SA Orthop J 2021;20(1)

CPD QUESTIONNAIRE. MARCH 2021 VOL 20 NO 1

Prevalence of pathological neck of femur fractures in patients 
undergoing arthroplasty at a tertiary referral hospital (Khan S, 
Wadee N, Burger M, Ferreira N, Jordaan K)
1. Mortality rate after surgery for femoral neck fractures in the 

elderly population is approximately:
a. 5% A
b. 12% B
c. 33% C
d. 55% D
e. 66% E
2. Select the most correct statement: 
a. Metastatic lesions are the most common cause of femoral 

neck fractures. A

b. Metastatic lesions are the least common cause of 
pathological femoral neck fractures. B

c. Primary bony lesions are the most common cause of 
pathological femoral neck fractures. C

d. Metastatic lesions and multiple myeloma are the least 
common causes of pathological fractures. D

e. Fragility fractures are the most common cause of femoral 
neck fractures. E

3. Which of the following primary malignancies most 
commonly metastasise to bone? 

a. Brain, oesophagus, stomach A
b. Breast, thyroid, kidney, lung and prostate B
c. Breast, thyroid, ovarian, lung and prostate C
d. Breast, thyroid, brain, lung and prostate D
e. Breast, thyroid, kidney, lung and prostate E
Tuberculosis of the extra-axial skeleton in paediatric patients 
(Vajapey S, Horn A)
4. Which of the following haematological studies are usually 

normal in children presenting with musculoskeletal 
tuberculosis?

a. Haemoglobin A
b. White cell count B
c. Platelet count C
d. Erythrocyte sedimentation rate (ESR) D
e. C-reactive protein (CRP) E
5. In children who are eventually diagnosed with musculo-

skeletal tuberculosis, the most common presenting 
physical complaint is:

a. Fatigue A
b. Weight loss and loss of appetite B
c. Joint stiffness C
d. Pain or limping D
e. Deformity E
6. In this study, the diagnostic test with the highest sensitivity 

or number of positive results was:
a. Tissue culture and sensitivity A
b. GeneXpert B
c. Histological examination C
d. Microscopy D
e. Mantoux skin test E

Short-term comparison of the use of static and expandable 
intramedullary rods in the lower limbs of children with 
osteogenesis imperfecta (De Jager LJ, Maré PH,  
Thompson DM, Marais LC)
7. What was the most frequent complication in the Rush  

rod group?
a. Infection A
b. Articular penetration B
c. Distal deformity C
d. Metalware failure D
e. Failure to expand E
8. What was the most frequent complication in the  

Fassier-Duval rod group? 
a. Infection A
b. Articular penetration B
c. Distal deformity C
d. Metalware failure D
e. Failure to expand E
9. What was the expected time to re-operation in the Rush  

rod group?
a. 6 months A
b. 1 year B
c. 2 years C
d. 3 years D
e. 5 years E
The management of chronic osteomyelitis in adults: 
outcomes of an integrated approach (Venter RG, Tanwar YS, 
Grey JP, Ferreira N)

10. Choose the most correct statement.
Considering current literature regarding ‘single-stage 
management’ of chronic osteomyelitis:

a. It is less cost effective than two-stage treatment methods but 
has similar success rates. A

b. It is more cost effective than two-stage treatment methods 
but has higher complication rates. B

c. It is more cost effective than two-stage treatment methods 
and has similar success rates. C

d. It is less cost effective than two-stage treatment methods 
but obviates the need for adjuvant systemic antimicrobial 
therapy.

D

e. It is more cost effective than two-stage treatment and 
obviates the need for adjuvant systemic antimicrobial 
therapy.

E

11. The following are all accepted dead space management 
strategies mentioned in current literature, except:

a. Gentamycin-loaded PMMA beads A
b. Antibiotic-loaded calcium-sulphate pellets B
c. Bioactive glass C
d. Hydroxyapatite powder D
e. Antibiotic-impregnated collagen sponges E

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Page 54 SA Orthop J 2021;20(1)

12. Choose the most correct statement regarding a modern 
definition of chronic osteomyelitis:

a. Infection involving bone, with a duration of at least one 
month, with signs of sequestrum on plain film X-ray or CT 
scan.

A

b. Infection involving bone, with a duration of at least one 
month, where the causative organisms were thought to have 
persisted either intracellularly or in interactive biofilm-based 
colonies.

B

c. Infection involving bone, with a duration of at least ten 
days, where the causative organisms were thought to have 
persisted either intracellularly or in interactive biofilm-based 
colonies.

C

d. Infection involving bone, with a duration of at least ten days, 
with signs of sequestrum on plain film X-ray or CT scan. D

e. Infection involving bone, with a duration of at least one 
month, with signs of both local and systemic signs of sepsis. E

Radiation-induced pathological fractures of the proximal 
femur: a case series considering an endoprosthetic solution 
(Vogel J, De Villiers S, Mugla W, McCaul J, Hosking K,  
Hilton T)

13. Standard trauma fixation methods, such as locked 
cephalo-medullary nails, used to treat radiation-induced 
pathological fractures of the proximal femur have a failure 
rate of:

a. 10–20% A
b. 20–40% B
c. 40–60% C
d. 60–80% D
e. 80–100% E
14. The mechanism of radiation-induced pathological  

fractures is:
a. Local sarcopaenia A
b. Tumour recurrence B
c. Osteonecrosis C
d. Post-radiation osteomyelitis D
e. Osteoporosis E
Intra-operative extracorporeal radiation therapy for skeletally 
immature patients with malignant bone tumours (Shah MR, 
Shah MM, Agrawal AK, Shah MD, Desai SM)

15. The advantage/s of extracorporeal radiation is/are:
a. Useful in skeletally immature patients A
b. High dose of radiation given in one sitting kills tumour cells 

better B

c. Patient’s own bone can be used C
d. Avoids prolonged radiation therapy D
e. All of the above E
16. The following are treatment options for malignant bone 

tumours in skeletally immature bones except:
a. Amputation A
b. Tumour excision and replacement with non-expandable 

megaprosthesis B

c. Tumour excision and replacement with expandable 
megaprosthesis C

d. ECRT D
e. None of the above E

17. ECRT can be a choice of treatment in the case of multiple 
metastases.

a. Strongly disagree A
b. Disagree B
c. Agree C
d. Strongly agree D
e. Not sure E
Intraprosthetic dislocation after a revision hip replacement:  
a case report (Sekeitto AR, Van der Jagt K, Sikhauli N,  
Mokete L, Van der Jagt DR)

18. A 75-year-old male with comorbid neuromuscular disease 
underwent a total hip arthroplasty for severe osteoarthritis 
of his hip. The orthopaedic surgeon who performed the 
procedure opted to use a dual mobility cup. Which of the 
following explains the rationale for this implant choice?

a. Increased offset A
b. Increased stability B
c. Increased range of motion C
d. Poor bone stock D
e. The patient’s sex E
19. A 75-year-old male who had a total hip replacement with a 

dual mobility cup a few weeks prior falls in the bathroom.  
He is brought into the accident and emergency department 
and after imaging is confirmed to have dislocated his 
previously operated hip. Which of the following is the 
appropriate management?

a. Open reduction A
b. Closed reduction under conscious sedation B
c. Closed reduction under general anaesthesia C
d. Closed reduction under general anaesthesia and full muscle 

relaxation D

e. Revision of the components E
20. A 75-year-old male who is post-reduction of a dislocated 

dual mobility cup has a formal X-ray performed in recovery. 
Review of the X-ray by his orthopaedic surgeon shows an 
intraprosthetic dislocation. Which of the following is the 
appropriate management?

a. Open reduction A
b. Closed reduction under conscious sedation B
c. Closed reduction under general anaesthesia C
d. Closed reduction under general anaesthesia and full muscle 

relaxation D

e. Revision of the components E

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