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A 65-year-old female undergoes total hip arthroplasty. Instability of the prosthesis with straight hip flexion is identified during intra-operative range of motion testing. A fluoroscopic image is shown in figure A. Impingement is caused by the structure labeled with the asterisk. Which muscle originates upon this structure?
Direct head of the rectus femoris
Reflected head of the rectus femoris
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A surgeon is planning to revise a left hip resurfacing component to a total hip arthroplasty. He wishes to decrease the joint reaction force of the left hip by increasing the femoral offset. Which of the following labeled measurements found in Figure A best describes femoral offset?
An 83-year-old man, who had a total hip arthroplasty performed 13 years ago, is referred to your office for evaluation. He reports worsening groin pain over the past year, which has been increasing in frequency. Prior to this past year, he had no other complaints. His current radiograph is shown in Figure A. If he continues to ambulate with this implant, he is at greatest risk for which of the following?
Acetabular component loosening
Femoral component loosening
Which of the following factors is most likely to increase the risk of hip dislocation after a total hip arthroplasty (THA)?
Large head-to-neck ratio
Use of a skirted femoral head
Femoral component in 15 degrees of anteversion
Acetabular cup in 15 degrees of anteversion
Acetabular cup in 50 degrees of abduction
The schematic shown in Figure A displays a ceramic-on-ceramic total hip arthroplasty articulation with impingement. Which of the following modifications would increase the primary arc range of motion?
Addition of a collar on the femoral head
Exchanging the ceramic liner with a hooded polyethylene liner
Increasing the femoral head size
Increasing the femoral offset
Increasing the acetabular anteversion
In total hip arthroplasty, which of the following techniques will lead to improved stability by increasing the abductor tension?
Use of a high offset femoral component
Decreasing neck length
Use of a low offset femoral component
Increasing the head size
Medializing the acetabular component
Figure A depicts an individual seen from behind during a single-leg stance on the left lower extremity. Which of the following modifications during a left-sided total hip arthroplasty would exacerbate the abnormal findings present in Figure A?
Decreasing femoral offset
Changing from a standard offset neck to an extended offset neck
Increasing femoral head size
Increasing femoral neck length
Moving acetabular cup inferiorly
During total hip arthroplasty, which of the following techniques increases range of motion prior to impingement?
Using implants with a smaller femoral head
Using implants with a larger femoral head to neck ratio
Using a ultra high molecular weight polyethylene liner on the acetabulum
Cementing the femoral stem
A 67-year-old female underwent a total hip arthroplasty 6 months ago and has had recurrent prosthetic dislocations. Figure A is a representative drawing of the mechanism of her dislocation. During the time of surgery what is the most likely factor leading to the bone-on-bone impingement?
Lateralizing the acetabular cup
Decreased femoral offset
Increased femoral offset
Increased acetabular inclination (>55 degrees)
Small head-neck ratio (<2)