Abstract
Hip I Structured SBA Questions
Hip I Structured SBA Questions
1. An imaging report refers to a pathological avulsion at the insertion of the Iliopsoas tendon.
What Gruen zone does this correspond to?
2. A new lower limb arthroplasty consultant is choosing validated outcome measures to be used for his THA patients.
Which of the following scores is completed by the clinician rather than the patient?
3. A physiotherapist refers a patient for an opinion on whether symptoms may be secondary to impingement between the ischium and lesser trochanter.
Which test would be most useful to help detect this?
4. A petite 73-year-old female underwent a THA 4 months ago. She presents to clinic at 6 months with pain and a snapping sensation in the groin on standing from a seated position. Initial examination does not reveal any concerns of infection and FBC/CRP/ESR are within normal values. Radiographs reveal a retroverted acetabular component.
What is the most appropriate initial management for this patient?
5. A woman who has recently given birth developed progressive, severe, non-traumatic hip and groin pain in the third trimester of her pregnancy. Hip radiographs show subchondral cortical loss, diffuse osteopaenia of the femoral head and neck and a preserved joint space.
What is the most appropriate management?
6. A patient with painful osteoarthritis of their hip underwent femoral nailing for a middiaphyseal fracture 15 years previously. Their surgeon plans to perform hip replacement surgery while keeping the nail in place.
What is the most suitable type of patient for this procedure?
7. A nerve is damaged during the direct lateral hip approach when muscles are inadvertently split more than 5cm proximal to the greater trochanter.
Asking the patient to perform which of the following movements is most likely to reveal a deficit?
8. A patient received a hip arthroplasty typically reserved for younger patients with good femoral head bone stock which comprises approximately 3.5% of all hip arthroplasties.
What follow-up is recommended for an asymptomatic patient with an ODEP 10 or 10A* rated implant?
9. You are consenting a 45-year old patient with a Garden II neck of femur fracture for surgery.
What is the most common risk of this surgery?
10. A patient has a hip replacement through an approach that is designed to be soft tissue preserving and is sometimes performed utilising a fracture table.
The nerve most commonly at risk during this approach crosses, in the majority of patients, the lateral border of which muscle?
11. After inserting an uncemented cup, you carefully define quadrants by drawing a line from the ASIS to the centre of the cup and a second line perpendicular to this. You turn your back and your registrar inserts a screw in the anterosuperior quadrant.
Which structure is most at risk?
12. An audit of a department’s THA complications reveals a spike in intraoperative periprosthetic femoral fractures (IOPFF) equivalent to intraoperative Vancouver Type A2.
Which factor is associated with the highest relative risk of this complication?
13. A 45-year-old welder with a history of steroid use presents with groin pain and an MRI that shows a 20% area of femoral head collapse.
What is the most appropriate management?
14. An 80-year-old patient listed for a THA has had previous lumbar spine surgery. Concerned about dislocation risk, you request sitting and standing lateral lumbar spine radiographs.
The angle between a line from the centre of the S1 end plate and the centre of the segment between the two femoral heads (the bicoxofemoral axis), and the vertical is called what?
15. A 55-year-old patient with Parkinson’s disease presents with a Garden 4 neck of femur fracture. Radiographs show that the ratio of the inner canal diameter at the midportion of the lesser trochanter divided by the diameter 10cm distal is >0.75.
What is the most appropriate management?
16. After thorough discussion, it is decided that the best option for a 20-year-old manual labourer with post-traumatic hip OA is a fusion.
What is the most appropriate position of fusion?
17. A patient underwent a THR for a NOF fracture while abroad on holiday. The patient was given strict rehabilitation instructions to avoid flexion beyond 90° and extreme internal rotation.
What structure was most likely to have been injured during the patient’s surgery?
18. A 77-year-old man presents with an insidious onset of hip and anterior thigh pain 15 years after a total hip arthroplasty. He denies fever or systemic upset, and initial bloods show normal inflammatory markers. Anteroposterior (AP) radiograph left hip are shown in the radiograph (Figure 3.1).
Figure 3.1 Anteroposterior (AP) radiograph left hip
You advise the patient that he should undergo revision surgery as he is at risk of what complication?
Related posts:
Chapter 11 – Shoulder/Elbow II Structured SBA
Chapter 20 – Pathology I Structured SBA
Chapter 19 – Structure and Function of Connective Tissue Structured SBA
Chapter 5 – Knee Structured I SBA
Chapter 26 – Clinical Environment, Evidence Management and Quality Improvement Structured SBA
Chapter 15 – Hand II Structured SBA
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