3. Adult Reconstruction (Hip & Knee) MCQs

During a total hip arthroplasty using a posterolateral approach, the surgeon identifies and protects the sciatic nerve. Which of the following is the most frequent cause of sciatic nerve palsy following a primary total hip arthroplasty?

When performing a total knee arthroplasty, the surgeon notices that the knee is tight in flexion but well-balanced in extension. Which of the following is the most appropriate surgical step to correct this mismatch?

In the workup for a suspected periprosthetic joint infection (PJI) of the knee, synovial fluid analysis reveals a highly elevated alpha-defensin level. What is the biological source of alpha-defensin in this context?

A 55-year-old active male underwent a total hip arthroplasty with a ceramic-on-ceramic bearing surface two years ago. He now complains of a squeaking noise from the hip during deep flexion, without pain. Radiographs show a well-fixed implant with the acetabular component in 55 degrees of inclination and 25 degrees of anteversion. What is the most likely cause of the squeaking?

Clinical improvement following ankle distraction arthroplasty:

First metatarsophalangeal prosthetic joint replacements:

In a randomized controlled trial comparing first metatarsophalangeal arthrodesis versus total joint replacement arthroplasty for end-stage hallux rigidus, all of the following statements are true except:

When comparing complication rates following operative and nonoperative management of ankle fractures in the elderly (age 65- 99):

Following a total hip arthroplasty utilizing a posterior approach, a patient is noted to have a sciatic nerve palsy. Which component of the sciatic nerve is most commonly injured, and what is the characteristic motor deficit?

During a total knee arthroplasty, internally rotating the femoral component relative to the epicondylar axis will most likely result in which of the following mechanical issues?

A 65-year-old female presents with persistent groin pain 1 year after an uncemented total hip arthroplasty. Radiographs reveal a radiolucent line involving all three DeLee and Charnley zones of the acetabulum with superior migration of the cup. What is the most appropriate management?

During a primary total knee arthroplasty, the surgeon notices that the knee is tight in flexion but stable and balanced in extension. Which of the following surgical adjustments should be made to correct this gap imbalance?

A 65-year-old male presents with groin pain and an enlarging soft tissue mass 5 years after a primary total hip arthroplasty utilizing a metal-on-polyethylene bearing with a large diameter modular metal head. Aspiration yields sterile, cloudy fluid. MRI demonstrates an adverse local tissue reaction (ALTR). What is the most likely etiology?

Displaced talar neck fractures should be treated:

C linical improvement following ankle distraction arthroplasty:

The most effective fixation technique that will ensure adequate visualization (imaging) of avascular necrosis changes following talar neck fracture is:

During a posterior-stabilized total knee arthroplasty, the surgeon notes that the knee is well-balanced in extension but tight in flexion. Which of the following maneuvers is the most appropriate next step to balance the knee?

According to Lewinnek, what is the ideal acetabular cup position during a total hip arthroplasty to minimize the risk of postoperative dislocation?

Which of the following factors most significantly increases the risk of "squeaking" in a ceramic-on-ceramic total hip arthroplasty?

During a primary total knee arthroplasty, the surgeon assesses the gaps with trial components. The extension gap is found to be symmetrically tight, while the flexion gap is well-balanced. What is the most appropriate next step to balance the knee?