Hip and knee disorders

Question 1

What are the two categories for hip fractures

Answer 1

intra and extra capsular

Question 2

What is the type of blood supply to the head of femur?

Answer 2

retrograde blood supply

Question 3

What is the arterial supply of the head of femur?

Answer 3

Branches of the medial and lateral circumflex arteries

Question 4

What is the management of displaced intracapsular fracture?

Answer 4

hemiarthroplasty or total hip replacement

Question 5

Which classification is used for intracapsular NOF?

Answer 5

Garden classification- grade I-IV

Question 6

Discuss the criteria for each Garden classification grade

Answer 6

Grade I – incomplete fracture and non-displaced
Grade II – complete fracture and non-displaced
Grade III – partial displacement (trabeculae are at an angle)
Grade IV – full displacement (trabeculae are parallel)

Question 7

Which type of NOF is internal fixation used for?

Answer 7

non-displaced (grade I and II) as they may have intact blood supply to femoral head therefore femoral health can be preserved without AVN

Question 8

Hemiarthroplasty is used in the management of which type of NOF grade?

Answer 8

Grade II-IV

Question 9

What is hemiarthroplasty?

Answer 9

replacement of the head of femur with acetabulum in place
(total= socket + head femur)

Question 10

What is the surgery for intertrochanteric fracture?

Answer 10

dynamic hip screw = sliding hip screw

Question 11

Lateral and medical circumflex arteries branch off from which artery?

Answer 11

deep femoral artery

Question 12

What is the surgery for subtrochanteric fractures?

Answer 12

intramedullary nail

Question 13

Other than mechanical fall, list three reasons why someone may present with NOF

Answer 13

Anaemia
Electrolyte imbalances
Arrhythmias
Heart failure
Myocardial infarction
Stroke
Urinary or chest infection

Question 14

Which view can you observe Shenton’s line?

Answer 14

AP

Question 15

What is the timeframe for operating on hip fractures?

Answer 15

48 hours

Question 16

Aside from surgery, list three aspects of management of NOF

Answer 16

analgesia
venous thromboembolism risk
orthogeriatrics
physio- mobility

Question 17

A 27 year old man complains of a painful and swollen right knee after injuring the joint during a tackle whilst playing football.

Answer 17

Meniscal tear
Collateral ligament injury
Cruciate ligament injury
Proximal tibia/tibial plateau fracture
Extensor mechanism injury including patella fracture, patella or quadriceps tendon rupture

Question 18

Patient with acute haemarthrosis of the knee with absence of any fractures, What is the likely diagnosis?

Answer 18

ACL rupture

Question 19

Two tests for ACL?

Answer 19

Lachman’s
Anterior drawer test

Question 20

What is Osgood Schattler’s disease?

Answer 20

Osgood-Schlatter disease is caused by inflammation at the tibial tuberosity where the patella ligament inserts. It is a common cause of anterior knee pain in adolescents.

Question 21

What is the pathophysiology of osgood schlatter’s disease?

Answer 21

multiple minor avulsion fractures occur where the patella ligament pulls away tiny pieces of the bone. This leads to growth of the tibial tuberosity,

Question 22

What is meralgia paraesthetica?

Answer 22

compression of lateral femoral cutaneous nerve causing sensory symptoms only

Question 23

Which movement of hip exacerbates meralgia paraesthetica?

Answer 23

extension of the hip