3. Adult Reconstruction (Hip & Knee) MCQs

A 50-year-old female with known syringomyelia presents with advanced Charcot arthropathy of the glenohumeral joint, experiencing severe instability and progressive loss of function that has failed extensive conservative management.

If surgical intervention is absolutely necessary, which procedure is generally considered the most appropriate salvage option despite high complication rates?

A 45-year-old patient with known syringomyelia presents with massive, painless swelling and instability of the right shoulder. Radiographs demonstrate severe articular destruction, loose bodies, and debris consistent with a neuropathic joint.

Which of the following mechanisms best explains this joint pathology?

A 5-year-old girl with active, untreated oligoarticular JIA affecting solely her left knee is evaluated in the orthopedic clinic. Which of the following growth disturbances is most likely to be observed in the affected limb during the active inflammatory phase?

In patients with severe, long-standing Juvenile Idiopathic Arthritis (JIA) undergoing Total Hip Arthroplasty (THA), the surgeon must anticipate distinct anatomic challenges. Which of the following is most commonly encountered in this patient population?

A 65-year-old man presents with end-stage knee osteoarthritis and a remote history of a midshaft femur fracture treated nonoperatively, leaving him with a symptomatic coronal plane deformity. When planning a primary total knee arthroplasty (TKA), what is the generally accepted maximum limit of extra-articular coronal plane femoral deformity that can be managed safely with intra-articular bone cuts and soft-tissue balancing?

During a primary total knee arthroplasty, the surgeon inadvertently places the femoral component in 5 degrees of internal rotation relative to the surgical transepicondylar axis. What is the most likely biomechanical consequence of this malpositioning?

During a total knee arthroplasty (TKA) gap balancing procedure, the surgeon notes that the knee is well-balanced and symmetric in extension, but symmetrically tight in 90 degrees of flexion. Which of the following is the most appropriate step to achieve balanced gaps?

Which of the following biomechanical effects is most strongly associated with joint line elevation during a revision total knee arthroplasty?

A 65-year-old woman with advanced primary knee osteoarthritis undergoes a posterior-stabilized (PS) TKA. The surgeon inadvertently internally rotates the tibial component. What is the most likely biomechanical consequence of this malrotation?

A patient with a severe 25-degree valgus knee deformity and a completely incompetent medial collateral ligament (MCL) presents for TKA. Which of the following implant constraints is most appropriate?

During a TKA, a measured resection technique is utilized. The surgeon uses the surgical transepicondylar axis (sTEA) to establish femoral component rotation. Which of the following best describes the sTEA?

A 55-year-old male presents with a symptomatic extra-articular distal femoral varus deformity of 15 degrees located 5 cm proximal to the joint line. If the surgeon decides to correct this entirely with an intra-articular bone cut during a TKA, what is the most significant risk?

In a posterior-stabilized (PS) TKA, at approximately what angle of flexion does the cam on the femoral component typically engage the tibial post to initiate posterior femoral rollback?

A patient presents with 'patellar clunk syndrome' two years following a TKA. Which implant characteristic and kinematic phase are most classically associated with this condition?

Increasing the posterior slope of the tibial bone cut during a TKA will have which of the following effects on the flexion and extension gaps?

In an excessively thick (overstuffed) patellar component during TKA, which of the following postoperative complications is most directly expected?

During pre-operative templating for a TKA on a patient with a 20-degree valgus deformity, the surgeon plans a lateral parapatellar approach. To preserve patellar viability, which critical arterial supply must the surgeon attempt to protect?

During a primary total knee arthroplasty (TKA), the joint is perfectly balanced in extension but demonstrates a tight flexion gap. Which of the following is the most appropriate corrective action?

Internal rotation of the tibial component in a primary total knee arthroplasty primarily leads to which of the following postoperative complications?

A 65-year-old patient presents with end-stage knee osteoarthritis and a 15-degree midshaft femoral varus deformity. When planning a primary TKA using an intra-articular resection alone to correct the mechanical axis, which of the following compromises must be accepted?