Total Hip Arthroplasty (THA) MCQs

Which patient or surgical factor is most strongly associated with squeaking in a ceramic-on-ceramic total hip arthroplasty?

A 55-year-old active male with a ceramic-on-ceramic THA complains of an audible squeaking sound from his hip when walking. Which of the following is the most significant risk factor for this phenomenon?

Following a total hip arthroplasty, the patient complains that the operative leg feels too long. Postoperative radiographs reveal the center of rotation of the femoral head is superior to the tip of the greater trochanter, and the teardrop-to-lesser trochanter distance is increased by 15 mm compared to the contralateral side. Which intraoperative adjustment would have best prevented this?

A 55-year-old active male presents with an audible squeaking sound from his hip 2 years after a ceramic-on-ceramic total hip arthroplasty. Which of the following component positions is most highly associated with this complication?

During a direct lateral (Hardinge) approach to the hip, proximal splitting of the gluteus medius is limited to prevent injury to the superior gluteal nerve. What is the generally accepted maximum safe distance for splitting the gluteus medius proximal to the tip of the greater trochanter?

In a direct anterior approach to the hip, careful deep dissection is required. In a different scenario where an adductor tenotomy and obturator nerve block are performed for spasticity, the surgeon isolates the anterior and posterior divisions of the obturator nerve. These divisions are anatomically separated by which of the following muscles?

During a posterior approach to the hip (Kocher-Langenbeck), preservation of the main blood supply to the adult femoral head is critical. To protect the ascending branch of the medial femoral circumflex artery (MFCA), the surgeon should strictly avoid transecting the tendon of the:

A 6-year-old boy sustains a spiral midshaft femur fracture. He is managed with a spica cast. Two years later, his parents are concerned about a leg length discrepancy. Which of the following is the most expected outcome regarding limb length after this injury?

Which anatomic structure is most frequently implicated in blocking the successful closed reduction of an acute posterior hip dislocation?

A healthy, independent 70-year-old woman sustains a displaced femoral neck fracture. She is an avid golfer and walks two miles daily. Comparing total hip arthroplasty (THA) to bipolar hemiarthroplasty for this specific patient, THA is associated with which of the following?

A 33-year-old man undergoes a successful closed reduction of a traumatic posterior hip dislocation. The post-reduction CT scan demonstrates a congruent hip joint without intra-articular step-off, but reveals a 2 mm osteochondral fragment in the inferior, dependent aspect of the joint. The patient has a full, unrestricted range of motion. What is the most appropriate management?

During a posterior approach to the hip for a displaced femoral neck fracture, care must be taken to protect the primary blood supply to the femoral head. Which artery provides the majority of the blood supply to the adult femoral head?

A healthy, community-ambulating 70-year-old woman sustains a displaced femoral neck fracture. When comparing total hip arthroplasty (THA) to bipolar hemiarthroplasty for her definitive treatment, THA is associated with:

A highly active 68-year-old male presents with a displaced femoral neck fracture. He is medically optimized and a decision is made between total hip arthroplasty (THA) and hemiarthroplasty. According to current literature, which of the following is true regarding THA compared to hemiarthroplasty in this patient population?

A 55-year-old male with a ceramic-on-ceramic total hip arthroplasty complains of a loud, high-pitched squeaking noise with ambulation. Which of the following factors is most strongly associated with this complication?

When comparing total hip arthroplasty (THA) to hemiarthroplasty for the treatment of a displaced femoral neck fracture in an active, independent 72-year-old woman, which of the following statements is most accurate?

An 81-year-old nursing home resident with severe Parkinson's disease sustains a displaced femoral neck fracture. Which of the following surgical options minimizes her risk of postoperative instability while addressing the fracture?

A 65-year-old woman undergoes conversion of a failed ORIF of a femoral neck fracture to a total hip arthroplasty. Compared to primary THA for osteoarthritis, this conversion procedure is associated with:

A 77-year-old woman undergoes total hip arthroplasty for a displaced femoral neck fracture. Which of the following surgical approaches, if performed without meticulous soft-tissue repair, is associated with the highest risk of postoperative dislocation?

A patient undergoes a posterior approach total hip arthroplasty. Postoperatively, the patient experiences recurrent anterior dislocations. Which of the following component malpositions is most likely responsible?