Page 183South African Orthopaedic Journal 
http://journal.saoa.org.za

SAOJ
SOUTH AFRICAN ORTHOPAEDIC JOURNAL

CPD QUESTIONNAIRE. AUGUST 2020 VOL 19 NO 3

Orthopaedics and COVID-19: The surgery, the surgeon and 
the susceptible – a scoping review (O’Connor M, Nieuwoudt L, 
Marais LC)
1. Of patients who require emergent surgery in the COVID 

environment, it is suggested that:
a. All patients should be tested prior to surgery A

b. Only patients undergoing elective procedures should be tested B

c. Symptomatic patients and patients from high prevalence areas 
and high risk contacts should be tested

C

d. Patients should be tested if they are symptomatic D

e. All patients from high prevalence areas and with high risk 
contacts should be tested

E

2. Which group of personal protective equipment listed below 
reflects best the requirements for an orthopaedic procedure 
on a COVID-positive patient?

a. Double glove, surgical hood, shoe covers, AAMI 3 gown A

b. Double glove, N95 respirator, visor, AAMI 2 gown B

c. Double glove, surgical mask, visor, AAMI 4 gown C
d. Double glove, N95 respirator, visor, AAMI 4 gown D

e. Double glove, surgical mask, glasses, AAMI 2 gown E
3. Which of the following correctly describes a 

recommendation to conserve respirators?
a. Extended use of the mask describes continuous wear while 

attending to different patients for 8–12 hours
A

b. Extended use of the mask describes repeatedly donning and 
doffing the mask between patients for 8–12 hours

B

c. Extended use of the mask describes continuous wear while 
attending to different patients for 4–6 hours

C

d. Re-use refers to continuous use of the mask while attending to 
different patients for 8–12 hours

D

e. Re-use refers to continuous use of the mask while attending to 
different patients for 4–6 hours

E

DEFCON 5: The CHBAH orthopaedic department’s COVID-19 
proactive action plan (Hirschmann A, Pillay T, Fang KW, 
Ramokgopa MT, Frey C)
4. Chris Hani Baragwanath Academic Hospital is:

a. The smallest hospital in the world A
b. The largest hospital in the world B
c. The largest hospital in the Eastern Cape C
d. The largest hospital in Africa D
e. The third-largest hospital in South Africa E

5. In terms of the CHBAH orthopaedic staff COVID-19 risk 
stratification score:

a. An age of >65 years is a criterion for 1 point A
b. A score of 3 or more was considered as high risk B
c. Lung disease is not a recognised risk factor C

d. Only type 2 diabetes mellitus is considered as a risk factor D
e. A score of 4 or more was considered as high risk E

Short-term outcomes of submuscular bridge plating of length-
unstable paediatric femoral shaft fractures in children: Insights 
from a South African tertiary hospital setting (Du Toit J, 
Salkinder R, Burger MC, Du Preez G, Lamberts RP)
6. Paediatric femoral diaphyseal fractures can be treated by 

multiple modalities, but the age group that seems to create 
the most controversy is:  

a. 1–3 years  A

b. 3–6 years B

c. 6–13 years C

d. 13–16 years D

e. 16 years and older E
7. The lateral entry nail is an excellent treatment option for 

children with femur fractures. What would be a correct 
absolute or relative contraindication for lateral entry nails 
for the treatment of femoral fractures in this population 
group?

a. 8–16 years of age A
b. Diaphyseal femoral fractures B
c. Length-unstable fractures of the diaphysis C
d. Metaphyseal junction fractures with intra-articular or 

transphyseal extension D

e. Transverse diaphyseal fractures in a child older than 8 years E
8. Which of the following short-term outcomes of the 

treatment of paediatric length-unstable diaphyseal femur 
fractures with sub-muscular bridge plating is incorrect?

a. Acceptable union rate A

b. Comparable blood loss when compared to the other operative 
treatment modalities B

c. Early mobilisation due to stable fixation C
d. Rotation abnormalities are not a problem due to the surgical 

technique D

e. Acceptable mechanical axis alignment on the frontal plane E

Outcomes of primary fusion in high-energy Lisfranc injuries at 
a tertiary state hospital (Panchoo P, Wiegerinck JI, Boskovic V, 
Laubscher M, Maqungo S, McCollum G, Dey R)
9. Choose the correct statement. The Lisfranc ligament:
a. Runs on the dorsal aspect of the foot from the lateral aspect of 

the medial cuneiform to the medial aspect of the base of the 
second metatarsal

A

b. Runs on the plantar aspect of the foot from the lateral aspect 
of the medial cuneiform to the medial aspect of the base of the 
second metatarsal

B

c. Runs on the plantar aspect of the foot from the medial aspect 
of the middle cuneiform to the lateral aspect of the base of the 
first metatarsal

C

d. Runs on the dorsal aspect of the foot from the medial aspect 
of the middle cuneiform to the lateral aspect of the base of the 
first metatarsal

D

e. Runs on the plantar aspect of the foot from the base of the first 
metatarsal to the base of the second metatarsal

E



Page 184 South African Orthopaedic Journal 
http://journal.saoa.org.za

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10. What is the current accepted range of lateral Meary’s angle?

a. -4 to 4 degrees A

b. 2 to 10 degrees B

c. 16 to 20 degrees C

d. 4 to 8 degrees D

e. None of the above E

Peri-articular infiltration in the resource-restrained 
environment – still a worthwhile adjunct to multimodal 
analgesia post total knee replacement (Van Heukelum M,  
Blake CA, Franken T, Burger MC, Ferreira N, Gobetz G)

11. Peri-articular infiltration as part of a pre-emptive 
multimodal analgesic protocol has proven to provide: 
(choose the most correct answer)

a. A complex analgesic modality requiring specific skills and 
equipment A

b. Analgesia associated with a complex side-effect profile B
c. No improvement in post-operative analgesia C
d. Major heterogeneity surrounding infiltration techniques D
e. Good analgesia, is cost effective, has minimal side effects, is 

easy to perform E

12. Considering post-operative analgesia following total knee 
replacement in a resource-poor environment:

a. The efficacy of peri-articular infiltration is dependent on infiltrates 
including liposomal bupivacaine, ropivacaine and ketorolac A

b. Peri-articular infiltration using a widely available, inexpensive 
infiltration mix, calculated on a volume per kilogram basis 
remains a valuable addition to the multimodal analgesia pathway

B

c. Peri-articular infiltration techniques are not possible as they 
require specialised skills and equipment C

d. Should be limited to opioid-based analgesic regimens D
e. Total knee replacement should not be performed in resource-

poor environments E

The short-term outcome of hip revision arthroplasty with 
Trabecular Metal™ components and augments (Noconjo L, 
Nortje MB)

13. Indications for hip revision include all of the following except:

a. Aseptic loosening A
b. Liner wear B
c. Infection C
d. Loose abductor muscle tension D
e. Peri-prosthetic fracture E

14. The main type of wear in hip arthroplasty is:
a. Adhesive A
b. Fatigue B
c. Abrasive C
d. Third body D
e. Linear E

15. Type 3 acetabular defect is mostly associated with use of:

a. Morcellised femoral head allograft A

b. Morcellised femoral head autograft B
c. Porous hemispheric acetabular cup C
d. Cup cage D
e. Acetabular augment E

Freedman-Bernstein musculoskeletal competence testing of 
South African intern doctors: is there a difference between 
health science faculties? (Coetzee KP, Gibson NW)

16. What is the validated pass mark for the Freedman–Bernstein 
musculoskeletal competency test?

a. 20% A
b. 50% B
c. 90% C
d. 70% D
e. 30% E

17. What statistical test was used to compare mean values 
between multiple groups in our study?

a. Paired t-test A
b. Pearson correlation B
c. ANOVA C
d. Fisher’s test D
e. Multiple linear regression E

18. What percentage of South African intern doctors demonstrated 
basic musculoskeletal competence? 

a. 6% A
b. 20% B
c. 12% C
d. 50% D
e. 70% E
Infantile Blount’s disease (Maré PH, Thompson DM)

19. A 3-year-old child is brought to you with the complaint of 
bilateral bow-leg deformity since birth and frequent falling. 
Which of the following would make the diagnosis of Blount’s 
disease most likely?

a. MDA ≥9° A
b. BMI >95th percentile for age B
c. MDA ≥10°, EMA >20° C
d. The appearance of normal valgus alignment of the proximal 

tibia when performing the ‘cover-up’ test
D

e. The triangular appearance of the distal femoral and proximal 
tibial epiphyseal ossification centres

E

20. An 8-year-old child is brought to you with the history of 
unilateral bow-leg deformity since birth. She has a thrust 
during the stance phase of gait on her affected leg, and her 
knee is unstable in full extension. X-ray shows Langenskiöld 
stage 5 changes. Which of the following would constitute the 
best treatment strategy?

a. Proximal tibial metaphyseal osteotomy (combined with fibula 
osteotomy) and realignment to physiological valgus

A

b. Guided growth with a lateral proximal tibial tension-band plate B
c. Medial elevation osteotomy combined with proximal tibial 

realignment and lateral proximal tibia and fibula epiphysiodesis
C

d. Hexapod assisted gradual correction of the proximal tibial 
metaphyseal deformity to re-orientate the plateau without 
elevation

D

e. Medial epiphysiolysis, proximal tibial realignment osteotomy 
and lateral proximal tibial and fibula epiphysiodesis

E

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