Menu

1. General Principles & Basic Science MCQs

Practice Set 221 of 789

This practice set contains high-yield board review questions covering key concepts in 1. General Principles & Basic Science. Each clinical scenario is designed to test your diagnostic and management skills relevant to this subspecialty.

Question 4401

Topic: Physiology & Rehabilitation

Creatine is currently being used by athletes as a dietary supplement in an attempt to enhance performance. What is the physiologic basis for its use?

. Assists in carbohydrate metabolism and glycogen synthesis by producing adenosine diphosphate (ADP) to enhance aerobic activities
. Converts to phosphocreatine (PCr), which acts as an energy reservoir for adenosine triphosphate (ATP) in muscle tissue
. Converts to PCr, which enhances the production of ADP and promotes the metabolism of triglycerides as an energy source
. Converts to PCr, which enhances the production of ADP and promotes the metabolism of proteins as an energy source
. Converts to ADP by creatine kinase (CK) providing an energy reservoir for the production of ATP

Correct Answer & Explanation

. Converts to phosphocreatine (PCr), which acts as an energy reservoir for adenosine triphosphate (ATP) in muscle tissue

Explanation

Creatine is currently used as a nutritional supplement in an attempt to enhance athletic performance. The physiologic basis for its use is based on its conversion by CK to PCr, which acts as an energy reservoir in muscle cells for the production of ATP. A number of studies that examined the effect of creatine supplementation on performance concluded that while creatine does not increase peak force production, it can increase the amount of work done in the first few anaerobic short duration, maximal effort trials. The mechanism for this enhancement of work is unknown, but it is most likely secondary to the increase in the available PCr pool. Greenhaff PL: Creatine and its application as an ergogenic aid. Int J Sport Nutr 1995;5:S100-S110. Greenhaff PL, Casey A, Short AH, Harris R, Soderlund K, Hultman E: Influence of oral creatine supplementation on muscle torque during repeated bouts of maximal voluntary exercise in man. Clin Sci 1993;84:565-571. Trump ME, Heigenhauser GJ, Putman CT, Spriet LL: Importance of muscle phosphocreatine during intermittent maximal cycling. J Appl Physiol 1996;80:1574-1580.

Question 4402

Topic: Infection, Pharmacology & VTE

Figures 32a and 32b show the AP and lateral radiographs of an 11-year-old boy who has a severe limp, a fever, and swelling and tenderness of the thigh. Aspiration of the bone reveals purulent material. The patient has most likely been symptomatic for

. 24 hours.
. 2 days.
. 5 days.
. 7 to 14 days.
. 6 months.

Correct Answer & Explanation

. 7 to 14 days.

Explanation

In patients with an osteomyelitic infection, radiographic findings at 1 to 5 days usually show soft-tissue swelling only. Seven to 14 days after symptoms begin, radiographs will most likely show the classic signs of acute osteomyelitis. Reactive bone formation would be expected by 6 months. Kasser JR (ed): Orthopaedic Knowledge Update 5. Rosemont, IL, American Academy of Orthopaedic Surgeons, 1996, pp 149-161.

Question 4403

Topic: 1. General Principles & Basic Science
A study was conducted in 500 patients to measure the effectiveness of a new growth factor in reducing healing time of distal radial fractures. The authors reported that average healing time was reduced from 9.2 to 8.9 weeks (P < 0.0001). Because the difference was highly statistically significant, they recommended routine clinical use of this drug despite its high cost. A more appropriate interpretation of these results is that they are
. clinically significant.
. statistically significant but perhaps not clinically significant.
. statistically and clinically significant.
. not statistically or clinically significant.
. nonconclusive.

Correct Answer & Explanation

. statistically significant but perhaps not clinically significant.

Explanation

The results are statistically significant (at the arbitrary level of P < 0.05). That is, they indicate a probability of only 1/10,000 that the observation that the drug is effective in reducing healing time by 0.3 weeks occurred by chance selection of the study subjects. However, because the statistical power of a study increases with the number of subjects included (sample size), a difference that is trivial clinically can occur with a very high level of statistical significance (a very small P-value) if enough patients are included in the study. Because of this, the P-value alone, no matter how small, does not establish clinical significance or importance. Rather, the clinical significance of the observed difference must be assessed taking into consideration the medical importance of the difference if it is, in fact, true in the general population. In this example, the reduction in healing time of only a few days is probably clinically unimportant, particularly if the use of the new growth factor is expensive, complex, and/or has substantial side effects.

Question 4404

Topic: Infection, Pharmacology & VTE

A 7-year-old boy sustained a 2-cm laceration to the anterior aspect of his left knee after falling on a rock. Examination reveals that the joint surface is not visible through the wound. Radiographs show no evidence of a foreign body or free air in the joint. Management should consist of

Pediatrics Board Review 2004: High-Yield MCQs (Set 2) - Figure 30

. debridement of the skin edges, closure of the wound, and administration of an oral cephalosporin for 10 days.
. a saline load test.
. arthroscopic examination of the knee.
. leaving the wound open, administration of an oral cephalosporin, and reevaluation in 48 hours.
. injection of contrast material into the laceration, followed by radiographic studies.

Correct Answer & Explanation

. a saline load test.

Explanation

The possibility of an open joint injury should be considered in any patient who has a small periarticular laceration. Failure to promptly diagnose and treat such injuries may lead to septic arthritis. The diagnosis of an open joint is easily made when there is visible communication of the joint through the traumatic wound, or when intra-articular air is present on a radiograph. In the absence of these findings, the diagnosis of an open joint may be established by the saline load test, in which a volume of saline is injected into the joint under sterile conditions. If fluid extravasates through the traumatic wound, the diagnosis of an open joint is established. Voit and associates used a saline load test in 50 patients with periarticular lacerations suggestive of joint penetration. When they compared the clinical prediction of whether or not the laceration had penetrated the joint and the test results, the authors reported a false-positive clinical result in 39% of patients and a false-negative clinical result in 43%. The authors concluded that the saline load test was valuable in evaluating periarticular lacerations. Voit GA, Irvine G, Beals RK: Saline load test for penetration of periarticular lacerations. J Bone Joint Surg Br 1996;78:732-733.

Question 4405

Topic: 1. General Principles & Basic Science

Figure 37 shows the T2-weighted MRI scan of the hip joint. What structure is labeled A?

Anatomy 2002 Practice Questions: Set 3 (Solved) - Figure 19

. Ischiofemoral ligament
. Ligamentum teres
. Obturator internus
. Piriformis
. Coccygeus

Correct Answer & Explanation

. Obturator internus

Explanation

The obturator internus originates on the obturator membrane and adjacent bone, including the quadrilateral plate, and exits the lesser sciatic notch to insert on the posterior medial greater trochanter. The structure labeled C is the pectineus, B is the sartorius, and D is the gluteus medius. Last RJ: Anatomy: Regional and Applied, ed 6. London, England, Churchill Livingstone, 1978, pp 145-150, 324.

Question 4406

Topic: Biology, Genetics & Bone Healing

A 34-year-old man underwent open reduction and internal fixation of a closed both bones forearm fracture 11 months ago. The radiographs shown in Figures 32a and 32b reveal a 3-mm gap and loose screws. What is the best treatment option?

. Vascularized fibular graft
. Locked intramedullary rodding
. Tricortical iliac crest grafting and compression plating
. Cancellous autograft and plating
. BMP-7

Correct Answer & Explanation

. Cancellous autograft and plating

Explanation

In an atrophic nonunion with a good soft-tissue envelope, adequate plating with cancellous bone graft can be used to span defects of up to 6 cm. Cortical graft from the fibula or iliac crest is not necessary. BMP-7 is a bone graft substitute and should not be used alone in this patient because the hardware is loose.

Question 4407

Topic: Surgical Anatomy & Approaches

Figure 25 shows an arthroscopic thermal capsular shrinkage device being used in the anterior inferior quadrant of a patient with a subluxating shoulder. Which of the following neurologic complications is most frequently reported with this technique?

Anatomy Board Review 2002: High-Yield MCQs (Set 2) - Figure 26

. Axillary nerve dysesthesia
. Axillary nerve motor partial paralysis
. Suprascapular nerve neurapraxia
. Musculocutaneous nerve neurapraxia
. Radial nerve sensory dysesthesia

Correct Answer & Explanation

. Axillary nerve dysesthesia

Explanation

The axillary nerve lies within millimeters of the anterior inferior capsule. The inferior capsule is of varying thickness, and thermal energy used in shortening the ligament can cause damage to the sensory fibers of the axillary nerve. Clinically, this is manifested as a burnt skin sensation in the axillary nerve distribution area. The motor branch of the axillary nerve is usually spared. The suprascapular nerve and the radial nerve are far from the shrinkage zone. The musculocutaneous nerve, frequently at risk with open procedures, lies well anterior. Fanton GS: Arthroscopic electrothermal surgery of the shoulder. Op Tech Sports Med 1998;6:157-160.

Question 4408

Topic: 1. General Principles & Basic Science

Which of the following factors will adversely affect bone ingrowth in a revision porous-coated stem?

. Pore size of 400 um
. Interface instability of 25 um of micromotion
. Use of a nonmodular implant
. Noncircumferential metaphyseal patch coating
. Failure of ingrowth in the previous stem

Correct Answer & Explanation

. Noncircumferential metaphyseal patch coating

Explanation

The optimal conditions for bony ingrowth include a pore size of 100 to 400 um, interface micromotion of 50 um or less, intimate contact between the bone and the implant, circumferential porous coating of the implant, and use of a biocompatible material. Stem designs with patch coatings have a poor record of bony ingrowth, especially in the revision setting. Failure of ingrowth in the previous stem would be the result of its own mechanical milieu and would not necessarily predict results for the new stem. Berry DJ, Harmsen WS, Ilstrup D, Lewallen DG, Cabanela ME: Survivorship of uncemented proximally porous-coated femoral components. Clin Orthop 1995;319:168-177. Cook SD, Thomas KA, Haddad RJ Jr: Histologic analysis of retrieved human porous-coated total joint components. Clin Orthop 1988;234:90-101.

Question 4409

Topic: 1. General Principles & Basic Science

Bacitracin is a topical antibiotic agent that may be added to solutions and used for intraoperative lavage. What is this agent effective against?

. Gram-positive bacteria
. Gram-negative bacteria
. Mixed flora
. Bacterial spores
. Fungi

Correct Answer & Explanation

. Gram-positive bacteria

Explanation

Bacitracin is a polypeptide obtained from a strain (Tracy strain) of Bacillus subtilis. It is stable and poorly absorbed from the intestinal tract; its only use is for topical application to skin, wounds, or mucous membranes. Concentrations of 500 to 2,000 units per milliliter of solution or gram of ointment are used for topical application. Bacitracin is mainly bactericidal for gram-positive bacteria, including penicillin-resistant staphylococci. In combination with polymixin B or neomycin, bacitracin is useful for suppression of mixed bacterial flora in surface lesions. Bacitracin is toxic for the kidney, causing proteinuria, hematuria, and nitrogen retention; therefore, it has no place in systemic therapy. Bacitracin is said not to induce hypersensivity readily, but reactions to this agent have been described. Rosenstein BD, Wilson FC, Funderburk CH: The use of bacitracin irrigation to prevent infection in postoperative skeletal wounds: An experimental study. J Bone Joint Surg Am 1989;71:427-430.

Question 4410

Topic: Biology, Genetics & Bone Healing

A 45-year-old man has had left thigh pain for the past 4 months. An AP radiograph, bone scan, MRI scans, and biopsy specimens are shown in Figures 6a through 6f. What is the most appropriate treatment?

. Physical therapy
. Medical management
. Radiation therapy
. Prophylactic internal fixation
. Wide resection

Correct Answer & Explanation

. Medical management

Explanation

The radiograph demonstrates thickened trabeculae and thickened cortices in the left proximal femur compared to the right, and the bone scan shows increased uptake in this area. The MRI scans show thickened trabeculae with normal marrow signal. These findings are diagnostic of Paget's disease. Medical treatment, including bisphosphonates and calcitonin, is indicated for painful bone lesions. Hadjipavlou AG, Gaitanis IN, Kontakis GM: Paget's disease of the bone and its management. J Bone Joint Surg Br 2002;84:160-169.

Question 4411

Topic: Surgical Anatomy & Approaches

A 68-year-old man reports a 1-year history of debilitating neck pain without neurologic symptoms. History reveals a C5-6 anterior diskectomy and bone grafting 10 years ago that provided good relief of arm and neck pain. Radiographs show evidence of fibrous union at C5-6, spondylotic disk narrowing at C4-5 and C6-7, and a fixed 2-mm subluxation at C3-4. Examination reveals cervical stiffness and discomfort at the extremes of movement. His neurologic examination is normal. Treatment should now consist of

Spine Surgery 2006 Practice Questions: Set 1 (Solved) - Figure 4

. posterior fusion at C3-C7.
. anterior fusion at C3-7 with plate fixation through the same scar.
. anterior fusion at C3-7 with plate fixation through a right-sided incision.
. an epidural steroid injection.
. patient education, exercise, and nonnarcotic medication.

Correct Answer & Explanation

. patient education, exercise, and nonnarcotic medication.

Explanation

Axial pain can be difficult to manage. Pain management is not always successful, and surgical approaches may provide disappointing results unless there is discrete pathology. Whereas planning of a surgical approach should consider prior approaches and preexisting laryngeal dysfunction, no compelling case for surgical intervention can be made for this patient. Therefore, management should consist of patient education, exercise, and nonnarcotic medication. Ahn NU, Ahn UM, Andersson GB, et al: Operative treatment of the patient with neck pain. Phys Med Rehabil Clin N Am 2003;14:675-692. Algers G, Pettersson K, Hildingsson C, et al: Surgery for chronic symptoms after whiplash injury: Follow-up of 20 cases. Acta Orthop Scand 1993;64:654-656.

Question 4412

Topic: Biology, Genetics & Bone Healing

A 15-year-old boy with epilepsy who is treated with phenytoin sustains a vertebral compression fracture during a breakthrough seizure. Radiographs of the spine reveal generalized osteopenia. What is the most likely cause of the osteopenia?

. Induced osteoporosis
. Acquired osteomalacia
. Calcitonin effect
. Hyperparathyroidism
. Disuse osteoporosis

Correct Answer & Explanation

. Acquired osteomalacia

Explanation

As a side effect of treatment, phenytoin induces osteomalacia, or rickets, in growing children, through interference with metabolism of vitamin D. Oral supplementation of vitamin D can minimize this effect in patients who are undergoing prolonged treatment with phenytoin.

Question 4413

Topic: Biology, Genetics & Bone Healing

A 62-year-old woman with a bone mass density (BMD) T-score of -2.0 sustained a subcapital fracture of her hip. She is an avid tennis player, and history reveals no previous fractures. What is the most appropriate follow-up care?

Hip & Knee Reconstruction Board Review 2007: High-Yield MCQs (Set 2) - Figure 22

. Antiresorptive bisphosphonate medication
. A repeat dual-energy x-ray absorptiometry scan (DEXA) and treatment if the T-score is less than -2.5
. A repeat DEXA scan and treatment if the T-score is greater than -1.5
. No treatment since the BMD is not in osteoporotic range
. (PTH) taraparatide hormone followed by surgery

Correct Answer & Explanation

. Antiresorptive bisphosphonate medication

Explanation

A DEXA scan is most appropriately used to establish a baseline score. Even if the bone mineral density is not within the osteoporotic range (T-score less than -2.5), a prior fragility fracture is a strong risk factor for a second fracture as a result of factors other than bone density, such as worsening vision or balance, confusion, or other predispositions to falls. The guidelines of the National Osteoporosis Foundation indicate that, following a fragility hip fracture, active anti-osteoporotic medication should be initiated, whether or not a DEXA scan is performed. A recent study showed that antiresorptive therapy following a hip fracture reduces not only the risk of a second fracture but also overall mortality.

Question 4414

Topic: 1. General Principles & Basic Science

A study is being designed to compare the effectiveness of an antibiotic. The choice of the number of patients (ie, the sample size) depends on several factors. What type of calculation assesses the potential of the study to successfully address the effectiveness of the antibiotic?

. Regression analysis
. Power analysis
. Correlation analysis
. Nonparametric analysis
. Analysis of variance

Correct Answer & Explanation

. Power analysis

Explanation

Power analysis is used to determine the minimum number of specimens (sample size) such that, if a difference is found that is large enough to be clinically important, the associated level of statistical reliability will be high enough (ie, the P-value will be small enough) for the investigators to conclude that the difference observed in the study also holds in general. For the statistician to do a power analysis, the investigators must first decide on the minimum difference that they consider to be clinically important, for example, a reduction of 3% in the rate of infection. It is important to recognize that the choice of what constitutes the minimum difference in the rate of infection that is clinically (ie, medically) important cannot and should not be done by the statistician. Rather, this is a clinical-medical issue and must be done by the physician researcher based on a comprehensive assessment of the medical risks and benefits. The power analysis also requires an estimate of the variance in the data, which may be based on previous similar studies, if available. A statistician can then calculate the minimum sample size (number of patients) required such that, if a clinically important difference does, in fact, exist between the full populations, there is a reasonable probability or power (typically 80% to 90%) that a difference this large also will occur between the sample populations at the desired level of statistical significance (usually, but not necessarily, P < 0.05). The other answers refer to types of analyses that are usually conducted after the data are collected.

Question 4415

Topic: Biomechanics & Biomaterials

Figure 40 shows the plain radiograph of a 30-year-old woman who has had a long history of standing bilateral anterior knee pain and a sense of patellar instability without frank dislocation. Nonsurgical management consisting of anti-inflammatory drugs and physical therapy has failed to provide relief. Examination reveals full range of motion of both knees, with moderate patellofemoral crepitance. Patellar apprehension and patellar grind tests are positive. The Q-angle measures 20 degrees. Management should now consist of

Sports Medicine Board Review 2001: High-Yield MCQs (Set 4) - Figure 11

. bilateral arthroscopic lateral releases.
. bilateral arthroscopic lateral releases and medial retinacular thermal shrinkage.
. bilateral lateral releases and anteromedialization of the tibial tubercles.
. physical therapy and the use of patella-stabilizing braces.
. physical therapy with taping.

Correct Answer & Explanation

. bilateral lateral releases and anteromedialization of the tibial tubercles.

Explanation

The history, physical examination, and radiographs indicate that the patellofemoral pain is most likely caused by excessive lateral patellar pressure and patellar maltracking. Because the radiographs reveal the lateral tilt of the patella and lateral subluxation, the treatment of choice is bilateral lateral releases with anteromedialization of the tibial tubercles. This procedure corrects not only the excessive lateral patellar pressure, but also the lateral subluxation. The use of patella-stabilizing braces or taping may provide temporary relief, but these implements are not well-tolerated and they will not change the underlying biomechanics of the knee. Simple lateral release is indicated for isolated lateral tilt, but it does not correct the lateral subluxation. The use of thermal capsular shrinkage for the medial retinaculum has not been proven to provide long-term correction of the deformity. Boden BP, Pearsall AW, Garrett We Jr, et al: Patellofemoral instability: Evaluation and management. J Am Acad Orthop Surg 1997;5:47-57.

Question 4416

Topic: 1. General Principles & Basic Science

A 17-year-old boy who fell on a pitchfork in a barn 1 day ago now has a painful, swollen forearm. Examination reveals erythema, exquisite tenderness, and crepitus to palpation of the forearm. He has a pulse rate of 110/min and a blood pressure of 80/60 mm Hg. Radiographs show subcutaneous air and no fractures. Gram stain of wound drainage reveals a gram-positive bacillus. The next most appropriate step in management should consist of

. surgical debridement with wound closure and IV antibiotics.
. surgical debridement with wound closure over suction drains and IV antibiotics.
. surgical debridement with open wound management and IV antibiotics.
. IV antibiotics alone.
. hyperbaric oxygen therapy.

Correct Answer & Explanation

. surgical debridement with open wound management and IV antibiotics.

Explanation

The successful treatment of necrotizing soft-tissue infections such as clostridial myonecrosis depends on prompt recognition and aggressive surgical debridement of all involved muscle, fascia, and soft tissue, resecting to a clearly normal healthy, viable margin. The effective antibiotic regimen for clostridial infection is high-dose penicillin; however, necrotizing infections are frequently polymicrobial so initially broad-spectrum antibiotics are indicated. Hyperbaric oxygen therapy may be used as an adjunct to surgical treatment but is insufficient as a primary therapy. Prolonged application of tourniquets and wound closure should be avoided. Pellegrini VD, Evarts CM: Complications, in Rockwood CA Jr, Green DP (eds): Fractures in Adults, ed 3. Philadelphia, PA, JB Lippincott, 1991, pp 365-370. Gerding DN, Peterson LR: Infections caused by anaerobic bacteria, in Shulman ST, Phair JP, Peterson LR, Warren JR (eds): Infectious Diseases, ed 5. Philadelphia, PA, WB Saunders, 1997, pp 416-417.

Question 4417

Topic: 1. General Principles & Basic Science

Figures 14a and 14b show the clinical photographs of a patient who was stranded in a subzero region for several days. The photographs were taken the morning after arrival in the hospital. The patient is otherwise healthy and fit, and takes no medication. He has no clinical signs of sepsis. He reports burning pain and tingling in both feet. What is the best treatment?

. Moist dressings and continued observation
. Debridement of the necrotic tissue
. Amputation at the metatarsophalangeal level with open wound management
. Closed forefoot amputation
. Guillotine transtibial amputation

Correct Answer & Explanation

. Moist dressings and continued observation

Explanation

The patient has no clinical or observed signs of sepsis. The skin just proximal to the gangrenous tissue appears somewhat hyperemic and is clearly viable. These wounds should be managed much like burn wounds. Moist dressings should be used until the tissue clearly demarcates. Much of the insult may simply be superficial and only require late debridement. McAdams TR, Swenson DR, Miller RA: Frostbite: An orthopedic perspective. Am J Orthop 1999;28:21-26.

Question 4418

Topic: 1. General Principles & Basic Science

Figure 8 shows the radiograph of a 72-year-old man who has had severe pain in the left hip for the past 3 weeks. History reveals alcohol abuse. The next most appropriate step should consist of

Hip 2001 Practice Questions: Set 1 (Solved) - Figure 15

. hip aspiration.
. Doppler ultrasound.
. AP tomograms.
. a CT scan.
. a technetium Tc 99m bone scan.

Correct Answer & Explanation

. hip aspiration.

Explanation

The radiograph reveals destruction of the femoral head with loss of the articular cartilage. These findings are consistent with an infected hip, and aspiration will confirm the diagnosis. Although the patient could have advanced osteonecrosis, typically the cartilage interval is maintained and such destruction is rarely associated with osteonecrosis.

Question 4419

Topic: 1. General Principles & Basic Science

Which of the following properties primarily provides the excellent corrosion resistance of metallic alloys such as stainless steel and cobalt-chromium-molybdenum?

. High surface hardness
. High levels of nickel
. Adherent oxide layer
. Low galvanic potential
. Metallic carbides

Correct Answer & Explanation

. Adherent oxide layer

Explanation

All of the metals and metallic alloys used in orthopaedic surgery obtain their corrosion resistance from an adherent oxide layer. For stainless steel and cobalt alloy, the addition of chromium as an alloying element ensures the formation of a chromium oxide passive layer that forms on the surface and separates the bulk material from the corrosive body environment. Titanium alloy achieves the same result without chromium by forming an adherent passive layer of titanium oxide. Although these layers can indeed be hard, hardness does not in and of itself provide corrosion resistance. Adding nickel to both metallic alloys adds to strength but does not influence corrosion resistance appreciably. Galvanic potential can influence corrosion but does so by differences in potential between two contacting materials; for example, stainless steel and cobalt alloy have substantially different potentials, and if they were in contact within an aqueous environment, corrosion would commence with the stainless steel becoming the sacrificial anode. Metallic carbides are important in strengthening the alloys but have no role in providing corrosion resistance. Williams DF, Williams RL: Degradative effects of the biological environment on metal and ceramics, in Ratner BD, Hoffman AS, Shoen FJ, et al (eds): Biomaterials Science. San Diego, CA, Academic Press, 1996, pp 260-265. Buckwalter JA, Einhorn TA, Simon SR (eds): Orthopaedic Basic Science: Biology and Biomechanics of the Musculoskeletal System, ed 2. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2000, pp 190-193.

Question 4420

Topic: 1. General Principles & Basic Science

A 19-year-old soccer player feels a pop in his knee while making a cut and notes the development of an effusion over several hours. Examination reveals medial joint line tenderness, but the knee is stable to manual stress testing of all ligaments. Examination under anesthesia confirms a stable knee. What is the most critical factor in determining healing after repair of the lesion shown in Figure 14?

Sports Medicine Board Review 2004: High-Yield MCQs (Set 2) - Figure 6

. Rim width
. Rim length
. Time from injury to repair
. Use of a fibrin clot
. Whether the tear occurred in the medial versus lateral meniscus

Correct Answer & Explanation

. Rim width

Explanation

Numerous clinical and basic science investigations have evaluated meniscal tear characteristics to identify factors that either promote or mitigate against meniscal healing. Complex tears have been noted to heal poorly, while longitudinal tears heal more predictably. Tear length, time from injury to repair, medial versus lateral meniscal tears, and the use of a fibrin clot have not been shown to consistently affect meniscal healing. However, rim width, the distance of the tear site from the peripheral meniscocapsular junction (vascular supply), has been shown to have a significant role in the ability of a meniscus repair to heal. DeHaven KE, Arnoczky SP: Meniscus repair: Basic science, indications for repair, and open repair. Instr Course Lect 1994;43:65-76.

Test Yourself

Switch to an interactive, timed exam simulation to truly master this topic.

On this Page