3. Adult Reconstruction (Hip & Knee) MCQs

To preserve the primary blood supply to the adult femoral head during a posterior approach to the hip, which anatomical structure protects the main arterial contribution before it enters the joint capsule?

A patient presents with a severe Trendelenburg gait following a direct lateral (Hardinge) approach for a total hip arthroplasty. To avoid iatrogenic denervation of the anterior portion of the abductor musculature, the proximal split of the gluteus medius should be limited to what maximum distance proximal to the tip of the greater trochanter?

A 22-year-old man sustains a scaphoid waist fracture. The high risk of avascular necrosis of the proximal pole is primarily due to its tenuous retrograde blood supply. The predominant arterial supply to the proximal pole of the scaphoid enters through which of the following areas?

During a posterior approach to the hip for arthroplasty, extreme external rotation of the femur prior to capsulotomy can put the deep branch of the medial circumflex femoral artery (MCFA) at risk. This critical vessel, which provides the main blood supply to the femoral head, courses between which two muscles prior to piercing the capsule?

The primary blood supply to the adult femoral head is the medial circumflex femoral artery (MCFA). The deep branch of the MCFA consistently courses between which two muscles prior to ascending to the trochanteric fossa?

During a posterior approach to the hip for a displaced femoral neck fracture, the surgeon carefully dissects the short external rotators. To avoid avascular necrosis of the femoral head in a joint-preserving procedure, the deep branch of the medial femoral circumflex artery (MFCA) must be protected. This vessel consistently runs between which two structures?

A 21-year-old man sustains a scaphoid waist fracture. The surgeon opts for percutaneous screw fixation. Which artery provides the primary blood supply to the proximal pole of the scaphoid, making it susceptible to avascular necrosis following this fracture?

Figure 20 shows the resting and stress radiographs of a patient who has had pain and feelings of instability after undergoing a total knee arthroplasty 1 year ago. Which of the following ligaments is not functional and is therefore responsible for the patient's symptoms?

The medial femoral circumflex artery (MFCA) provides the primary blood supply to the adult femoral head. Which of the following muscles must be protected during a posterior approach to the hip to avoid injury to the deep branch of the MFCA?

To protect the posterior interosseous nerve (PIN) during an anterior (Henry) approach to the proximal radius, the forearm should be positioned in what way and why?

The blood supply to the adult femoral head is predominantly provided by the lateral epiphyseal artery. This artery is a direct terminal branch of which of the following vessels?

When performing a posterior approach to the hip (Kocher-Langenbeck), the medial femoral circumflex artery (MFCA) is at risk. The main ascending branch of the MFCA consistently runs deep to which muscle?

A 55-year-old woman presents with acute medial knee pain after a deep squat. MRI reveals a medial meniscal extrusion of 4 mm and a hyperintense signal separating the posterior horn from its tibial attachment. What is the most appropriate management for an active patient with no significant osteoarthritis?

A 19-year-old male presents to the trauma bay after a rugby tackle. He complains of severe medial clavicle pain, dysphagia, and a choking sensation. Clinical examination demonstrates a palpable depression at the medial end of the clavicle. What is the most appropriate definitive management?

A 45-year-old active female presents with sudden-onset posterior knee pain and a popping sensation while squatting. MRI reveals a medial meniscus posterior root tear with 4 mm of meniscal extrusion. Which of the following is the most appropriate management?

A 19-year-old female soccer player sustains a noncontact anterior cruciate ligament (ACL) tear. Which of the following anatomic factors is most strongly associated with an increased risk of this injury?

An 18-month-old girl presents with a limp and a leg length discrepancy. Radiographs confirm a high, untreated dislocation of the right hip. What is the most appropriate initial management?

A 2-year-old girl is undergoing closed reduction and spica casting for late-presenting developmental dysplasia of the hip. Which of the following intraoperative positioning parameters represents the highest risk for developing avascular necrosis of the femoral head?

Figure 36a shows the current radiograph of a 65-year-old woman who slipped and fell. History reveals that prior to the fall she was actively functioning without pain. Figure 36b shows a radiograph obtained 1 year ago. Based on the fracture pattern, the failure is most likely related to

A 65-year-old female presents with recurrent posterior instability of her total hip arthroplasty. Evaluation of her acetabular component reveals 20 degrees of abduction and 0 degrees of anteversion. What is the primary cause of her posterior dislocations?