Total Hip Arthroplasty (THA) MCQs

Trunnionosis, or mechanically assisted crevice corrosion at the head-neck taper, has emerged as a significant cause of adverse local tissue reactions in modern THA. Which combination of implant factors is most associated with an increased risk of trunnionosis?

A 45-year-old man underwent a primary THA using a ceramic-on-ceramic bearing. Three years postoperatively, he complains of an audible squeaking sound from the hip during deep flexion activities, though he is pain-free. What is the most significant risk factor for this phenomenon?

Following a primary THA, a patient complains that the operative leg feels significantly longer. Clinical examination and scanograms confirm a true 2 cm leg length discrepancy. Assuming the femoral neck osteotomy was performed perfectly according to preoperative templating, which intraoperative error most likely caused this outcome?

A 65-year-old patient experiences recurrent posterior dislocations of their THA. CT imaging reveals the acetabular component is in 45 degrees of inclination and 0 degrees of anteversion, while the femoral stem is in 15 degrees of anteversion. What is the most appropriate surgical treatment?

During the fixation of an uncemented acetabular cup in THA, the surgeon decides to place supplementary screws. According to the quadrant system described by Wasielewski, screw placement in the anteroinferior quadrant places which of the following vascular structures at greatest risk of direct injury?

The deep branch of the medial circumflex femoral artery (MCFA) provides the primary vascular supply to the adult femoral head. During a posterior approach to the hip, releasing which of the following short external rotators too close to the femur places this artery at greatest risk?

To preserve the primary blood supply to the femoral head during a posterior approach to the hip, the surgeon must be careful not to injure the medial femoral circumflex artery (MFCA). The main deep branch of the MFCA typically runs between which two muscles?

Which of the following is an advantage of anterior surgical approach over a posterior approach for direct spinal cord decompression of an anteriorly located extradural tumor?

Which surgical technique is most commonly used for repair of a distal biceps tendon rupture?

Which of the following is a common early complication specific to the anterior approach for L5-S1 spondylolisthesis fusion?

When performing a 2-incision (modified Boyd-Anderson) approach for a distal biceps tendon rupture repair, which of the following complications occurs at a significantly higher rate compared to the single-incision anterior approach?

The concept of 'stress shielding' in orthopedics primarily refers to:

In a viva discussing total hip arthroplasty, the examiner presents a scenario where a patient develops a leg length discrepancy post-operatively. What is the MOST crucial initial step in managing this complaint?

A 35-year-old highly active man underwent a primary total hip arthroplasty with a ceramic-on-ceramic bearing. Two years later, he complains of a loud squeaking sound emanating from his hip when he walks or bends, though it is painless. Which of the following technical factors is most strongly associated with the development of this specific complication?

Which of the following surgical steps has been shown in the literature to be the most critical in reducing the risk of dislocation following primary total hip arthroplasty (THA) using a posterior approach?

A 62-year-old woman presents with an audible 'squeaking' sound coming from her total hip arthroplasty during ambulation. Review of the operative report indicates she has a ceramic-on-ceramic bearing. Which of the following component malpositions is most strongly associated with this phenomenon?

A 65-year-old patient who underwent a primary total hip arthroplasty using a ceramic-on-ceramic bearing complains of an audible squeaking sound from the hip when walking. Which of the following biomechanical factors is most directly associated with the development of this complication?

A 65-year-old male presents with groin pain 5 years after a primary total hip arthroplasty using a metal-on-polyethylene bearing with a modular titanium stem and cobalt-chromium head. Abrasive wear at the head-neck junction (trunnionosis) is suspected. Which of the following serum markers is most likely to be elevated?

A 65-year-old woman undergoes a primary total hip arthroplasty. Six weeks postoperatively, she dislocates her hip while tying her shoe in a seated position. Which surgical approach was most likely utilized, and which structure's insufficiency contributes most to this specific instability?

A 68-year-old female undergoes a posterior approach total hip arthroplasty. During trialing, the hip dislocates posteriorly when positioned in flexion, adduction, and internal rotation. What is the most appropriate intraoperative adjustment?