Biomechanics of hip arthroplasty

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QUESTION 1 OF 7

95.An 80-year-old female patient attends the arthroplasty follow up clinic complaining of nonspecific left hip pain.
The appearance of the left uncemented femoral stem calcar (Figure 4.1) would have been minimised by using:

 Stress shielding 2 Q LR.jpg

AP pelvis radiograph 

QUESTION ID: 1163

1. A. A Co-Cr alloy
2. B. A round stem
3. C. A shorter stem length
4. D. A tapered stem
5. E. Avoiding flutes
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QUESTION 2 OF 7

Postoperative radiographic femoral offset measurements of a patient following THA suggest an excessive femoral offset.

Offset 3.jpg

Figure 1.Anteroposterior(AP) radiograph hip 
Consequences of an excessive femoral offset include:

QUESTION ID: 1164

1. A. Abductor weakness
2. B. Increased likely of using a walking aid
3. C. Increased hip joint reaction forces
4. D. Instability
5. E. Trochanteric pain
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QUESTION 3 OF 7

A 72-year-old female attends the arthroplasty follow up clinic Her anteroposterior (AP) radiograph is shown below (Figure 4.2). She has lower back pain and non-specific left hip pain.

hip ii.jpg

The appearance will:

QUESTION ID: 1165

1. A. Affect implant survival
2. B. Depends on stem stiffness
3. C. Lead to increased rates of osteolysis
4. D. Leads to mid-thigh pain
5. E. Results in loosening of the implant
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QUESTION 4 OF 7

81.An 85-year-old. female attends clinic complaining of a 2-week history of hip pain on weight bearing, groin tenderness on rotation. No history of injury. Her radiographs are shown below. The daughters are in clinic with the patient and mention they have been told their mother needs revision hip surgery

Figure 4.3Q.LR.jpg 

Figure 1.Anteroposterior(AP) radiographs pelvis
The best choice of management would be:

QUESTION ID: 1167

1. Bone scan
2. CT scan
3. Full revision of both femoral and acetabular components
4. Observation with yearly follow up clinic review
5. Revision femoral stem
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QUESTION 5 OF 7

Regarding MoM resurfacing biomechanics.
Contact Patch to Rim Distance (CPRD) is most influenced by:

QUESTION ID: 1184

1. Arc of cover
2. Cup inclination angle
3. Cup version angle
4. Femoral head diameter
5. Head-cup clearance
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QUESTION 6 OF 7

88.In the team brief before surgery the lead surgeon is concerned about the dislocation risk in a patient with early cognitive impairment. The plan of action is to use a large 36mm femoral head. The rationale being that a larger femoral head will increase the jump distance.
Factors known to increase the jump distance include

QUESTION ID: 1185

1. Decreased femoral head offset
2. Increase in cup anteversion angle
3. Increased abduction angle
4. Polyethylene liners with an offset
5. Smaller acetabular hemisphere
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QUESTION 7 OF 7

44.Which of the following factors will result in the greatest chance of an elective primary hip replacement dislocating?

QUESTION ID: 3240

1. Use of a collarless femoral prosthesis.
2. Use of a long posterior wall acetabular component.
3. Use of a monoblock femoral prosthesis.
4. Use of a small femoral head.
5. Use of hybrid components.
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