📚 Campbell Ch.9: Arthrodesis of the Knee
The lower-right construct in this series places two plates medially and laterally, staggered. Which two problems were these choices specifically meant to prevent?
The lower-right construct in this series places two plates medially and laterally, staggered. Which two problems were these choices specifically meant to prevent?
Anonymous Quiz
0%
Pin track infection; implant loosening
15%
Fat embolism; intramedullary spread of infection
15%
Nonunion; 5-cm limb shortening
8%
Recurrent sepsis; patellar tendon rupture
62%
Fracture at the plate margin; difficult wound closure with an anterior plate
📚 Campbell Ch.10: Knee Preservation Surgery
🌟 Sᴀʟᴀᴍ Aʙᴀʏᴀᴄʜɪ
Recurrent popliteal cyst 2 years after open excision; MRI shows a degenerative posterior horn medial meniscus tear feeding it. Lowest recurrence follows:
🌟 Sᴀʟᴀᴍ Aʙᴀʏᴀᴄʜɪ
Recurrent popliteal cyst 2 years after open excision; MRI shows a degenerative posterior horn medial meniscus tear feeding it. Lowest recurrence follows:
Anonymous Quiz
54%
Arthroscopic cystectomy with valve resection and partial meniscectomy
15%
Repeat open posteromedial cystectomy alone through a Henderson incision
0%
Ultrasound-guided aspiration and corticosteroid injection of the cyst
23%
Arthroscopic lavage and partial meniscectomy, leaving the cyst wall
8%
Open cystectomy combined with immediate total knee synovectomy
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📚 Campbell Ch.10: Knee Preservation Surgery
During a lateral closing-wedge HTO the wedge is out, but the compression clamp cannot close the osteotomy. The medial cortical hinge is intact and the plate fits. What first?
During a lateral closing-wedge HTO the wedge is out, but the compression clamp cannot close the osteotomy. The medial cortical hinge is intact and the plate fits. What first?
Anonymous Quiz
0%
Osteotome the intact medial cortical hinge so the gap can close
36%
Confirm complete proximal tibiofibular joint disruption and remove residual wedge bone
29%
Convert to a medial opening-wedge osteotomy and bone-graft the gap
21%
Fix the construct with the wedge gap open and rely on callus fill
14%
Distract the lateral gap with a lamina spreader and reapply compression
📚 Campbell Ch.10: Knee Preservation Surgery
🌟 Sᴀʟᴀᴍ Aʙᴀʏᴀᴄʜɪ
A 62-year-old with seropositive RA on methotrexate and twice-weekly etanercept needs TKA. Which plan follows the 2017 ACR/AAHKS perioperative guideline?
🌟 Sᴀʟᴀᴍ Aʙᴀʏᴀᴄʜɪ
A 62-year-old with seropositive RA on methotrexate and twice-weekly etanercept needs TKA. Which plan follows the 2017 ACR/AAHKS perioperative guideline?
Anonymous Quiz
14%
Stop methotrexate and etanercept 1 week preop, resume both 1 week postop
7%
Continue both methotrexate and etanercept without interruption
64%
Continue methotrexate, hold etanercept, and operate in week 2 after the last dose
14%
Withhold methotrexate 4 weeks preop and cover with hydrocortisone stress dosing
0%
Stop all antirheumatic therapy and await documented remission before surgery
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📚 Campbell Ch.10: Knee Preservation Surgery
A 66-year-old woman, 12 years after lateral closing-wedge HTO, undergoes TKA for end-stage arthritis. Which intraoperative difficulty is most frequent in this setting?
A 66-year-old woman, 12 years after lateral closing-wedge HTO, undergoes TKA for end-stage arthritis. Which intraoperative difficulty is most frequent in this setting?
Anonymous Quiz
17%
MCL incompetence from scarring at the old osteotomy level
11%
Lateral laxity from proximal riding of the fibula
39%
Patella baja requiring tibial tubercle osteotomy
0%
Obtaining adequate exposure of the arthritic joint
33%
Tibial stem impingement from lateral offset of the proximal fragment
📚 Campbell Ch.10: Knee Preservation Surgery
A 34-year-old man has chronic grade III posterolateral corner instability with an 8-degree varus deformity and wants a single procedure. Which strategy best addresses both?
A 34-year-old man has chronic grade III posterolateral corner instability with an 8-degree varus deformity and wants a single procedure. Which strategy best addresses both?
Anonymous Quiz
10%
Lateral closing-wedge HTO alone to correct the malalignment
15%
Fibular-based PLC reconstruction now, osteotomy only if arthritis develops
25%
One-stage lateral closing-wedge HTO with acute PLC reconstruction
50%
Medial opening-wedge HTO then mandatory staged PLC reconstruction at 3 months
0%
Medial opening-wedge HTO alone; most such knees need no second ligament procedure
📚 Campbell Ch.10: Knee Preservation Surgery
🌟 Sᴀʟᴀᴍ Aʙᴀʏᴀᴄʜɪ
A 34-year-old's knee stays stiff after femoral nailing; the depicted release is complete but flexion remains inadequate. What is added, and how is the limb splinted?
🌟 Sᴀʟᴀᴍ Aʙᴀʏᴀᴄʜɪ
A 34-year-old's knee stays stiff after femoral nailing; the depicted release is complete but flexion remains inadequate. What is added, and how is the limb splinted?
Anonymous Quiz
37%
Z-lengthening of the rectus femoris tendon; splint ~50° less than maximal flexion, then CPM
16%
Quadriceps VY turndown; cast in full extension for 3 weeks
5%
Release of vastus intermedius from the femur; brace locked at 90°
26%
Z-lengthening of the rectus femoris; splint in maximal flexion for 3-4 weeks
16%
Distal rectus tenodesis to the patella; CPM deferred until day 7
📚 Campbell Ch.10: Knee Preservation Surgery
Runner with isolated medial joint-line pain; maximal tenderness just below the joint line at the depicted bursa. One steroid injection fails. What MRI sign and next step?
Runner with isolated medial joint-line pain; maximal tenderness just below the joint line at the depicted bursa. One steroid injection fails. What MRI sign and next step?
Anonymous Quiz
10%
Inverted-U fluid deep to the ligament; inject once more, then semitendinosus transfer
35%
Inverted-U fluid deep to the ligament; MRI/arthroscopy to exclude derangement or stress fx
20%
Fish-hook fluid over the ligament; urgent exploration for septic bursitis
15%
Geode-like erosion beneath the ligament; arthroscopic debridement of the bursa
20%
Complex cyst between meniscus and ligament; excise, it never resolves
📚 Campbell Ch.10: Knee Preservation Surgery
In the posteromedial cyst excision depicted (patient supine, knee flexed 90°), where does the capsular incision begin, and how is a lax posterior oblique ligament handled at closure?
In the posteromedial cyst excision depicted (patient supine, knee flexed 90°), where does the capsular incision begin, and how is a lax posterior oblique ligament handled at closure?
Anonymous Quiz
26%
Between adductor tubercle and medial epicondyle; imbricate over the semimembranosus
5%
Posterior to the iliotibial band at the joint line; it re-tensions spontaneously
42%
Between epicondyle & adductor tubercle behind the TCL; advance it onto the epicondyle
26%
Anterior to the semimembranosus tendon; reef it to the oblique popliteal ligament
0%
Midline between the gastrocnemius heads; excise it with the cyst wall
📚 Campbell Ch.10: Knee Preservation Surgery
🌟 Sᴀʟᴀᴍ Aʙᴀʏᴀᴄʜɪ
In the depicted medial opening-wedge osteotomy, parallel 0.062 K-wires guide the saw. What is their target, minimum joint distance, and hinge width?
🌟 Sᴀʟᴀᴍ Aʙᴀʏᴀᴄʜɪ
In the depicted medial opening-wedge osteotomy, parallel 0.062 K-wires guide the saw. What is their target, minimum joint distance, and hinge width?
Anonymous Quiz
27%
Proximal fibular head; 2 cm to joint; 5-mm lateral hinge
15%
Fibular tip; 1 cm to joint; 2-cm hinge
19%
Proximal half of the fibular head; 2 cm to joint; 1-cm hinge
35%
Proximal half of the fibular head; ≥1.5 cm to the articular surface; ≥1-cm lateral hinge
4%
Lateral tibial spine; 1.5 cm to joint; 1.5-cm hinge
📚 Campbell Ch.10: Knee Preservation Surgery
Valgus knee corrected at 10 years by the osteotomy shown. What deformity threshold mandates this correction, and how do outcomes compare with arthroplasty in active patients under 65?
Valgus knee corrected at 10 years by the osteotomy shown. What deformity threshold mandates this correction, and how do outcomes compare with arthroplasty in active patients under 65?
Anonymous Quiz
18%
Valgus >8°; superior function vs TKA at 10 years
21%
Valgus >20° or joint plane >15° off horizontal; identical results to UKA
15%
Any valgus with MCL laxity; 91% 10-year survival
13%
Tibial deformity >12°; better knee scores than TKA
33%
Valgus >12-15° or joint plane >10° off horizontal; results do not differ from TKA
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