Decrease extension gap (flexion contracture)
Decrease flexion gap (tight in flexion)
Will not affect gap if appropriate polyethylene is used
Correct answer: c. Decrease extension gap (flexion contracture)
Submit Response
Question 60
Excessive internal rotation of the tibial component should be avoided because of which resultant effect?
Net internal rotation of tibial tubercle, increased wear
Net external rotation of tibial tubercle, patellar subluxation
Net external rotation of the leg causing thigh pain
Will likely have no effect if ligaments are balanced
Net internal rotation of the leg causing the patient to in-toe
Correct answer: b. Net external rotation of tibial tubercle, patellar subluxation
Submit Response
Question 61
A 65-year-old patient presents with complaints of giving way in her knee. She underwent a total knee arthroplasty 2 years ago. Intraoperatively, the medial collateral ligament was disrupted, but repaired primarily. This has gone on to give the patient instability when she ambulates. Physical therapy and bracing have not helped. On radiographic examination, the components are well fixed and in appropriate position. Physical examination reveals a range of motion from 0° to 130° with no anteroposterior laxity. There is laxity at 0°, 45°, and 90º to valgus stress. Appropriate treatment should now consist of:
Ipsilateral semitendinosis and gracillis autograft reconstruction of the medial collateral ligament
Contralateral semitendinosis and gracillis autograft reconstruction of the medial collateral ligament
Revision to a constrained-condylar type prosthesis
Contralateral bone-patellar-tendon autograft reconstruction of the medial collateral ligament
Allograft Achilles tendon reconstruction of the medial collateral ligament
Correct answer: c. Revision to a constrained-condylar type prosthesis
Submit Response
Question 62
When comparing the subvastus approach to the medial parapatellar approach to the knee for total knee arthroplasty, which of the following statements is true?
Range of motion is better long term for the subvastus approach.
The need for lateral retinacular release is more common in the medial parapatellar approach.
The subvastus approach is more technically difficult and exposure is more difficult than a medial parapatellar approach.
Patella subluxation is more common in the medial parapatellar approach.
The subvastus approach is associated with more wound complications than the medial parapatellar approach.
Correct answer: c. The subvastus approach is more technically difficult and exposure is more difficult than a medial parapatellar approach.
Submit Response
Question 63
The most common extensor mechanism complication in total knee arthroplasty is:
Patella fracture
Patellar instability
Patellar clunk
Quadriceps tendon rupture
Patellar tendon rupture
Correct answer: b. Patellar instability
Submit Response
Question 64
A patient with a 35° valgus deformity and a 20° flexion contracture of the knee undergoes primary total knee arthroplasty successfully. In the recovery room, the patient is seen to have no dorsiflexion of the foot or toes and numbness over the dorsum of the foot. There is no pain with passive range of motion of the foot and calf compartments are soft. The next appropriate step is:
Re-observation in 30 minutes, leg elevation, and ice
Bring the patient back to the operating room to explore the peroneal nerve
Strict extension splinting, removal of the constrictive dressings
Remove the dressings and flex the leg
Fasciotomies of the leg
Correct answer: d. Remove the dressings and flex the leg
Submit Response
Question 65
A 70-year-old patient with a past history of prostate cancer treated with pelvic irradiation wishes to have a total hip arthroplasty for severe unilateral hip osteoarthritis. What is the most likely consequence of cementless fixation of the acetabular cup?
Fracture
Bleeding
Aseptic loosening of the acetabular cup
Abductor weakness
Allergic reaction to titanium
Correct answer: c. Aseptic loosening of the acetabular cup
Submit Response
Question 66
In patients with osteoarthritis, mechanical forces induce changes in the form and structure of many biological materials including bone and cartilage. This effect is known as:
Wolff's law
Koch's postulate
Hilgenreiner's law
Singh's index
Evans law
Correct answer: a. Wolff's law
Submit Response
Question 67
The reduction mechanism of venous thromboembolism from epidural anesthesia in total joint replacement is:
Inhibition of platelet adhesion
Stimulation of endothelial fibrinolysis
Sympathetic effect of epidural blockage
Decreased lower extremity blood flow
Increased lower extremity blood flow
Correct answer: c. Sympathetic effect of epidural blockage
Submit Response
Question 68
Which of the following is not a clinical sign of pulmonary embolism:
Pleuritic chest pain and pleural rub
Dyspnea
Tachypnea
Pleural rub
Bradycardia
Correct answer: e. Bradycardia
Submit Response
Question 69
In total joint replacement, osteolysis that results in bone loss and bone resorption is caused by:
Breakdown of polymethylmethacrylate
Hydroxyapatite
Metal debris
Allergic reaction to titanium
Polyethylene debris
Correct answer: e. Polyethylene debris
Submit Response
Question 70
Bone grafts (autograft) used to restore bone stock in total joint replacements are the result of what biological process:
Osteogenesis
Osteoinduction only
Osteoconduction only
Osteogenesis and osteoinduction
Osteogenesis, osteoinduction, and osteoconduction
Correct answer: e. Osteogenesis, osteoinduction, and osteoconduction
Submit Response
Question 71
Ceramics are used as an osteoconductive bone-graft material. The optimal pore size is:
50 μm to 100 μm
100 μm to 150 μm
150 μm to 500 μm
500 μm to 700 μm
800 μm to 1000 μm
Correct answer: c. 150 μm to 500 μm
Submit Response
Question 72
The American College of Cardiology recommends that a patient wait how long after a myocardial infarction before undergoing a total hip replacement:
3 weeks
6 weeks
3 months
6 months
1 year
Correct answer: b. 6 weeks
Submit Response
Question 73
Patients with rheumatoid arthritis must be radiologically evaluated for this condition:
Odontoid abnormality
C1 - C2 subluxation
C2 - C3 subluxation
C3 - C4 subluxation
C4 - C5 subluxation
Correct answer: b. C1 - C2 subluxation
Submit Response
Question 74
In hypotensive total joint replacement surgery, the mean blood pressure is kept at:
50 mm Hg
60 mm Hg
70 mm Hg
80 mm Hg
90 mm Hg
Correct answer: b. 60 mm Hg
Submit Response
Question 75
The optimal position of a patient’s knee during total knee replacement surgery is:
3° of anatomic valgus
5° of anatomic valgus
7° of anatomic valgus
8° of anatomic valgus
Neutral
Correct answer: c. 7° of anatomic valgus
Submit Response
Question 76
The optimal position for the acetabular cup during total hip replacement surgery is:
Neutral version
5° anteversion
15° anteversion
30° anteversion
45° anteversion
Correct answer: c. 15° anteversion
Submit Response
Question 77
Gallium-67 citrate used in scanning techniques can result in increased gallium-67 localization in:
Infection
Fracture
Aseptic loosening
Infection and fracture
Infection, fracture, and aseptic loosening
Correct answer: e. Infection, fracture, and aseptic loosening
Submit Response
Question 78
The most specific scanning method to detect infection in total joint replacement is:
White blood cell scanning
Technetium bone scanning
Sequential technetium bone scans
Sequential gallium-67 citrate scans
A combination of white blood cell scanning and technetium bone scanning
Correct answer: e. A combination of white blood cell scanning and technetium bone scanning
Submit Response
Question 79
Outcomes, as opposed to traditional results, are more reliable because they include:
Measured and recorded clinical results
Economic consequences only
Social consequences and political consequences
Political consequences only
Measured and recorded clinical results, economic consequences, and social consequences
Correct answer: e. Measured and recorded clinical results, economic consequences, and social consequences
Submit Response
Question 80
The anterolateral (Watson-Jones) approach to the hip dissects in an interval between:
The gluteus medius and gluteus minimus
The gluteus medius and tensor fascia lata muscles
The tension fascia lata muscles and rectus femoris
The gluteus medius and quadratus femoris
The gluteus maximus
Correct answer: b. The gluteus medius and tensor fascia lata muscles
Submit Response
Question 81
The direct lateral (modified Hardinge) approach to the hip has the following disadvantage(s):
Limited proximal acetabular exposure
Increased incidence of heterotopic ossification
Slower abductor rehabilitation
Limited proximal acetabular exposure, increased heterotopic ossification, and slower abductor rehabilitation
Increased dislocation rate
Correct answer: d. Limited proximal acetabular exposure, increased heterotopic ossification, and slower abductor rehabilitation
Submit Response
Question 82
When using the direct lateral (modified Hardinge) approach to the hip, the incidence of total hip dislocation is:
2%
0.1%
0.3%
3%
4%
Correct answer: c. 0.3%
Submit Response
Question 83
When using the direct lateral (modified Hardinge) approach for total hip replacement, what percentage of patients will have a moderate or severe limp at 2 years postoperative:
0.5%
1%
5%
10%
15%
Correct answer: d. 10%
Submit Response
Question 84
The posterior approach to the hip has the following advantage(s) over the direct lateral approach when performing total hip arthroplasty:
Easy exposure
Decreased operative time
Decreased heterotopic ossification
Easy exposure, decreased operative time, and decreased heterotopic ossification
Increased dislocation rate
Correct answer: d. Easy exposure, decreased operative time, and decreased heterotopic ossification
Submit Response
Question 85
The posterior approach to the hip splits the following muscle(s) when exposing the hip:
Gluteus medius
Gluteus maximus
Vastus lateralis
External rotators
Tensor fascia lata
Correct answer: b. Gluteus maximus
Submit Response
Question 86
The trochanteric slide osteotomy involves:
Osteotomy of anterior greater trochanter bone
Keeping the gluteus medius in continuity
Keeping the gluteus medius and vastus lateralis in continuity
Osteotomy of anterior greater trochanter bone and keeping the vastus lateralis in continuity
Cutting the lateral third of the proximal femur
Correct answer: c. Keeping the gluteus medius and vastus lateralis in continuity
Submit Response
Question 87
The advantage(s) of an extended trochanteric osteotomy in approaching a revision hip surgery include:
Easier access to bone-cement interface
Decreased operative time
Better exposure of acetabulum
Easier access to bone-cement interface, decreased operative time, and better exposure of acetabulum
More predictable healing of the osteotomized fragment, neutral recovery of femoral canal, and better tensioning of the abductors with distal advancement
Correct answer: d. Easier access to bone-cement interface, decreased operative time, and better exposure of acetabulum
Submit Response
Question 88
When using the direct lateral (modified Hardinge) approach to the hip, the incision is extended distally along the posterior border of the:
Gluteus medius
Gluteus maximus
Vastus lateralis
External rotators
Tensor fascia lata
Correct answer: b. Gluteus maximus
Submit Response
Question 89
The vastus slide utilizes a:
Modified anterior approach to the hip joint
A trochanteric osteotomy
Keeping the gluteus medius and vastus lateralis in continuity
Posterior approach to the hip
Femoral nerve block
Correct answer: c. Keeping the gluteus medius and vastus lateralis in continuity
Submit Response
Question 90
The anatomy of the hip provides considerable rotation in:
One anatomic plane
Two anatomic planes
Three anatomic planes
Four anatomic planes
Six anatomic planes
Correct answer: c. Three anatomic planes
Submit Response
Question 91
Most patients have a hip flexion-extension arc of:
100° to 110°
110° to 120°
120° to 140°
130° to 150°
110° to 140°
Correct answer: c. 120° to 140°
Submit Response
Question 92
Femoral implants with greater anteversion will impinge (trochanter against the pelvis):
Posteriorly in extension with lesser external rotation
Anteriorly in extension with lesser external rotation
Posteriorly in extension with lesser internal rotation
Anteriorly in flexion with lesser external rotation
Posteriorly in extension with lesser internal rotation
Correct answer: a. Posteriorly in extension with lesser external rotation
Submit Response
Question 93
Level walking requires the following hip range of motion:
40° of flexion-extension and the same internal-external rotation/abduction-adduction
55° of flexion-extension and the same internal-external rotation/abduction-adduction
70° of flexion-extension and the same internal-external rotation/abduction-adduction
80° of flexion-extension and the same internal-external rotation/abduction-adduction
90° of flexion-extension and the same internal-external rotation/abduction-adduction
Correct answer: b. 55° of flexion-extension and the same internal-external rotation/abduction-adduction
Submit Response
Question 94
To put on a pair of shoes, the arc of motion required in the hip joint is:
100°
130°
140°
170°
180°
Correct answer: c. 140°
Submit Response
Question 95
Recent mathematical modeling of hip joint forces during activities of daily living relative to body weight show elevations by a factor of:
1 to 2
2 to 3
2 to 4
3 to 5
4 to 6
Correct answer: c. 2 to 4
Submit Response
Question 96
Implantation of a total hip prosthesis can significantly alter hip forces. The lowest forces occur at the:
Anatomic center
Lateral anatomic center
Superior anatomic center
Inferior anatomic center
Posterior anatomic center
Correct answer: a. Anatomic center
Submit Response
Question 97
Implantation of a total hip prosthesis can significantly alter hip forces. The greatest increase in hip forces occur at the:
Anatomic center
Lateral anatomic center
Superior anatomic center
Inferior anatomic center
Posterior anatomic center
Correct answer: b. Lateral anatomic center
Submit Response
Question 98
When implanting a total hip prosthesis, the greatest strains occur at what part of the femoral implant:
Neck of the femoral anatomic
Greater trochanteric area
Midportion of the prosthesis
Tip of the prosthesis
Calcar
Correct answer: d. Tip of the prosthesis
Submit Response
Question 99
What percentage of bone is turned over in the skeleton each year:
5%
10%
15%
20%
25%
Correct answer: a. 5%
Submit Response
Question 100
The stem and mantle is easily extracted in a failed hip arthroplasty if:
A circumferential lytic line surrounds the entire prosthesis
A circumferential lytic line surrounds the cement mantle
There is a nonunion of the greater trochanteric osteotomy
Ultrasound equipment is used
One uses an extended trochanteric osteotomy
Correct answer: b. A circumferential lytic line surrounds the cement mantle
Submit Response
* 51
* 52
* 53
* 54
* 55
* 56
* 57
* 58
* 59
* 60
* 61
* 62
* 63
* 64
* 65
* 66
* 67
* 68
* 69
* 70
* 71
* 72
* 73
* 74
* 75
* 76
* 77
* 78
* 79
* 80
* 81
* 82
* 83
* 84
* 85
* 86
* 87
* 88
* 89
* 90
* 91
* 92
* 93
* 94
* 95
* 96
* 97
* 98
* 99
* 100
