CCOC Dag 2 Flashcards
(30 cards)
- Pain at the implant site is associated PJI in :
A. 10% of patients B. 30% of patients C. 50% of patients D. 70% of patients E. 90% of patients
- Pain at the implant site is associated PJI in :
E. 90% of patients
- PJI that manifest itself only at 6 months post implantation is considered
A. Acute postoperative B. Late chronic postoperative C. Acute hematogenous D. Subacute postoperative E. None of these refer to the time interval
- PJI that manifest itself only at 6 months post implantation is considered
B. Late chronic postoperative
- How many cultures are advised during a prosthetic revision procedure to assess the possible septic nature of the loosened THA?
A. 1 B. 2 C. 3 D. 4 E. 5
- How many cultures are advised during a prosthetic revision procedure to assess the possible septic nature of the loosened THA?
E. 5
- In the Netherlands minimum quality requirements for THA have been defined. The following statements are part of this guideline :
I a hip implant with a mean revision percentage of 10% or less at 10 years
II a hip implant with a mean revision percentage of 5% or less at 5 years
A. I is true, II is false B. I and II are true C. I is false, II is true D. Both statements do comply with this Dutch guideline E.
requirements for THA have been defined. The following statements are part of this guideline :
I a hip implant with a mean revision percentage of 10% or less at 10 years
II a hip implant with a mean revision percentage of 5% or less at 5 years
B. I and II are true
- Before an implant is accepted to be introduced to the market, it has to comply to regulatory requirements. In the US one notified body (ie FDA) controls this, while the EU about 75 notified bodies regulate this.
Medical devices are classified I through III in the EU, with class III having the highest patient risk
A. Hip, knee and shoulder implants and cardiovascular devices (like pacemakers) are class III devices B. Hip, knee implants are class II devices, pacemakers are class III devices C. Hip, knee implants are class II devices, shoulder implants and pacemakers are class III devices D. Hip, knee and shoulder implants and cardiovascular devices (like pacemakers) are class II devices
- Before an implant is accepted to be introduced to the market, it has to comply to regulatory requirements. In the US one notified body (ie FDA) controls this, while the EU about 75 notified bodies regulate this.
Medical devices are classified I through III in the EU, with class III having the highest patient risk
A. Hip, knee and shoulder implants and cardiovascular devices (like pacemakers) are class III devices
- Since MoM THA revision rates increased, follow up has been changed rigorously, using MRI as a modality.
At MRI abnormal tissue reactions can be found in :
A. 25%-50% of symptomatic patients and 10-25% of asymptomatic patients
B. 40-75% of symptomatic patients and 10-25% of asymptomatic patients
C. 25-50% of both symptomatic and asymptomatic patients
D. 10-25% of both symptomatic and asymptomatic patients
- Since MoM THA revision rates increased, follow up has been changed rigorously, using MRI as a modality.
At MRI abnormal tissue reactions can be found in :
C. 25-50% of both symptomatic and asymptomatic patients
- The definition of bio activity is best described by?
A. The property of a material to develop a direct, adherent and strong bond with the surrounding tissue
B. The ability of a material to perform with an appropriate host response in a specific application
C. The ability of a scaffold to facilitate new bone formation which is primarily based on mechanical stimuli as well as chemical composition and geometry of the material
D. Ability to promote cellular functions leading to new bone formation
E. Materials designed to elicit specified cellular responses mediated by interactions with peptides from extra cellular matrix proteins
- The definition of bio activity is best described by?
A. The property of a material to develop a direct, adherent and strong bond with the surrounding tissue
- With regard to the osteoconductive and osteoinductive capacity of demineralized bone matrix (DBM) products, which of the following statements is TRUE?
A. The osteoconductive capacity is equal among DBM products
B. The osteoinductive capacity of DBM is unaffected by the age of the donor
C. The osteoinductive capacity of DBM is affected by method of sterilization
D. The osteoconductive capacity of DBM is high
E. All of the above
- With regard to the osteoconductive and osteoinductive capacity of demineralized bone matrix (DBM) products, which of the following statements is TRUE?
C. The osteoinductive capacity of DBM is affected by method of sterilization
- Bio materials have various mechanical properties. Which statement about the “Youngs modulus” is correct?
A. The Youngs modulus correlates with the strength of a material
B. The Youngs modulus is the maximum stress that a material or object can support
C. The Youngs modulus is the load carrying capacity of a material
D. The Youngs modulus is a measure of a material to resist deformation and return to its original shape
E. The Youngs modulus is the area under the stress strain curve of a material or object that describes the energy needed to cause the material or object to break or fail
- Bio materials have various mechanical properties. Which statement about the “Youngs modulus” is correct?
D. The Youngs modulus is a measure of a material to resist deformation and return to its original shape
- Which osteotomy is now the mainstay for the treatment of acetabular re-orientation?
A. Triple innominate B. Chiari (medial displacement) C. Bernese periacetabular (PAO) D. Salter E. Double innominate
- Which osteotomy is now the mainstay for the treatment of acetabular re-orientation?
C. Bernese periacetabular (PAO)
- The optimal position for hip arthrodesis is:
A. Flexion 30 degrees, abduction 10 degrees, external rotation 20 degrees
B. Flexion 10-20 degrees, adduction 10 degrees, external rotation 0 degrees
C. Flexion 25-40 degrees, abduction 5 degrees, internal rotation 5 degrees
D. Flexion 25-30 degrees, adduction 0-5 degrees, external rotation 5-10 degrees
E. Flexion 25-40 degrees, abduction 0-5 degrees, internal rotation 0-5 degrees
- The optimal position for hip arthrodesis is:
D. Flexion 25-30 degrees, adduction 0-5 degrees, external rotation 5-10 degrees
- You get a patient, 54 years, 18 years after hip arthrodesis on his left side. He has severe lower back pain, sitting is getting more and more difficult. He asks for a THA. Which clinical outcome is most difficult to predict?
A. Limping B. Ability to flex the hip C. Ability to sit properly D. Survival of the prosthesis E. Possibility to use an uncemented implant
- You get a patient, 54 years, 18 years after hip arthrodesis on his left side. He has severe lower back pain, sitting is getting more and more difficult. He asks for a THA. Which clinical outcome is most difficult to predict?
A. Limping
- What is the predominant deformity resulting in structural instability and acetabular rim overload?
A. Coax valga B. Perches disease C. Deficient (anterolateral) coverage of the femoral head D. CAM-impingement E. Coax magna
- What is the predominant deformity resulting in structural instability and acetabular rim overload?
C. Deficient (anterolateral) coverage of the femoral head
- Osseointegration of uncemented total hip implant is dependent of several implant- and non-implant related factors. Initial primary stability is a key feature in implant designs.
Which of the factors below does NOT contribute to early stability?
A. Geometry B. Surface texture C. Surgical technique D. Accuracy of surgical tools E. Osteoconductivity or osteoinductivity of the coating
- Osseointegration of uncemented total hip implant is dependent of several implant- and non-implant related factors. Initial primary stability is a key feature in implant designs.
Which of the factors below does NOT contribute to early stability?
E. Osteoconductivity or osteoinductivity of the coating
- What’s the difference between the ODEP-rating 10A and 10A*?
A. More or less than 500 patients included
B. Inclusion or exclusion of data from developing centers
C. Follow up of more or less than 10 years
D. Survivorship of more or less than 95% at 10 years
E. None of these refer to the difference between 10A and 10A*
- What’s the difference between the ODEP-rating 10A and 10A*?
D. Survivorship of more or less than 95% at 10 years
- For safe insertion of screws in a cluster hole acetabular shell, the best position is in
A. The posterior-superior and posterior-inferior quadrant
B. The posterior-inferior and anterior-inferior quadrant
C. The anterior-inferior and anterior-superior quadrant
D. The anterior-superior and posterior-superior quadrant
E. None of these is correct
- For safe insertion of screws in a cluster hole acetabular shell, the best position is in
A. The posterior-superior and posterior-inferior quadrant
- Osteolysis after THA is often associated with particle wear debris. The most common cause for that is:
A. Abrasive wear B. Adhesive wear C. Fatigue wear D. Delamination E. Third body wear
- Osteolysis after THA is often associated with particle wear debris. The most common cause for that is:
B. Adhesive wear
- A 22 year old soccer player presents with groin pain since a few months and catching of his right hip. There is no evidence of trauma. He has seen 2 different medical doctors who diagnosed his condition as a muscular sprain.
The physical examination shows a positive Drehman’s sign and a positive FADIR test. The diagnosis is:
A. Osteoarthritis B. Cam impingement C. Slipped capital femoral epiphysis D. Synovial chondromatosis E. Pincer impingement
- A 22 year old soccer player presents with groin pain since a few months and catching of his right hip. There is no evidence of trauma. He has seen 2 different medical doctors who diagnosed his condition as a muscular sprain.
The physical examination shows a positive Drehman’s sign and a positive FADIR test. The diagnosis is:
B. Cam impingement
- Pincer impingement is seen more often in females. What is a typical sign on a well taken AP pelvis
A. Big femoral head B. Acetabular cysts C. Positive cross over sign ( figure of 8) D. Valgus hip E. Increased alpha angle
- Pincer impingement is seen more often in females. What is a typical sign on a well taken AP pelvis
C. Positive cross over sign ( figure of 8)
20 cam impingement is seen more often in young sportive men. What’s the typical chondroblast lesion seen in arthroscopy?
A. Aggressive delamination of the acetabular cartilage and dis rupture of the chondrolabral junction
B. Contre coup lesion
C. Circumferential small cartilage defect of the acetabulum
D. De lamination of the cartilage of the femoral head
E. Disrupture of the ligamentum teres
20 cam impingement is seen more often in young sportive men. What’s the typical chondroblast lesion seen in arthroscopy?
A. Aggressive delamination of the acetabular cartilage and dis rupture of the chondrolabral junction
- Typical for the third generation femoral cementing technique is:
A. Use of a distal bone plug B. Use of a porosity reduction system C. Use of a cement gun D. Use of a titanium stem E. Use of femoral bone grafts
- Typical for the third generation femoral cementing technique is:
B. Use of a porosity reduction system
- In 2007 the Dutch Arthroplasty Registry started to collect prospective data, in 2013 the registry is already very reliable with over 98% of the implanted hip protheses in the Netherlands registered.
A. The number of THA in 2013 in the Netherlands was 40.000, only 5000 were cemented
B. The most used surgical approach for THA is nowadays the direct anterior approach
C. A ceramic head on polyethylene cup or liner is the most used articulation
D. The number of THA in 2013 in the Netherlands was 25.000, 60% of the implanted hips were cemented
E. About 50% of all THA were hybrid using a cemented stem and a non cemented cup
- In 2007 the Dutch Arthroplasty Registry started to collect prospective data, in 2013 the registry is already very reliable with over 98% of the implanted hip protheses in the Netherlands registered.
C. A ceramic head on polyethylene cup or liner is the most used articulation
- Bone cement is based on polymethylacrylate and
A. Is very effective as the cement works like a glue
B. Can only be used in combination with precoated femoral stems
C. During the curing of the cement the maximal temperature is 42 degrees Celcius
D. Particles of bone cement are the major cause of osteolysis
E. Is often loaded with antibiotics to prevent infection
- Bone cement is based on polymethylacrylate and
E. Is often loaded with antibiotics to prevent infection
- Which statement is correct concerning polyethylene?
A. Y-irradiation lowers the number of free radicals
B. Ethylene oxide (ETO) gives better cross linking than Y-irradiation
C. Remelting of polyethylene is meant for capturing of free radicals and improves wear characteristics of PE
D. Annealing captures free radical abut less than remelting and consequently leads to higher chance of oxidation of PE
E. Annealing is a form of vitamin E stabilization of PE
- Which statement is correct concerning polyethylene?
D. Annealing captures free radical abut less than remelting and consequently leads to higher chance of oxidation of PE
