CME questions based on the Mini-Symposium on “The Hip”
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Transcript of CME questions based on the Mini-Symposium on “The Hip”
CME SECTION
OR
CME questions based on the Mini-Symposium on “TheHip”
The following series of questions are based on the
Mini-Symposium on ‘‘The Hip”. Please read the articles in
the Mini-Symposium carefully and then complete the
self-assessment questionnaire by filling in the square cor-
responding to your response to each multiple-choice ques-
tion. After completing the questionnaire, either post or fax
the answer page to the Orthopaedics and Trauma Editorial
Office at the address at the bottom of the RESPONSE sheet.
Please photocopy this page if you wish to keep your
copy of Orthopaedics and Trauma. Replies received before
the next issue of the journal is published will be marked and
those reaching an adequate standard will qualify for three
external CME points. You will be notified of your marks and
a CME certificate will be despatched, via email, for your
records.
Questions
1 Currently in Europe, how many different agencies can
award a ‘CE mark’ to a device (such as a new hip
implant), allowing use of the marked device throughout
Europe
A 1
B 3
C 8
D 31
E 83
2 Approximately what proportion of new joint
replacement implants introduced in the USA reach the
market through the fast e track 510 k pathway
(‘me too’), obtaining clearance on the basis that they
are substantially equivalent to a device already in use
A 2%
B 10%
C 33%
D 66%
E 90%
3 According to NICE guidelines in the UK, what is the
minimum survivorship of a new hip replacement
implant at 5 years required for continuation of its
clinical use
A 80%
B 90%
C 95%
D 97%
E 99%
4 How many different types of femoral stem were
available for implantation in the UK in 2010
A 43
B 87
THOPAEDICS AND TRAUMA 26:4 292
C 112
D 146
E 159
5 Which parameter most commonly indicates rotational
instability of a femoral stem that is being followed
using radiostereometry
A Anterior head migration
B Distal migration
C Posterior head migration
D Valgus tilt
E Varus tilt
6 In which of the following situations will estimates of
wear using RSA methods on sequential radiographs be
least reliable
A Stainless steel femoral stem and titanium alloy backed
polyethylene cup, no tantalum beads
B Stainless steel femoral stem with stainless steel backed
polyethylene cup, tantalum beads in acetabular bone
C Tantalum beads in polyethylene cup, stainless steel
femoral component
D Tantalum beads in polyethylene cup and femoral bone,
cobalt chrome femoral head
E Tantalum beads in polyethylene cup, titanium femoral
stem with ceramic head
7 Under standard conditions in a wear simulator, which of
the following combinations has the lowest wear rates
A Ceramic on ceramic
B Ceramic on metal
C Metal on conventional polyethylene
D Metal on highly cross-linked polyethylene
E Metal on metal
8 Which of the following statements concerning metal-on-
metal bearing surfaces in hip arthroplasty is incorrect
A Component malorientation can leave an implant devoid
of a boundary layer
B Friction is higher when lubricated with water than with
serum
C Hyaluronic acid and glycoproteins form a boundary
layer in vivo that protects against wear and corrosion
D They operate with a mixed lubrication regime
E Wear rates are highest before the boundary layer forms
9 Which of the following is not one of the defined aims of
a national joint register, as suggested by the European
Arthroplasty Register and EFFORT
A Failure defined as revision of at least one part of the
implant
B Follow up of all implants until the patient, amongst
other alternatives, dies
� 2012 Published by Elsevier Ltd.
CME SECTION
C Follow up of all implants until the patient, amongst
other alternatives, emigrates
D Inclusion of hip, knee, ankle and shoulder
replacements
E Registration in a central database of all revision joint
replacements
10 In a simulator, which of the following is associated
with the greatest volumetric wear in metal-on-metal
hip arthroplasty components
A Full hemisphere 36 mm bearing, translational
malposition
B Full hemisphere 36 mm bearing, 65� rotational
malposition
C Full hemisphere 36 mm bearing, standard walking
conditions
D Sub hemisphere 39 mm bearing, standard walking
conditions
E Sub hemisphere 39 mm bearing, 65� rotational
malposition
11 Which of the following procedures is not covered by
the national requirement to collect patient reported
outcome measures that has been part of the Standard
NHS contract for acute services since 2009
A Groin hernia
B Instrumented spinal fusion
C Total hip replacement
D Total knee replacement
E Varicose vein surgery
12 Which of the following is not, at the time of publication
of this issue, a function of the National Joint Registry in
the UK
A Allows rapid identification of affected surgeons and
patients in the event of a batch recall of implants
B Allows surgeons to check their personal 3-year revi-
sion rate
C Provides feedback directly to hospitals on the revision
rates of surgeons working in the hospital
ORTHOPAEDICS AND TRAUMA 26:4 293
D Provides feedback directly to individual surgeons in
the form of a funnel plot
E Provides feedback directly to manufacturers on the
performance of the implants they supply
Please fill in your answers to the CME questionnaire above in
the response section provided to the right. A return address
and fax number is given below the response section.
Responses
Please shade in the square for the correct answer.
1 A B C D E
2 A B C D E
3 A B C D E
4 A B C D E
5 A B C D E
6 A B C D E
7 A B C D E
8 A B C D E
9 A B C D E
10 A B C D E
11 A B C D E
12 A B C D E
Your details (Print clearly)
NAME.....................
ADDRESS....................
........................
EMAIL.....................
RETURN THE COMPLETED RESPONSE FORM by fax to
þ44-113-392-3290, or by post to CME, Orthopaedics and
Trauma, Academic Department of Orthopaedic Surgery,
“A” Floor Clarendon Wing, Leeds General Infirmary, Great
George Street, Leeds LS1 3EX, UK.
� 2012 Published by Elsevier Ltd.