Henry Ford Macomb Orthopaedics

Henry Ford Macomb Orthopaedics Quiz 4 August 26, 2011

1. Following total knee arthroplasty with resurfacing of the patella, a patient has lateral subluxation of the patella. What issue with the components is a cause of this complication?

1-Lateral placement of the tibial tray 2-Reduced composite thickness of the patella 3-External rotation of the femoral component 4-Internal rotation of the tibial component 5-Posterior translation of the femoral component

2. What method of terminal polyethylene sterilization results in the greatest number of remaining free radicals within the polyethylene?

1-Gas plasma 2-Ethylene oxide 3-Gamma irradiation 4-Gamma irradiation and annealing 5-Gamma irradiation and remelting

3. What surgical technique will improve a flexion-extension mismatch in a revision total knee arthroplasty when the knee is stable in extension and loose in flexion?

1- Remove additional tibial bone 2- Insert a full block tibial augment 3- Use distal femoral augments 4- Downsize the femoral component 5- Translate the femoral component posteriorly

4. A 21-year-old soccer player reports pain and is unable to straighten his knee following an acute injury during a game. He is unable to continue to play. An MRI scan is shown in Figure 3. What is the next most appropriate step in management?

1- No weight bearing 2- Cortisone injection 3- Physical therapy 4- Arthroscopic meniscectomy or repair 5- Anterior cruciate ligament reconstruction. 5. Commotio cordis is best treated with

1- immediate cardiac defibrillation. 2- the chest thump maneuver. 3- IV fluids and hydration. 4- epinephrine. 5- albuterol inhalers.

6. Use of prophylactic knee bracing in contact sports participants results in which of the following?

1- Decreased incidence of anterior cruciate ligament injuries 2- Decreased incidence of posterior cruciate ligament injuries 3- Decreased incidence of medial collateral ligament injuries 4- Decreased incidence of meniscal tears 5- Decreased incidence of ankle injuries

7. A 27-year-old professional baseball pitcher who underwent arthroscopic olecranon debridement continues to have medial-sided elbow pain during late cocking. Physical examination reveals laxity and pain with valgus stress testing. What is the most likely cause of his pain?

1- Ulnar neuritis 2- Excessive olecranon resection 3- Osteochondritis dissecans of the capitellum 4- Olecranon stress fracture 5- Valgus extension overload

8. A 45-year-old tennis player undergoes surgery for chronic lateral epicondylitis. After returning to play, he notes increasing lateral elbow pain with mechanical catching and locking. Examination shows positive supine posterolateral rotatory instability. What ligament has been injured?

1- Annular 2- Anterior band of the medial collateral 3- Lateral orbicular 4- Lateral radial collateral 5- Lateral ulnar collateral

9. Which of the following anatomic structures are in contact with internal impingement in the throwing athlete?

1- Humerus and posterior-superior glenoid 2- Humerus and anterior inferior glenoid 3- Humerus and acromion 4- Biceps and acromion 5- Rotator cuff and acromion

10. A 68-year-old man had a 3-year history of shoulder pain that failed to respond to nonsurgical management. Examination reveals forward elevation to 120 degrees and external rotation to 30 degrees. True AP and axillary radiographs and an axial CT scan are shown in Figures 1a through 1c. What management option would lead to the best long-term results?

1- Hemiarthroplasty 2- Total shoulder arthroplasty 3- Reverse total shoulder arthroplasty 4- Arthroscopic debridement 5- Glenoid osteotomy and interposition arthroplasty

11. A 40-year-old woman underwent an arthroscopic acromioplasty and mini-open rotator cuff repair 4 weeks ago. At follow-up examination, the incision is painful, erythematous, and draining fluid. The patient is febrile and has an elevated WBC count. What infectious organism should be under high suspicion of causing this outcome?

1- Escherichia coli 2- Streptococcus viridans 3- Oxalophagus oxalicus 4- Proprionobacter acnes 5- Enterococcus faecalis

12. Figure 38 shows the radiograph of a 75-year-old woman who has had right shoulder pain, difficulty sleeping on the affected arm, and difficulties performing activities of daily living for the past 6 weeks. Initial nonsurgical management includes analgesics, a subacromial cortisone injection, and gentle range-of-motion exercises. However, these modalities have failed to provide relief, and the patient reports that she is unable to elevate her arm. Her pain is worse and she would like the most reliable treatment method for pain relief and functional improvement. What is the best surgical treatment? 1- Reverse shoulder arthroplasty 2- Hemiarthroplasty 3- Resurfacing of the humeral head 4- Arthroscopic debridement 5- Shoulder fusion