Deck 19: Orthopedic Management of the Hip and Pelvis

Question 1

Which of the following terms describes pain and bony erosion of the symphysis pubis characterized with pain aggravated by striding,kicking,or pivoting?

A) Arthralgia
B) Pubalgia
C) Bursitis
D) Osteitis pubis

Answer 1

Osteitis pubis

Question 2

Which of the following is NOT a main clinical complication noted with subtrochanteric fractures?

A) Malunion
B) Delayed union
C) Nonunion
D) Refracture of the femur

Answer 2

Refracture of the femur

Question 3

In which of the following types of hip surgeries is the femoral head and the acetabulum replaced?

A) ORIF
B) Total hip arthroplasty (THR)
C) Hemiarthroplasty
D) Femoral osteotomy

Answer 3

Total hip arthroplasty (THR)

Question 4

What criterion does the PT use to determine bone healing following hip surgery?

A) Patient's statement that the hip feels better
B) Strength of the limb in walking exercises
C) An X-ray that suggests secure bone healing
D) A healed surgical wound and decreased swelling in the hip

Question 5

Select the most common serious complication(s)related to THR.

A) Postoperative hip dislocation
B) Persistent thigh pain
C) Deep vein thrombosis (DVT)
D) All of the above

Question 6

In the maximum protection phase after hip surgery,which of the following treatments are performed by the physical therapist assistant (PTA)?

A) Isometric exercises,gentle protected range of motion (ROM)exercise,limited weight bearing,isometric quadriceps sets,gluteal sets,and heel slides
B) Partial wall squats and step-ups
C) Pool walking
D) Treadmill and gait exercises

Question 7

How would a hip dislocation generally be treated?

A) Bed rest,traction,protected limited weight bearing for 12 weeks
B) Open reduction with internal fixation (ORIF)with bed rest and protected weight bearing for 3-4 weeks
C) ORIF with limited weight bearing for 2-3 weeks
D) Bed rest,casting,and limited exercise for 12 weeks

Question 8

Your patient had an anterior surgical approach to a total hip replacement.Which of the following positions in the affected hip are avoided in an anterior approach versus a posterolateral or lateral approach following surgery?

A) Hip adduction
B) Hip extension and external rotation
C) Hip flexion > 90°
D) Hip internal rotation

Question 9

Which of the following patient characteristics are considered when determining the type of hip fracture repair to be done?

A) Age,location of the fracture,quality of the bone
B) Severity of the fracture,activity level of the patient before fracture
C) Goals for the patient's return to activity
D) All of the above

Question 10

Which of the following interventions must NOT be done during the maximum protection phase following a hamstring strain?

A) Tolerated cardiovascular conditioning exercises
B) Aggressive stretching program for the hamstrings
C) Full knee extension
D) Full leg flexion
E) B,C,and D

Question 11

Select the risk factors that predict failure to achieve overall postoperative hip surgery success.

A) Cardiovascular or pulmonary diseases
B) Obesity and osteoporosis
C) Dementia and poor upper body strength
D) All of the above

Question 12

Which of the following terms is described as chronic pain in the region of the pubic tubercle and inguinal region resulting from athletic involvement and includes lower abdominal pain as a symptom?

A) Arthralgia
B) Pubalgia
C) Bursitis
D) Osteitis pubis

Question 13

What guides the physical therapist (PT)in deciding the type of weight bearing a postoperative proximal femoral intertrochanteric osteotomy patient should use?

A) The amount of pain the patient is having
B) The rate and quality of the bone healing
C) The patient's request to stop using the walker
D) The number of weeks since the patient had surgery

Question 14

When can the moderate protection phase begin for hip replacement patients?

A) When they show no pain and can ambulate with full weight bearing
B) When they demonstrate quadriceps control and active knee flexion
C) When they show compliance with all hip precautions
D) B and C

Question 15

What is the overall mortality of hip fracture patients 6 years postoperatively?

A) 20%
B) 50%
C) 60%
D) 70%

Question 16

Your patient had a lateral total hip replacement a week ago.You enter the room and find the patient on her back with the abduction wedge between her knees.What is your next action?

A) Remove the wedge and reposition the patient observing universal hip precautions
B) Nothing,the patient is in a good position
C) Place the hip in 90° of flexion
D) Place the affected hip in internal rotation

Question 17

Which disease is characterized by a noninflammatory,self-limiting syndrome where the femoral head becomes flattened at the weight-bearing surface?

A) Complete hip fracture
B) Osteoarthritis of the hip
C) Rheumatoid arthritis of the hip
D) Legg-Calvé-Perthes disease

Question 18

What is the most significant complication after hip fracture?

A) Postoperative pain
B) Postoperative osteonecrosis and avascular necrosis
C) Repeat hip fracture
D) None of the above

Question 19

When can total hip precautions be stopped?

A) When the PTA determines the patient's strength and flexibility have returned to normal
B) When the patient decides that he has enough strength and control in the quadriceps muscle to balance appropriately
C) When the doctor elects to discontinue the total hip replacement precautions
D) When the PT determines the patient has enough quadriceps strength and control

Question 20

Which of the following procedures are done for degenerative joint disease (DJD)when it is extensive and the patient has pain from subchondral bone erosion,articular cartilage fibrillation,and hip joint incongruity?

A) ORIF
B) Conservative treatment (bed rest)
C) Proximal femoral osteotomy
D) Total hip replacement