3. Adult Reconstruction (Hip & Knee) MCQs

A 30-year-old female is diagnosed with symptomatic primary synovial chondromatosis of the knee. What is the most appropriate initial surgical management?

A 35-year-old male with severe ankylosing spondylitis is scheduled for bilateral total hip arthroplasty due to disabling hip ankylosis. What is the most appropriate perioperative intervention to mitigate a highly prevalent postoperative complication in this population?

A 40-year-old female presents with chronic catching and locking in her right hip. Radiographs demonstrate numerous uniform, intra-articular calcified loose bodies. What is the definitive surgical management required to minimize the risk of recurrence?

Which of the following is a recognized and statistically higher risk complication specifically associated with total hip arthroplasty in a patient with advanced Paget's disease compared to standard osteoarthritis?

A 70-year-old man requires a total hip arthroplasty for severe secondary osteoarthritis caused by Paget's disease of the pelvis and proximal femur. Which of the following is the most likely perioperative complication related to his underlying bone disorder?

A 35-year-old male with Ankylosing Spondylitis presents for a total hip arthroplasty (THA) due to severe bilateral hip autofusion.

Compared to patients undergoing THA for primary osteoarthritis, this patient is at significantly higher risk for which of the following postoperative complications?

A 50-year-old man with severe bilateral hip pain and a known history of Ankylosing Spondylitis is scheduled for a total hip arthroplasty (THA). He is at significantly increased risk for which of the following postoperative complications?

A 45-year-old male with a 20-year history of ankylosing spondylitis presents with severe bilateral hip pain and stiffness. Bilateral total hip arthroplasty (THA) is planned. Which of the following prophylactic measures is highly recommended postoperatively for this specific patient population?

A 45-year-old active male underwent a total hip arthroplasty with a ceramic-on-ceramic bearing. Two years postoperatively, he complains of an audible squeaking sound from the hip during deep flexion. What is the most common mechanical etiology for this phenomenon?

A 55-year-old female with a metal-on-metal total hip arthroplasty presents with groin pain and a palpable mass 6 years postoperatively. Aspiration yields thick, dark fluid with a low nucleated cell count. MRI shows a large periarticular cystic collection. Histology of this tissue would most likely demonstrate:

During a primary total knee arthroplasty, the surgeon inadvertently places the femoral component in 5 degrees of internal rotation. What is the most likely biomechanical consequence of this specific error?

During a primary total knee arthroplasty for a patient with a severe fixed varus deformity, the surgeon removes medial osteophytes and releases the deep medial collateral ligament, but the medial compartment remains significantly tight in extension. Which structure should typically be sequentially released next to balance the extension gap?

A 45-year-old highly active male undergoes a total hip arthroplasty using a ceramic-on-ceramic bearing surface. At his 2-year follow-up, he complains of an audible squeaking sound during certain movements. Which of the following factors is most strongly associated with this phenomenon?

During a total knee arthroplasty for a patient with a severe fixed valgus deformity, the surgeon plans a lateral soft tissue release. To avoid iatrogenic injury, what structure must be carefully protected during the release of the posterolateral capsule and popliteus tendon?

During a total knee arthroplasty, trial reduction reveals that the knee is tight in full extension but appropriately balanced in 90 degrees of flexion. Which of the following is the most appropriate next step to balance the knee?

A 72-year-old female sustains a periprosthetic femur fracture around her cementless total hip arthroplasty. Radiographs show a fracture at the tip of the stem. The stem is radiographically loose, but she has excellent proximal bone stock. According to the Vancouver classification, what is the most appropriate treatment?

A patient with a ceramic-on-ceramic total hip arthroplasty complains of a new-onset audible 'squeaking' during walking. Radiographic evaluation is most likely to show which of the following component positions?

A 65-year-old patient presents with end-stage knee osteoarthritis and a 25-degree extra-articular diaphyseal varus deformity of the femur. What is the most appropriate management?

A 72-year-old woman with a history of a malunited midshaft femur fracture (30 degrees of apex anterior bowing) presents for a total knee arthroplasty (TKA). If standard intra-articular cuts are used, which adjustment to the distal femoral cut is required to avoid anterior notching and knee component hyperextension?