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Technique guide are not considered high yield topics for orthopaedic standardized exams including the ABOS, EBOT and RC.
A 35-year-old man presents with mechanical knee pain after a fall. An arthroscopic picture taken during diagnostic arthroscopy is shown in Figure A. His surgeon considers treatment with Technique B and Technique C, which are shown in Figures B and C, respectively. Which of the following statement is true with respect to Technique B and C?
A diminished immune response to transplanted chondrocytes is seen in Technique C because the dense cartilage matrix acts as a barrier that limits antigen exposure.
In Technique C, healing is initiated by mesenchymal stem cell migration from subchondral bone. In Technique B, healing is initiated by allogeneic chondrocytes reimplanted beneath a periosteal patch.
Grafts in Technique C are transferred to an antibiotic solution to kill microorganisms and stored at 4°C until use.
A biopsy of the repair site at 3 months will reveal more Type I collagen in Technique B than in Technique C.
Technique C is a 2-stage procedure. Technique B is a single-stage procedure.
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A 25-year-old patient undergoes the procedure seen in Figure A. Which of the following statements best describes the incorporation of the graft and biopsy results of the graft at one year?
The transplanted chondrocytes are viable and articular cartilage heals. Biopsy shows type I collagen.
The transplanted chondrocytes are viable and articular cartilage heals. Biopsy shows type II collagen.
The transplanted chondrocytes are nonviable and cartilage is used as a scaffold for growth of new articular cartilage. Biopsy shows type II collagen.
The transplanted chondrocytes are nonviable and articular cartilage is gradually replaced by fibrocartilage. Biopsy shows type I collagen.
The transplanted chondrocytes are nonviable and articular cartilage is gradually replaced by fibrocartilage. Biopsy shows mixture of type I and II collagen.
What type of tissue is formed by the activation of marrow mesenchymal cells following subchondral drilling of an 8x7 mm osteochondral defect?
A 24-year-old female has moderate arthrosis of the medial facet of the patella and the medial femoral condyle. Which of the following procedures is contraindicated?
Anterior (Maquet) tibial tubercle osteotomy
Anteromedial (Fulkerson) tibial tubercle osteotomy
Anterolateral tibial tubercle osteotomy
Medial opening wedge high tibial osteotomy
Lateral closing wedge high tibial osteotomy
Following a medial femoral condyle osteochondral autograft mosaicplasty, which of the following statements best describes the fixation of the graft?
Graft fixation strength increases linearly with time until subchondral union at 3 months
Graft fixation strength initially decreases during the early healing phase, and then increases with subchondral bone healing
Graft fixation strength does not change during the first 3 months following surgery
Graft fixation strength is enhanced by early weight bearing
Graft fixation strength initially increases over the first 6 weeks, then recedes with bony remodeling
A 32-year-old female is referred to you for definitive treatment of a symptomatic focal chondral defect on her medial femoral condyle. A photograph from a recent diagnostic arthroscopy shows the defect (Figure A), which measured 25 x 25mm after debridement. What surgical treatment would you recommend?
Osteochondral autograft with 1-2 plugs
A patient with a symptomatic chondral defect undergoes the arthroscopic procedure seen in Figure A. The reparative tissue would best be described as which of the following?
All of the following are acceptable scenarios for the use of autologous chondrocyte implantation (ACI) in the patellofemoral joint EXCEPT:
Grade 4 lesion of the medial femoral condyle
Grade 4 lesion of the trochlea
Joint space narrowing on Merchant view
Varus mechanical axis on standing full length radiograph
Concomitant anteromedial tibial tubercle transfer osteotomy (Fulkerson's)