Interactive Orthopedic MCQs Bank Online - Test Your Knowledge and Prepare for Exams!
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?
Correct answer: d. Previous osteonecrosis
Question 52
Long stemmed tibial components for revision total knee arthroplasty are not cemented for which of the following reasons?
Correct answer: a. Extensive stress shielding
Question 53
Unicompartmental arthroplasty is contraindicated in which patient?
Correct answer: c. A patient with rheumatoid arthritis concentrated in the medial compartment
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?
Correct answer: c. 8 mm to 10 mm
Question 55
Which of the following is not a contraindication for high tibial osteotomy to treat medial compartment arthritis?
Correct answer: e. A young patient unwilling to stop high activity occupation
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?
Correct answer: b. The lateral most longitudinal incision
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:
Correct answer: d. Arthroscopic debridement or open revision of the patellar component
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?
Correct answer: e. Plate fixation (Dynamic Condylar Screw or fixed angle blade) with retention of femoral component
Question 59
Resection of too little distal femur will have what effect on the "flexion/extension gap" with regard to ligamentous balancing?
Correct answer: c. Decrease extension gap (flexion contracture)
Question 60
Excessive internal rotation of the tibial component should be avoided because of which resultant effect?
Correct answer: b. Net external rotation of tibial tubercle, patellar subluxation
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:
Correct answer: c. Revision to a constrained-condylar type prosthesis
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?
Correct answer: c. The subvastus approach is more technically difficult and exposure is more difficult than a medial parapatellar approach.
Question 63
The most common extensor mechanism complication in total knee arthroplasty is:
Correct answer: b. Patellar instability
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:
Correct answer: d. Remove the dressings and flex the leg
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?
Correct answer: c. Aseptic loosening of the acetabular cup
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:
Correct answer: a. Wolff's law
Question 67
The reduction mechanism of venous thromboembolism from epidural anesthesia in total joint replacement is:
Correct answer: c. Sympathetic effect of epidural blockage
Question 68
Which of the following is not a clinical sign of pulmonary embolism:
Correct answer: e. Bradycardia
Question 69
In total joint replacement, osteolysis that results in bone loss and bone resorption is caused by:
Correct answer: e. Polyethylene debris
Question 70
Bone grafts (autograft) used to restore bone stock in total joint replacements are the result of what biological process:
Correct answer: e. Osteogenesis, osteoinduction, and osteoconduction
Question 71
Ceramics are used as an osteoconductive bone-graft material. The optimal pore size is:
Correct answer: c. 150 μm to 500 μm
Question 72
The American College of Cardiology recommends that a patient wait how long after a myocardial infarction before undergoing a total hip replacement:
Correct answer: b. 6 weeks
Question 73
Patients with rheumatoid arthritis must be radiologically evaluated for this condition:
Correct answer: b. C1 - C2 subluxation
Question 74
In hypotensive total joint replacement surgery, the mean blood pressure is kept at:
Correct answer: b. 60 mm Hg
Question 75
The optimal position of a patient’s knee during total knee replacement surgery is:
Correct answer: c. 7° of anatomic valgus
Question 76
The optimal position for the acetabular cup during total hip replacement surgery is:
Correct answer: c. 15° anteversion
Question 77
Gallium-67 citrate used in scanning techniques can result in increased gallium-67 localization in:
Correct answer: e. Infection, fracture, and aseptic loosening
Question 78
The most specific scanning method to detect infection in total joint replacement is:
Correct answer: e. A combination of white blood cell scanning and technetium bone scanning
Question 79
Outcomes, as opposed to traditional results, are more reliable because they include:
Correct answer: e. Measured and recorded clinical results, economic consequences, and social consequences
Question 80
The anterolateral (Watson-Jones) approach to the hip dissects in an interval between:
Correct answer: b. The gluteus medius and tensor fascia lata muscles
Question 81
The direct lateral (modified Hardinge) approach to the hip has the following disadvantage(s):
Correct answer: d. Limited proximal acetabular exposure, increased heterotopic ossification, and slower abductor rehabilitation
Question 82
When using the direct lateral (modified Hardinge) approach to the hip, the incidence of total hip dislocation is:
Correct answer: c. 0.3%
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:
Correct answer: d. 10%
Question 84
The posterior approach to the hip has the following advantage(s) over the direct lateral approach when performing total hip arthroplasty:
Correct answer: d. Easy exposure, decreased operative time, and decreased heterotopic ossification
Question 85
The posterior approach to the hip splits the following muscle(s) when exposing the hip:
Correct answer: b. Gluteus maximus
Question 86
The trochanteric slide osteotomy involves:
Correct answer: c. Keeping the gluteus medius and vastus lateralis in continuity
Question 87
The advantage(s) of an extended trochanteric osteotomy in approaching a revision hip surgery include:
Correct answer: d. Easier access to bone-cement interface, decreased operative time, and better exposure of acetabulum
Question 88
When using the direct lateral (modified Hardinge) approach to the hip, the incision is extended distally along the posterior border of the:
Correct answer: b. Gluteus maximus
Question 89
The vastus slide utilizes a:
Correct answer: c. Keeping the gluteus medius and vastus lateralis in continuity
Question 90
The anatomy of the hip provides considerable rotation in:
Correct answer: c. Three anatomic planes
Question 91
Most patients have a hip flexion-extension arc of:
Correct answer: c. 120° to 140°
Question 92
Femoral implants with greater anteversion will impinge (trochanter against the pelvis):
Correct answer: a. Posteriorly in extension with lesser external rotation
Question 93
Level walking requires the following hip range of motion:
Correct answer: b. 55° of flexion-extension and the same internal-external rotation/abduction-adduction
Question 94
To put on a pair of shoes, the arc of motion required in the hip joint is:
Correct answer: c. 140°
Question 95
Recent mathematical modeling of hip joint forces during activities of daily living relative to body weight show elevations by a factor of:
Correct answer: c. 2 to 4
Question 96
Implantation of a total hip prosthesis can significantly alter hip forces. The lowest forces occur at the:
Correct answer: a. Anatomic center
Question 97
Implantation of a total hip prosthesis can significantly alter hip forces. The greatest increase in hip forces occur at the:
Correct answer: b. Lateral anatomic center
Question 98
When implanting a total hip prosthesis, the greatest strains occur at what part of the femoral implant:
Correct answer: d. Tip of the prosthesis
Question 99
What percentage of bone is turned over in the skeleton each year:
Correct answer: a. 5%
Question 100
The stem and mantle is easily extracted in a failed hip arthroplasty if:
Correct answer: b. A circumferential lytic line surrounds the cement mantle
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