Orthopaedic review

Question 1

Bone Marrow Biopsy location and indication

Answer 1

• location
  
  • anterior or posterior iliac crest
  • sternum
  • tibia
• indications
  
  • malignancies (most common)
    
    • multiple myeloma, lymphoma, leukemia, metastatic disease
  • infection
    
    • TB (rare)
• technique
  
  • needle/trochar biopsy
  • open surgical biopsy

Question 2

Fracture around a loose stem in the presence of a chronic sinus at the previous site of surgery

Answer 2

1. Removal of components
2. debridement
3. insertion antibiotic spacer

Question 3

A medial vertical fracture, not extending beyond the lesser trochanter is noted during stem insertion during primary uncemented hip replacement

Answer 3

Stem removal, cable the calcar, reinsert stem,

Question 4

Local recurrence despite surgery occurs in approximately 40 % which is reduced with radiotherapy to 15%

Answer 4

Diffuse Pigmented Villonodular Synovitis

Question 5

Imaging may show cystic erosions around the joint

Answer 5

Diffuse Pigmented Villonodular Synovitis