3. Adult Reconstruction (Hip & Knee) MCQs

A 20-year-old hockey player presents with chronic anterior groin pain. Physical examination demonstrates a positive FADIR test. Radiographs reveal a pistol grip deformity and an alpha angle of 65 degrees. During arthroscopic osteochondroplasty for this cam impingement, the surgeon must be careful to avoid extending the resection too far posteriorly. Which vessel provides the primary blood supply to the femoral head and is most at risk during posterior extension of the femoral neck resection?

In total hip arthroplasty, which of the following bearing surface combinations is associated with the lowest expected linear and volumetric wear rate?

During a primary posterior-stabilized total knee arthroplasty, the surgeon employs spacer blocks to assess the gaps. The knee is found to be excessively tight in flexion but perfectly balanced in extension. Which of the following surgical adjustments is most appropriate to correct this mismatch?

Which artery provides the predominant blood supply to the adult femoral head?

A 55-year-old active female undergoes a primary total hip arthroplasty. At her 2-year follow-up, she complains of a reproducible 'squeaking' noise coming from her hip during walking, though she denies any pain. Which of the following bearing surface combinations was most likely used?

A 65-year-old male presents with a painful total knee arthroplasty 3 years after the index procedure. Joint aspiration yields synovial fluid. Which of the following synovial fluid biomarkers has the highest specificity for diagnosing a periprosthetic joint infection (PJI)?

A 60-year-old male undergoes total hip arthroplasty using a ceramic-on-ceramic bearing surface. Three years later, he complains of an audible squeaking sound from the hip during movement, though he is pain-free. What is the most common mechanical etiology associated with this phenomenon?

During a posterior-stabilized total knee arthroplasty, the surgeon prepares to make the proximal tibial bone cut. The popliteal artery is at risk during this step. At the level of the knee joint, what is the anatomical relationship of the popliteal artery to the posterior capsule?

In the adult hip, vascular insult can lead to devastating avascular necrosis (AVN) of the femoral head. Which of the following vessels provides the predominant blood supply to the adult femoral head?

A 45-year-old sustains a displaced intracapsular femoral neck fracture. The risk of avascular necrosis is high due to disruption of the primary blood supply to the adult femoral head. Which vessel provides the majority of this blood supply?

During a posterior approach to the hip (Kocher-Langenbeck), the medial circumflex femoral artery (MCFA) is at risk. Prior to branching to supply the femoral head, the main vessel classically passes between which two muscles posteriorly?

In performing a standard medial parapatellar arthrotomy for a total knee arthroplasty, a patient postoperatively develops isolated numbness over the anterolateral aspect of the proximal leg. Which nerve was most likely injured?

During a posterior-stabilized total knee arthroplasty, the trial components are placed and the knee's kinematics are assessed. The knee demonstrates symmetrical balancing and stability in full extension, but is excessively tight and cannot achieve full flexion. Which of the following is the most appropriate intraoperative adjustment to balance the knee?

A 40-year-old active female undergoes primary total hip arthroplasty using a ceramic-on-ceramic bearing surface. While ceramic bearings offer excellent wear properties, which of the following is a recognized, unique complication specific to this particular bearing combination?

Which of the following bearing surface combinations in total hip arthroplasty primarily utilizes fluid-film lubrication rather than boundary lubrication to minimize wear?

During a posterior-stabilized total knee arthroplasty, trial reduction reveals that the knee is tight in flexion, but symmetric and well-balanced in extension. Which of the following intraoperative adjustments is most appropriate to correct this mismatch?

A 65-year-old male is undergoing total hip arthroplasty (THA). The surgeon chooses a ceramic-on-ceramic bearing surface to minimize wear. Which of the following complications is most uniquely associated with this specific bearing combination?

During a primary total knee arthroplasty using a measured resection technique, trial components are placed. The surgeon notes that the knee is well-balanced and stable in full extension, but it is extremely tight in 90 degrees of flexion, preventing full range of motion. Which of the following is the most appropriate surgical adjustment?

A 55-year-old active male underwent a total hip arthroplasty using a ceramic-on-ceramic bearing. Three years postoperatively, he complains of an audible 'squeaking' sound during ambulation. Which of the following factors is most strongly associated with the development of squeaking in this specific bearing surface?