3. Adult Reconstruction (Hip & Knee) MCQs

According to the 2018 International Consensus Meeting (ICM) criteria, which of the following is considered a major criterion for the diagnosis of periprosthetic joint infection (PJI)?

Dual mobility components in total hip arthroplasty reduce the risk of dislocation primarily through which biomechanical mechanism?

A 65-year-old female presents with persistent knee pain 2 years after a primary TKA. Infection workup is negative. She reports her knee feels unstable when walking down stairs. Examination reveals 15 degrees of recurvatum, 130 degrees of flexion, and a mid-flexion instability. What is the most likely cause of her mid-flexion instability?

A 70-year-old woman presents with sudden onset groin pain 6 weeks after an uncomplicated uncemented total hip arthroplasty. Radiographs show a Vancouver B2 periprosthetic femur fracture. Which of the following is the most appropriate management?

Which of the following bearing surface combinations in total hip arthroplasty is most closely associated with the phenomenon of "stripe wear"?

A 62-year-old male undergoes a primary total knee arthroplasty. Postoperatively, the patient develops a foot drop and paresthesias over the dorsum of the foot. The surgeon suspects a common peroneal nerve palsy. Which of the following preoperative deformities is most commonly associated with this complication?

A 58-year-old male presents with groin pain 3 years after a metal-on-metal total hip arthroplasty. Inflammatory markers are normal. A MARS MRI shows a large, thick-walled cystic mass communicating with the joint. What is the most appropriate next step in management?

In assessing a patient for a potential unicompartmental knee arthroplasty (UKA), which of the following MRI findings is an absolute contraindication for a medial UKA?

During a revision total knee arthroplasty for aseptic loosening, the surgeon encounters a large uncontained (Type 3) diaphyseal bone defect in the proximal tibia. What is the most appropriate method for managing this specific defect?

During a primary total knee arthroplasty utilizing a posterior-stabilized (PS) implant design, a central cam-and-post mechanism is incorporated. This specific design feature is intended to primarily substitute for which of the following native knee kinematic functions?

During a posterior-stabilized total knee arthroplasty, the surgeon notes that the knee is well-balanced in extension but excessively tight in flexion. Which of the following adjustments is most appropriate to correct this specific mismatch?

In a young, highly active patient undergoing total hip arthroplasty, which of the following bearing surface combinations demonstrates the lowest volumetric wear rate?

During a primary total knee arthroplasty, the surgeon uses trial components and notes that the knee is tight in flexion but well-balanced in full extension. Which of the following surgical adjustments is the most appropriate next step?

Which of the following vascular structures provides the predominant blood supply to the adult femoral head?

In the context of a displaced proximal humerus fracture, which of the following radiographic predictors carries the highest risk for the development of avascular necrosis of the humeral head?

During a posterior approach to the hip (Kocher-Langenbeck), the main blood supply to the femoral head must be protected. The deep branch of the medial femoral circumflex artery (MFCA) is most at risk during the surgical release of which of the following structures?

A direct lateral (Hardinge) approach to the hip requires splitting the gluteus medius. To avoid iatrogenic denervation, the proximal split should not extend beyond what distance from the tip of the greater trochanter?

During a direct lateral (Hardinge) approach to the hip, proximal splitting of the gluteus medius is limited to prevent denervation of the anterior portion of the muscle. The superior gluteal nerve is at greatest risk if the split extends more than what distance proximal to the tip of the greater trochanter?

In the manufacturing of highly cross-linked polyethylene (HXLPE) for total hip arthroplasty, what is the primary consequence of the remelting process performed after gamma irradiation?

During a total hip arthroplasty, the surgeon decides to medialize the acetabular component to the true floor of the acetabulum. How does this modification alter the biomechanics of the hip joint in the coronal plane?