J Arthroplasty. 2016 Jul;31(7):1476-82. Epub 2016 Feb 27.
Which of the following motions shows the greatest difference between a normal and ACL deficient knee?
Posterior femoral translation at 30° flexion
Posterior femoral translation at 60° flexion
Axial rotation in full extension
Axial rotation at 50° flexion
Varus angulation at 30 ° flexion
Dr. Anonymous - this question you are looking at is based off a 2006 question. We have questions this far back, but also update them as new information emerges. The questions we have continue to be written on a daily basis, and we have plenty of questions based off of 2017 OITE and now even the
AAOS self-assessment exam questions. The references for any question are the original references from the question these were based upon, and we make sure to include them, as they were felt to be testable material, and may show up again in the future.Prevalence of answers to orthopaedic in-training examination questions in 3 commonly used orthopedic review sources.Krueger CA, Shakir I, Fuller BCOrthopedics. 2012 Sep. doi: 10.3928/01477447-20120822-32. 35. (9). :e1420-6PMID: 22955412 (Link to Abstract)
A 55-year-old patient is scheduled for total knee arthroplasty. A radiograph is provided in Figure A. Each of the following are risk factors for heterotopic ossification EXCEPT?
Incorrect sizing of femoral and/or tibial components
History of trauma
Presence of preoperative osteophytes (hypertrophic arthrosis)
With the change in the answer choice, the explanation for the preferred response should be modified. FYI
Performing an isolated release of the popliteus tendon during a total knee arthroplasty is most appropriate in which of the following scenarios?
Valgus deformity that is tight in extension
Varus deformity that is tight in extension
Valgus deformity that is tight in flexion
Valgus deformity that is tight in both flexion and extension
Varus deformity that is tight in flexion
Thanks Dr Stroh,Your explanation cleared the puzzle. The solution to which I was seeking in the comments.
A 75-year-old man who underwent total hip arthroplasty 20 years ago now complains of thigh pain for the past four months. Laboratory studies show a normal white blood cell count (WBC), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). An aspiration of the hip is performed and is negative for infection. A radiograph is shown in Figure A. Which of the following is the best management option for the femoral implant?
Bone scan to look for loosening
Touch down weight bearing and physical therapy
Revision with a tumor prosthesis
Revision of femoral component with metaphyseal cement fixation of the stem
Revision to a cementless femoral component with diaphyseal press-fit fixation of the stem
Why in this modern, digital age do we use such terrible quality X-rays to make decisions? Can we please have a better image to answer this question?
A 91-year-old male with a history of chronic leukemia and dementia falls and sustains the hip fracture shown in Figure A. He undergoes a hemiarthroplasty through a posterior approach. A post-operative radiograph is shown in Figure B. Three weeks later he dislocates the hip arising from the toilet seat. A radiograph is shown in Figure C. The patient undergoes a closed reduction and is placed in a hip abduction brace. Post reduction radiograph is shown in Figure D. One month later he returns to clinic complaining of pain and inability to bear weight through the leg. A radiograph of the hip is included in Figure E. Which of the following factors has MOST likely contributed to the instability of the hip hemiarthroplasty?
Femoral stem subsidence
Inadequate femoral stem neck length
Patient's dementia status
Regardless of reference, the patient was left short based on post-op x-ray.
Proc Inst Mech Eng H. 2011 Jan;225(1):16-24.
Proc Inst Mech Eng H. 2014 Jan;228(1):98-106. Epub 2013 Dec 2.
A 45-year-old woman is scheduled to undergo a TKA. Which of the following implant designs theoretically reduces poylethylene wear and reduces bone-implant-interface stress?
Posterior stabilized fixed bearing TKA
Cruciate retaining fixed bearing TKA
Mobile-bearing hinged TKA
I think this is still a very confusing topic:There are conflicting data/evidence about the relationship between congruence and wear, with some authors defending that a higher congruence=increased wear; while others, that a higher congruence =decreased wear, like depicted in this question. For what I could understand:One argument is that higher congruence=greater contact area=lesser pressure=lesser STRUCTURAL wear. This seemed to be particularly important in the old air-irradiated PE, where the weak mechanical properties were susceptible to the high stresses provided by a flat design and the structural wear lead to catastrophic failure. However, with the better mechanical properties of newer PEs, recent studies reported that higher congruence=greater contact area=greater volumetric wear, since structural fatigue and delamination is now rare. (Somehow, a reproduction of Sir J. Charnley's philosophy of a small sized-head for a "low friction" THR).What is your opinion on this matter?The effect of insert conformity and material on total knee replacement wear.Abdelgaied A, Brockett CL, Liu F, Jennings LM, Jin Z, Fisher JProc Inst Mech Eng H. 2014 Jan. pii: 0954411913513251. doi: 10.1177/0954411913513251. 228. (1). :98-106PMID: 24297773 (Link to Abstract)A new formulation for the prediction of polyethylene wear in artificial hip joints.Liu F, Galvin A, Jin Z, Fisher JProc Inst Mech Eng H. 2011 Jan. doi: 10.1243/09544119JEIM819. 225. (1). :16-24PMID: 21381484 (Link to Abstract)
J Bone Joint Surg Am. 1979 Jan;61(1):15-23.
Adult Dysplasia of the Hip
Total hip replacement in congenital dislocation and dysplasia of the hip.Crowe JF, Mani VJ, Ranawat CSJ Bone Joint Surg Am. 1979 Jan. 61. (1). :15-23PMID: 365863 (Link to Abstract)
J Am Acad Orthop Surg. 2002 Sep-Oct;10(5):334-44.
Surgical treatment of developmental dysplasia of the hip in adults: II. Arthroplasty options.Sanchez-Sotelo J, Berry DJ, Trousdale RT, Cabanela MEJ Am Acad Orthop Surg. 2002 Sep-Oct. 10. (5). :334-44PMID: 12374484 (Link to Abstract)
Risk factors for a motor nerve palsy following primary total hip arthroplasty include all of the following EXCEPT?
Developmental dysplasia of the hip
This question has come up before and the answer was postraumatic oa has no increase . What is the correct answer? The question has been in OB before and now has two answers
This is a general comment regarding Orthobullets, that is apropos this particular question, but also relates to many other questions and topics that are reviewed on this site. I am concerned that much of the content on this site references data that is quite old. In many cases the cited references are over 10-15 years old, and the questions are often pulled from OITEs prior to 2008. My understanding is that at least 50% of the ABOS exam generally tests concepts from articles published in the past 5 years. Are we covering the most important information, or are we spending a lot of time on outdated ideas that are less likely to appear in upcoming examinations?
A 62-year-old female has persistent activity related anterior groin pain 10 months after total hip arthroplasty (THA). Infection workup is negative. New radiographs are unchanged compared to the intial films provided in Figures A and B. Pain is temporarily relieved following an injection of lidocaine and cortisone into the iliopsoas tendon sheath. What is the next appropriate treatment option?
Indefinite activity modification
Iliopsoas tendon release
Femoral component revision
Acetabular component revision
Femoral and acetabular component revision
how about some XR's where you can see the acetabular component version, like the illustration?
A 60-year-old female underwent hybrid total hip arthroplasty with good position of implants and post-operatively is instructed not to extend, adduct, and externally rotate the hip to prevent dislocation. What approach was likely performed?
why is adduction to be avoided in the precautions given after an anterior approach THA? extension,external rotation and abduction make sense to me,but not adduction.
TKA Periprosthetic Fracture
I am not getting the questions for the topic (only getting 2 out of 12) Why?
THA Other Complications
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4419015/i think this is worth adding..
Orthopedics. 2008 Mar;31(3):227.