Arthroplasty, Knee & Osteotomy MCQs - Part 16

Question 1

Which of the following is considered an absolute contraindication to a medial unicompartmental knee arthroplasty (UKA)?

Explanation

Inflammatory arthropathy (e.g., Rheumatoid arthritis) is considered an absolute contraindication to a UKA due to the systemic nature of the disease, which typically leads to global joint destruction. The remaining compartments are at a very high risk of rapid progression. Modern indications have expanded to include some younger patients and varying weights, but inflammatory arthritis remains a strict contraindication.

Question 2

During a posterior-stabilized (PS) total knee arthroplasty, the surgeon notes that the cam of the femoral component jumps over the tibial post during deep flexion. What is the most likely cause of this complication?

Explanation

Posterior cam jump (dislocation) in a PS TKA typically occurs in deep flexion when the flexion gap is too loose. A loose flexion gap allows the femur to translate excessively forward relative to the tibia, allowing the cam to escape over the tibial post. Management involves balancing the flexion gap by either downsizing the femur to close the gap or using a thicker polyethylene liner if the extension gap allows.

Question 3

A medial opening wedge high tibial osteotomy (HTO) is planned for a patient with medial compartment osteoarthritis and varus deformity. If not properly controlled during the procedure, what are the classic unintended effects on tibial slope and patellar height?

Explanation

Medial opening wedge HTO traditionally increases the posterior tibial slope (because the medial tibia is triangular and wider anteriorly, so a uniform wedge opens the anterior aspect more) and decreases patellar height (patella baja) relative to the joint line due to the elevation of the tibial plateau above the tibial tubercle.

Question 4

A patient presents with mid-flexion instability following a primary total knee arthroplasty. The knee is stable in full extension and at 90 degrees of flexion, but exhibits gross anterior-posterior laxity at 45 degrees. Which of the following technical errors is most likely responsible?

Explanation

Mid-flexion instability is classically associated with joint line elevation. When the joint line is elevated (often due to excessive distal femoral resection combined with a thicker tibial polyethylene insert to balance extension), the collateral ligaments are tensioned abnormally in mid-flexion, leading to laxity between 30 and 60 degrees, while being stable at 0 and 90 degrees.

Question 5

Patellar maltracking is a common complication in total knee arthroplasty. Which combination of component positioning errors is most likely to result in lateral patellar subluxation?

Explanation

Internal rotation of the femoral component medializes the trochlear groove, while internal rotation of the tibial component lateralizes the tibial tubercle. This combination dramatically increases the equivalent Q-angle of the arthroplasty, pulling the patella laterally and leading to lateral patellar tilt or subluxation.

Question 6

When using the measured resection technique for total knee arthroplasty, rotational alignment of the femoral component is critical. The surgical transepicondylar axis (TEA) is defined by a line connecting which two landmarks?

Explanation

The surgical transepicondylar axis (TEA) connects the medial epicondylar sulcus (the origin of the deep MCL) to the prominence of the lateral epicondyle. This axis closely approximates the center of rotation of the knee. The clinical TEA connects the prominences of both epicondyles.

Question 7

A surgeon is planning a conversion of a previous closing wedge high tibial osteotomy (HTO) to a total knee arthroplasty. Which of the following technical challenges is most specifically anticipated compared to a primary TKA in a virgin knee?

Explanation

Conversion of a closing wedge HTO to TKA is technically demanding due to altered proximal tibial anatomy. It is classically associated with relative patella baja (due to the proximal osteotomy and subsequent scarring/shortening of the patellar tendon) and lateral offset of the tibial metaphysis/tubercle, making tibial component positioning and extensor mechanism balancing challenging.

Question 8

A 45-year-old active laborer presents with lateral compartment knee osteoarthritis and a mechanical valgus deformity of 16 degrees. Weight-bearing radiographs reveal the deformity is primarily driven by a mechanical axis deviation in the distal femur. Which of the following is the most appropriate surgical treatment?

Explanation

For severe valgus knee osteoarthritis (>12-15 degrees) originating from a distal femoral deformity, a distal femoral osteotomy (DFO) is indicated. A medial closing wedge or lateral opening wedge DFO corrects the mechanical axis. Tibial osteotomies are contraindicated for severe femoral-based valgus as they would induce an abnormal joint line obliquity.

Question 9

During a lateral closing wedge high tibial osteotomy, a fibular osteotomy is required to allow the tibial osteotomy to close. To minimize the risk of peroneal nerve injury, at what level should the fibular osteotomy ideally be performed?

Explanation

To minimize the risk of iatrogenic injury to the common peroneal nerve—which wraps around the fibular neck—a fibular osteotomy required for a lateral closing wedge HTO is typically performed in the middle third of the fibular shaft.

Question 10

Kinematic alignment in total knee arthroplasty aims to restore the patient's pre-arthritic constitutional alignment. Compared to traditional mechanical alignment, a strictly kinematically aligned TKA most typically results in the components being positioned in which manner relative to the mechanical axis?

Explanation

Kinematic alignment co-aligns the component axes with the native kinematic axes of the knee, restoring the pre-arthritic joint line obliquity. Because the native proximal tibia typically has about 3 degrees of varus and the distal femur has corresponding valgus, the resulting components are placed in slight tibial varus and femoral valgus relative to the strict mechanical axes.

Question 11

A 70-year-old patient presents with an inability to actively extend the knee 3 years following a primary total knee arthroplasty. Examination and MRI confirm a chronic, retracted patellar tendon rupture with poor local tissue quality. Which of the following is the most reliable reconstructive option?

Explanation

Chronic extensor mechanism ruptures post-TKA with poor tissue quality cannot be treated with primary repair due to high failure rates. Reconstruction using an Achilles tendon allograft with a calcaneal bone block press-fit into the tibial tubercle, or a synthetic mesh reconstruction, offers the most reliable long-term outcomes.

Question 12

During trial reduction of a posterior-stabilized total knee arthroplasty, the knee is found to be perfectly balanced in full extension but excessively tight in 90 degrees of flexion. Which of the following surgical adjustments will best correct this imbalance?

Explanation

A tight flexion gap with a balanced extension gap requires isolated augmentation of the flexion gap. Increasing the posterior slope of the tibial resection increases the flexion gap without significantly affecting the extension gap. Alternatively, resecting more posterior femoral condyle (e.g., by downsizing the femur in an anterior-referencing system) would also selectively open the flexion gap. Downsizing the polyethylene would open both gaps, causing extension laxity.

Question 13

Historical catastrophic early failure of total knee arthroplasty polyethylene inserts via sub-surface delamination was primarily linked to which of the following manufacturing or sterilization processes?

Explanation

Gamma irradiation of ultra-high-molecular-weight polyethylene (UHMWPE) in the presence of oxygen (air) leads to the generation of free radicals that cause oxidation and polymer chain scission over time. This sub-surface oxidation classically resulted in severe wear patterns such as delamination and structural failure.

Question 14

In the Anderson Orthopaedic Research Institute (AORI) classification for bone defects in revision total knee arthroplasty, a Type 2B defect is best described by which of the following?

Explanation

The AORI classification guides bone defect management in revision TKA. Type 1 is intact metaphysis. Type 2 represents damaged metaphyseal bone; Type 2A involves one condyle (medial or lateral), while Type 2B involves both condyles. Type 3 represents severe defects compromising a major portion of the metaphysis and extending into the diaphysis.

Question 15

A 65-year-old female undergoes a primary total knee arthroplasty for a severe, fixed valgus deformity (Ranawat Type II). Intraoperatively, the medial collateral ligament (MCL) is found to be completely incompetent. Which of the following implant constraints is required?

Explanation

In the setting of a completely incompetent or absent medial collateral ligament (MCL), a constrained condylar knee (CCK) design is insufficient because it relies on functional collateral ligaments to prevent coronal plane failure. A linked implant, such as a rotating hinge component, is mandatory to substitute for the global coronal instability.

Question 16

In a cruciate-retaining (CR) total knee arthroplasty, failure to properly balance a tight posterior cruciate ligament (PCL) will most likely result in which of the following kinematic abnormalities?

Explanation

An excessively tight PCL in a CR TKA causes exaggerated and premature femoral rollback during flexion. This drives the femoral component off the posterior edge of the tibia, which forces the anterior aspect of the tibial tray to lift off (anterior lift-off), potentially leading to accelerated wear, pain, or component loosening.

Question 17

A patient presents with a painful clunking sensation over the superior pole of the patella when extending the knee from 40 degrees of flexion, 1 year after a posterior-stabilized total knee arthroplasty. What is the pathognomonic cause of 'patellar clunk syndrome'?

Explanation

Patellar clunk syndrome is historically associated with posterior-stabilized (PS) TKA designs. It is caused by the formation of a fibrosynovial nodule on the undersurface of the quadriceps tendon just proximal to the patella. As the knee extends from deep flexion, this nodule catches in the intercondylar box of the femoral component and then forcefully pops out, causing a painful 'clunk'.

Question 18

Tranexamic acid (TXA) is widely used in arthroplasty to reduce blood loss. What is the primary mechanism of action of TXA?

Explanation

Tranexamic acid is a synthetic derivative of the amino acid lysine. It functions as an antifibrinolytic by reversibly and competitively binding to the lysine receptor sites on plasminogen. This prevents plasminogen from converting into active plasmin, thereby stabilizing fibrin clots and reducing bleeding.

Question 19

During a total knee arthroplasty using a standard medial parapatellar arthrotomy, which of the following arteries provides the predominant remaining blood supply to the patella and must be preserved if a lateral retinacular release is performed?

Explanation

A standard medial parapatellar arthrotomy disrupts the medial blood supply to the patella (supreme, medial superior, and medial inferior geniculate arteries). The superior lateral geniculate artery, located at the superior-lateral pole, becomes the primary blood supply. If a lateral retinacular release is performed, care must be taken to preserve this vessel to avoid patellar avascular necrosis.

Question 20

Which of the following is the most common cause of failure requiring revision for a medial unicompartmental knee arthroplasty (UKA) at long-term follow-up (>10 years)?

Explanation

While aseptic loosening is a common early-to-midterm reason for UKA revision, at long-term follow-up (>10 years), the progression of osteoarthritis in the unreplaced lateral or patellofemoral compartments is the leading cause of late failure requiring conversion to a total knee arthroplasty.

Question 21

A 45-year-old male undergoes a medial opening-wedge high tibial osteotomy (HTO) for isolated medial compartment osteoarthritis and varus deformity. To optimize the long-term survivorship of the osteotomy and unload the medial compartment adequately, where should the postoperative weight-bearing line (WBL) be directed through the tibial plateau?

Explanation

The optimal postoperative mechanical axis following a high tibial osteotomy for medial compartment OA intersects the tibial plateau at approximately 62% to 62.5% of its width from the medial edge. This corresponds to the Fujisawa point, which slightly overcorrects the varus deformity to adequately unload the medial compartment.

Question 22

During a primary total knee arthroplasty, the surgeon evaluates the ligamentous tension with trial components in place. The extension gap is found to be excessively tight, while the flexion gap demonstrates appropriate tension and stability. What is the most appropriate surgical step to achieve a balanced knee?

Explanation

Resecting more distal femur increases the extension gap without altering the flexion gap. This effectively addresses a tight extension / balanced flexion mismatch without destabilizing the knee in flexion.

Question 23

A 68-year-old female presents with a feeling of knee instability particularly when standing up from a chair, 1 year after a posterior-stabilized total knee arthroplasty. Examination reveals stability at 0 degrees and 90 degrees, but marked laxity at 30 to 45 degrees of flexion. What is the most likely surgical cause of this complication?

Explanation

Mid-flexion instability in TKA is most commonly caused by elevation of the joint line. This alters the tension of the collateral ligaments in mid-flexion, causing laxity, even if the knee appears balanced in full extension and 90 degrees of flexion.

Question 24

A 65-year-old female complains of a painful "catching" sensation at the anterior aspect of her knee when extending from 45 degrees to 30 degrees of flexion, one year after undergoing a primary total knee arthroplasty. Which prosthetic design feature is most strongly associated with the development of this specific complication?

Explanation

Patellar clunk syndrome is most commonly associated with older posterior-stabilized TKA designs with a high/sharp intercondylar box. A fibrosynovial nodule forms at the superior pole of the patella and catches in the intercondylar notch during active extension.

Question 25

In revision total knee arthroplasty, an Anderson Orthopaedic Research Institute (AORI) Type 3 bone defect of the proximal tibia is identified. The surgeon decides to use a highly porous tantalum metaphyseal cone. What is the primary biomechanical advantage of utilizing a metaphyseal cone in this setting?

Explanation

Porous metaphyseal cones provide excellent initial mechanical stability through structural support and allow for long-term biologic fixation via osteointegration. This makes them ideal for managing severe cavitary and segmental bone loss (AORI Type 2b and 3).

Question 26

A 40-year-old female presents with isolated advanced lateral patellofemoral arthritis, a tibial tubercle-trochlear groove (TT-TG) distance of 22 mm, and patella alta (Caton-Deschamps index of 1.4). Which tibial tubercle osteotomy modification is most appropriate to optimize patellofemoral tracking and contact pressures?

Explanation

In the setting of lateral tracking (TT-TG > 20 mm) and patella alta (Caton-Deschamps > 1.2) with isolated patellofemoral arthritis, a medializing and distalizing tibial tubercle osteotomy is indicated. This combination corrects the lateral vector and normalizes patellar height, effectively unloading the lateral facet.

Question 27

According to the 2018 International Consensus Meeting (ICM) criteria for diagnosing periprosthetic joint infection (PJI), which of the following synovial fluid biomarkers carries the highest weight (points) in establishing a definitive diagnosis?

Explanation

Under the 2018 ICM scoring criteria for PJI, a positive synovial fluid alpha-defensin test is highly specific and carries a weight of 3 points. This is equivalent to the combined weight of an elevated synovial WBC count and an elevated PMN percentage.

Question 28

A 72-year-old male sustains a complete patellar tendon rupture off the tibial tubercle 6 weeks following a primary total knee arthroplasty. Primary repair attempts have failed due to poor tissue quality. What is the most reliable reconstructive option that demonstrates the highest clinical success rate for extensor mechanism continuity?

Explanation

Synthetic mesh (Marlex) reconstruction of the extensor mechanism has demonstrated superior long-term survivorship, lower complication rates, and more reliable functional outcomes compared to allograft reconstructions in the setting of chronic post-TKA disruption.

Question 29

A 60-year-old female with an extensively documented history of severe cutaneous hypersensitivity to cheap jewelry is scheduled for a primary total knee arthroplasty. Patch testing confirms a severe systemic allergy to nickel. Which femoral component material is the most appropriate choice to prevent a delayed hypersensitivity reaction?

Explanation

Standard Cobalt-Chromium alloys contain trace amounts of nickel and can elicit metal hypersensitivity. Oxidized zirconium (Oxinium) components lack nickel while providing excellent wear characteristics, making them ideal for patients with documented severe nickel allergies.

Question 30

In calipered kinematic alignment total knee arthroplasty, what is the primary surgical goal regarding the placement of the femoral component?

Explanation

The central tenet of kinematic alignment in TKA is restoring the native, pre-arthritic joint lines and kinematic axes of the knee. This is achieved by removing only the precise thickness of bone and cartilage that corresponds to the thickness of the implant.

Question 31

During a medial opening-wedge high tibial osteotomy (HTO), the surgeon realizes the anterior gap is inadvertently opened wider than the posterior gap. What is the direct biomechanical consequence of this asymmetric opening?

Explanation

Opening the anterior aspect of a medial opening-wedge HTO more than the posterior aspect increases the posterior tibial slope. This shifts the resting position of the tibia anteriorly, placing increased strain on the anterior cruciate ligament (ACL).

Question 32

During the proximal tibial resection in a total knee arthroplasty, the popliteal artery is at risk of iatrogenic injury. At the level of the standard tibial cut, where is the popliteal artery most commonly located in relation to the posterior tibial plateau?

Explanation

At the level of the standard proximal tibial resection, the popliteal artery runs slightly lateral to the midline. It is located directly posterior to the posterior horn of the lateral meniscus, making it particularly vulnerable during lateral plateau resection.

Question 33

In revision total knee arthroplasty with severe bone loss, anatomic landmarks must be utilized to restore the native joint line. Which of the following relationships is the most reliable anatomic guide for re-establishing the distal femoral joint line?

Explanation

The medial epicondyle is a highly reliable landmark for joint line restoration in revision TKA. The native joint line is consistently located approximately 25 to 30 mm distal to the prominence of the medial epicondyle.

Question 34

During a primary total knee arthroplasty (TKA), the surgeon notes the knee is tight in full extension but symmetrically well-balanced at 90 degrees of flexion. Which of the following is the most appropriate surgical step to correct this mismatch?

Explanation

A tight extension gap with a balanced flexion gap is managed by resecting more bone from the distal femur. Altering the tibial resection depth or slope would incorrectly affect the already balanced flexion gap.

Question 35

During a total knee arthroplasty, trial reduction reveals that the joint is tight in flexion but symmetric and well-balanced in extension. Which of the following is the most likely cause of this mismatch?

Explanation

An oversized AP femoral component tightens the flexion gap by increasing the posterior femoral offset, without affecting the extension gap. Downsizing the femoral component or increasing posterior tibial slope would help loosen the flexion gap.

Question 36

Which of the following surgical steps during a primary total knee arthroplasty carries the highest risk of iatrogenic injury to the popliteal artery?

Explanation

The popliteal artery is tethered by the soleus arch just distal to the joint line, making it highly vulnerable during the proximal tibial cut. Proper posterior retractor placement is essential to protect the neurovascular bundle during this step.

Question 37

A 72-year-old patient with severe valgus osteoarthritis presents for a total knee arthroplasty. Intraoperative assessment reveals a completely absent and non-reconstructable medial collateral ligament (MCL). Which level of prosthetic constraint is required?

Explanation

Constrained condylar knee (CCK) implants rely on a competent medial collateral ligament for coronal stability. Complete MCL deficiency or severe global instability requires a rotating hinge prosthesis to prevent catastrophic failure.

Question 38

During a total knee arthroplasty, the tibial component is inadvertently placed in excessive internal rotation. Which of the following clinical consequences is most likely to occur?

Explanation

Internal rotation of the tibial component effectively externalizes the tibial tubercle relative to the trochlear groove, thereby increasing the Q-angle. This typically leads to lateral patellar maltracking and potential subluxation.

Question 39

An 80-year-old woman sustains a Lewis-Rorabeck Type II periprosthetic distal femur fracture (comminuted fracture with a loose femoral component) following a fall. What is the most appropriate surgical management?

Explanation

Lewis-Rorabeck Type II fractures involve a loose component but adequate bone stock; however, comminution in elderly patients often precludes stable fixation. Distal femoral replacement allows for immediate weight-bearing and addresses both the fracture and the loose implant.

Question 40

A surgeon is performing an anteriorly based medial opening wedge high tibial osteotomy (HTO). To maintain the patient's native posterior tibial slope, how should the osteotomy gap be managed?

Explanation

To maintain the normal posterior tibial slope during an anteriorly based medial opening wedge HTO, the anterior osteotomy gap must be approximately half the size of the posterior gap. An equal gap will inadvertently increase the posterior slope.

Question 41

A patient presents with a painful popping sensation at the superior aspect of the patella when extending the knee from a flexed position, 8 months after a primary total knee arthroplasty. This complication is most classically associated with which implant design?

Explanation

Patellar clunk syndrome is classically associated with posterior-stabilized (PS) TKA designs. It occurs when a fibrous nodule forms at the superior pole of the patella and catches in the femoral intercondylar box during extension.

Question 42

A patient with severe lateral bowing of the femur in the coronal plane is undergoing a TKA. If a standard straight intramedullary alignment rod is used without adjustments, what will be the likely effect on the distal femoral resection?

Explanation

When using an intramedullary guide in a femur with significant lateral coronal bowing, the rod is forced medially at the distal aspect. This leads to a relatively varus distal femoral resection if not preoperatively templated and adjusted.

Question 43

A 65-year-old man presents with acute knee pain, swelling, and fever 4 weeks after an uncomplicated primary TKA. Symptoms began 2 days ago. Aspiration yields 85,000 WBC/hpf with 95% neutrophils. Implants are well-fixed radiographically. What is the treatment of choice?

Explanation

DAIR with a modular polyethylene exchange is indicated for acute hematogenous infections (symptoms < 3 weeks) or acute post-operative infections (< 4 weeks from index surgery) when the implants are well-fixed.

Question 44

Tranexamic acid (TXA) is routinely used in total knee arthroplasty to reduce blood loss. Which of the following best describes its primary mechanism of action?

Explanation

Tranexamic acid (TXA) is a synthetic analog of the amino acid lysine. It acts as an antifibrinolytic by competitively inhibiting the activation of plasminogen to plasmin, thereby preventing the degradation of fibrin clots.

Question 45

A lateral opening wedge distal femoral osteotomy (DFO) is planned for a young patient with symptomatic valgus osteoarthritis. Compared to a medial closing wedge DFO, what is the expected effect on leg length?

Explanation

An opening wedge osteotomy adds volume to the bone segment, thereby increasing overall leg length. In contrast, a closing wedge osteotomy removes a bone segment and decreases leg length.

Question 46

During a total knee arthroplasty for a severe fixed valgus deformity, the surgeon notes that the lateral compartment remains excessively tight in flexion but is balanced in extension. Release of which structure will most effectively address this mismatch?

Explanation

In the lateral compartment, the popliteus tendon is the primary soft tissue structure that is tight predominantly in flexion. The iliotibial (IT) band is predominantly tight in extension.

Question 47

Which of the following is considered an absolute contraindication to a mobile-bearing medial unicompartmental knee arthroplasty (UKA)?

Explanation

ACL deficiency is an absolute contraindication to mobile-bearing UKA. The resultant abnormal anterior-posterior translation of the tibia can lead to bearing dislocation and accelerated wear.

Question 48

A surgeon inadvertently overstuffs the patellofemoral joint during a total knee arthroplasty by using an excessively thick patellar component. What is the most likely clinical manifestation of this error?

Explanation

Overstuffing the anterior compartment increases tension on the extensor mechanism. This commonly restricts terminal knee flexion and leads to persistent anterior knee pain.

Question 49

A 68-year-old patient presents with a chronic, complete patellar tendon rupture 2 years after a primary TKA. The patient is unable to perform a straight leg raise. What is the most reliable surgical option?

Explanation

Direct primary repair of a chronic patellar tendon rupture post-TKA has an unacceptably high failure rate. Reconstruction utilizing synthetic mesh (e.g., Marlex) or a complete extensor mechanism allograft is the preferred treatment.

Question 50

A patient presents with severe arthrofibrosis (ROM 5 to 65 degrees) following a primary total knee arthroplasty. According to the literature, manipulation under anesthesia (MUA) is most successful when performed within what postoperative timeframe?

Explanation

Manipulation under anesthesia (MUA) is most effective when performed between 6 to 12 weeks postoperatively. Waiting beyond 3 months significantly decreases the success rate and increases the risk of complications such as periprosthetic fracture.

Question 51

When setting the distal femoral cut angle during a TKA, the surgeon must account for the angle between the anatomical and mechanical axes. In a short patient with short femora, how does this valgus angle typically compare to a tall patient?

Explanation

The valgus cut angle represents the divergence between the anatomical and mechanical axes of the femur. In shorter patients, or those with wider pelvises, this angle is larger (typically 7-9 degrees) compared to taller patients (typically 5 degrees).

Question 52

During a primary total knee arthroplasty (TKA) for a severe varus deformity, the surgeon evaluates the gaps after preliminary medial releases. The joint is perfectly balanced in 90 degrees of flexion, but the medial side remains significantly tighter than the lateral side in full extension. Which of the following structures should be released next to achieve balance?

Explanation

A medial gap that is tight in extension but balanced in flexion requires release of the posteromedial structures, specifically the posteromedial capsule and semimembranosus. Releasing the anterior superficial MCL would inappropriately loosen the flexion gap.

Question 53

A surgeon is performing a primary TKA on a severe valgus knee using a sequential lateral release. If the popliteus tendon is completely resected from its femoral insertion during this process, what is the most likely resulting biomechanical consequence?

Explanation

The popliteus tendon acts as a primary restraint to lateral opening in knee flexion. Resecting it preferentially increases the lateral flexion gap, potentially leading to lateral flexion instability.

Question 54

A patient develops patellar clunk syndrome after a posterior-stabilized (PS) TKA. Which of the following technical errors during the primary surgery is most likely responsible for exacerbating this condition?

Explanation

Anterior placement of the femoral component increases the anteroposterior dimension of the femur, causing the patella to track with increased pressure against the anterior aspect of the intercondylar box. This strongly predisposes the patient to patellar clunk syndrome.

Question 55

An 80-year-old patient presents with a massive osteolytic defect in the medial tibial metaphysis 15 years post-TKA. The cortical rim is completely deficient medially, and the tibial baseplate has subsided. According to the Anderson Orthopaedic Research Institute (AORI) classification, this Type 3 defect is best managed by which of the following during revision?

Explanation

AORI Type 3 defects involve severe metaphyseal bone loss with compromised cortical bone that cannot support a component. Management requires a metaphyseal cone or sleeve combined with a diaphyseal engaging stem to securely bypass the deficient metaphysis.

Orthopedic Surgery Board Review MCQs: Arthroplasty, Trauma & Spine Part 255

Orthopedic Board Prep MCQs: Arthroplasty, Knee & Osteotomy | Part 16

Key Takeaway

Orthopedic Board Prep MCQs: Arthroplasty, Knee & Osteotomy | Part 16

Chapter Index