1. General Principles & Basic Science MCQs

Because of the avascular nature of articular cartilage, chondrocytes reside in a relatively hypoxic environment. Which of the following represents the primary metabolic pathway utilized by mature chondrocytes for ATP production?

A 65-year-old woman is evaluated for osteoporosis and is recommended to start therapy with denosumab. What is the specific mechanism of action of this medication?

In normal articular cartilage, which zone is characterized by the highest concentration of proteoglycans, the lowest concentration of water, and collagen fibers oriented perpendicular to the joint surface?

When evaluating the biomechanics of a cortical screw, which of the following alterations to the screw's design will most significantly increase its pullout strength?

According to Perren's strain theory, what is the maximum amount of interfragmentary strain that can be tolerated for the formation of lamellar bone during fracture healing?

Mixing stainless steel and titanium implants within the same surgical construct should generally be avoided primarily due to the increased risk of which of the following processes?

What is the primary biomechanical function of aggrecan within the extracellular matrix of articular cartilage?

A physical therapist applies a constant load to a patient's contracted knee joint, resulting in a gradual increase in deformation of the periarticular soft tissues over time. Which viscoelastic property does this phenomenon describe?

Romosozumab is a biologic therapy utilized in the management of osteoporosis. What is its cellular target and resulting primary effect?

Bone morphogenetic proteins (BMPs) such as BMP-2 and BMP-7 transmit their intracellular signals primarily through the phosphorylation and activation of which of the following?

Which of the following transcription factors is considered the essential 'master regulator' required for mesenchymal stem cells to commit to the osteoblast lineage?

During the swing phase of the human gait cycle, the knee joint experiences relatively low compressive loads and high sliding speeds. Which mechanism of articular cartilage lubrication predominates under these conditions?

When evaluating the material properties of an orthopedic implant on a load-deformation curve, the stiffness of the material is represented by which of the following parameters?

In the context of fracture fixation with a bridging plate, increasing the working length by leaving empty screw holes directly over the fracture site has what specific biomechanical effect?

During the proximal extension of the volar (Henry) approach to the forearm, the surgeon elevates the supinator muscle to expose the proximal radius. Which nerve lies within the substance of the supinator and is at highest risk of iatrogenic injury if the muscle is elevated aggressively or incorrectly?

During a deltopectoral approach to the shoulder, the conjoint tendon is identified and retracted medially to access the subscapularis. Excessive medial retraction of the conjoint tendon places which of the following nerves at greatest risk of neuropraxia?

The anterior (Smith-Petersen) approach to the hip utilizes both superficial and deep internervous planes. Which of the following describes the deep internervous plane for this approach?

During a direct lateral (Hardinge) approach to the hip, the gluteus medius and vastus lateralis are split. The proximal split of the gluteus medius must not extend beyond 3 to 5 cm from the tip of the greater trochanter to avoid denervating the anterior portion of the muscle. Which nerve is at risk?

While performing a modified Stoppa approach for an anterior column acetabular fracture, the surgeon encounters severe hemorrhage when dissecting over the superior pubic ramus. This bleeding is most likely originating from the corona mortis, an anastomosis between which two vascular systems?