INSTRUCTIONS Innovations in total hip arthroplasty
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Innovations in total hip arthroplasty
General Purpose: To provide information on the advancement of total hip arthroplasty procedures. Learning Objectives: After reading the preceding article and taking this test, the reader should be able to: 1. Identify materials and techniques used in THA. 2. Select interventions to minimize postoperative complications after THA.
1. Femoral stems are manufactured in all of the following materials except
a. cobalt-chromium alloy.
2. Which statement is true regarding arthroplastic hip resurfacing?
a. It's usually performed on older patients who are less mobile.
b. It was approved by the FDA in the 1990s.
c. It's generally performed on patients who want to continue a high level of activity.
d. It's only performed using metal-on-polyethylene implants.
3. Advantages and disadvantages of hip resurfacing include
a. less range of motion.
b. less risk of femoral neck fractures.
c. an increased dislocation rate.
d. smaller leg length discrepancy.
4. The minimally invasive surgical incision for THA is approximately
a. 2 in (5.1 cm).
b. 4 in (10.2 cm).
c. 6 in (15.2 cm).
d. 8 in (20.3 cm).
5. The posterolateral approach incision
a. involves the hip capsule at its weakest area.
b. decreases the risk of dislocation.
c. reduces the need for postoperative hip precautions.
d. is positioned over the posterior 1/2 of the lesser trochanter.
6. Which surgical approach may be particularly beneficial for patients who have difficulty adhering to postoperative hip precautions?
a. Modified Hardinge
b. two-incision anterior
c. one-incision anterior
7. One complication with the two-incision anterior approach is
a. more postoperative pain.
b. longer recovery.
c. nerve palsy.
d. more soft tissue trauma.
8. One option to prevent postoperative hip dislocation is a(n)
a. smaller femoral head implant.
b. metal acetabular liner.
c. cross-linked chromium liner.
d. elevated-rim polyethylene liner.
9. The FDA recommends not using metal-on-metal implants for people with
a. renal insufficiency.
b. peripheral arterial disease.
c. cardiovascular disease.
10. Compared to conventional polyethylene liner components, highly cross-linked polyethylene liners
a. decrease the risk of osteolysis by 92%.
b. show less wear.
c. reduce the rate of dislocations.
d. are linked to fewer incisional infections.
11. A study conducted by Viscusi and colleagues showed that patients had significant pain relief for the first 48 hours after THA with which modality?
a. an indwelling epidural catheter with morphine
b. patient-controlled analgesia with hydromorphone
c. an extended-release epidural morphine injection
d. a periarticular intraoperative injection with multimodal pain drugs
12. Platelet-rich plasma used during total knee surgery resulted in
a. increased blood loss.
b. increased Gram-positive bacterial infections.
c. longer hospital stays.
d. less need for postoperative pain medications.
13. The drug of choice for VTE prevention is
a. low-dose unfractionated heparin.
b. vitamin K antagonists.
c. low-molecular-weight heparin.
14. The time frame for postoperative VTE preventive drugs has been expanded to up to
a. 7 days.
b. 10 days.
c. 14 days.
d. 35 days.
15. The American College of Chest Physicians recommends the use of IPCDs
a. 20 hours/day.
b. in the hospital and upon return home.
c. only in the hospital with graduated compression stockings used at home.
d. at home after the discontinuation of antithrombotic drugs.
16. In a 2010 Danish study, there was a lower risk of VTE in THA patients with
a. rheumatoid arthritis.
c. cardiovascular disease.
d. a history of thromboembolism.
17. Perioperative hypothermia can result in
a. three times the incidence of surgical site infections.
b. four times the risk of cardiac complications.
c. less blood transfusions.
d. decreased bleeding.
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