Total Knee Arthroplasty (TKA) MCQs

A 65-year-old man presents with acute knee pain, swelling, and fever 4 weeks after an uncomplicated primary TKA. Symptoms began 2 days ago. Aspiration yields 85,000 WBC/hpf with 95% neutrophils. Implants are well-fixed radiographically. What is the treatment of choice?

When setting the distal femoral cut angle during a TKA, the surgeon must account for the angle between the anatomical and mechanical axes. In a short patient with short femora, how does this valgus angle typically compare to a tall patient?

A surgeon is performing a primary TKA on a severe valgus knee using a sequential lateral release. If the popliteus tendon is completely resected from its femoral insertion during this process, what is the most likely resulting biomechanical consequence?

A patient develops patellar clunk syndrome after a posterior-stabilized (PS) TKA. Which of the following technical errors during the primary surgery is most likely responsible for exacerbating this condition?

A 65-year-old woman reports anterior knee pain and frequent subluxation of her patella 1 year following a primary TKA. Clinical examination demonstrates severe patellar apprehension and lateral tracking. A CT scan to evaluate component position is most likely to show which of the following?

During a primary TKA utilizing measured resection techniques, the surgeon evaluates the trial components. The knee is perfectly balanced and stable in extension but demonstrates severe laxity in flexion. What is the most appropriate step to balance the knee?

During the second stage of a revision total knee arthroplasty for a prior infection, the surgeon evaluates the joint spaces using trial spacer blocks. The knee is noted to be unacceptably tight in flexion but excessively loose in extension. Which of the following surgical adjustments is most appropriate to balance the gaps?

A 72-year-old woman has had progressively increasing pain in the right knee for the past 6 months. She denies any trauma and has no pain in any other joints, but she notes occasional swelling in the knee and a catching sensation. Figures 31a and 31b show the plain radiographs and Figure 31c shows the MRI scan. Treatment should consist of

A patient who underwent a high tibial osteotomy (HTO) is now scheduled to undergo total knee arthroplasty (TKA). When compared with a patient undergoing primary TKA without a prior HTO, the patient should be advised to expect a higher incidence of

A 17-year-old basketball player and pole vaulter who has had anterior knee pain for the past 18 months now reports a recent inability to jump. Based on the MRI scan shown in Figure 11, management should consist of

Consider the theoretic articulation shown in Figure 11 as femoral and tibial components of a total knee prosthesis in which the components fit like a "roller in trough." Which of the following best describes the articulation?

A 63-year-old woman reports giving way of the knee and pain after undergoing primary total knee arthroplasty (TKA) 1 year ago. Examination reveals that the knee is stable in full extension but has gross anteroposterior instability at 90 degrees of flexion. The patient can fully extend her knee with normal quadriceps strength. Studies for infection are negative. AP and lateral radiographs are shown in Figures 12a and 12b, respectively. What is the appropriate management?

During total knee arthroplasty, what component position aids in proper tracking and stability of the patellar component?

A 17-year-old high school gymnast who has peripatellar knee pain has been unable to practice on a consistent basis for the past 3 years. She denies any specific injury events. Physical therapy for modalities, quadriceps strengthening, and hamstring stretching provide temporary relief. A trial of patellar taping significantly reduces her pain. Examination reveals an 15-degree Q angle, moderate lateral facet tenderness, negative patellar apprehension, and the inability to evert the patella. Radiographs show a moderate lateral patellar tilt. Treatment should now consist of

During a measured resection primary total knee arthroplasty (TKA) for an osteoarthritic varus knee, the surgeon utilizes spacer blocks to assess the gaps. The knee is found to be excessively tight in full extension, but perfectly balanced in 90 degrees of flexion. Which of the following isolated bone resection steps is the most appropriate next maneuver to achieve a balanced knee?

During a primary total knee arthroplasty (TKA), the surgeon inadvertently places the femoral component in internal rotation relative to the surgical epicondylar axis. This specific technical error is most likely to result in which of the following postoperative issues?

During a measured resection primary Total Knee Arthroplasty (TKA), the surgeon utilizes trial components and notes the knee is perfectly balanced in full extension but excessively tight in flexion.

Which of the following maneuvers is the most appropriate next step to achieve a balanced knee?

In kinematic alignment for Total Knee Arthroplasty (TKA), the primary objective is to align the components to the:

During a primary Total Knee Arthroplasty (TKA), after the preliminary bony cuts have been made and trial components are placed, the surgeon evaluates the joint spaces.

The surgeon finds that the extension gap is excessively tight, while the flexion gap is perfectly balanced and stable. Which of the following is the most appropriate next step to balance the knee?