JII BCS Exam: Kinematic Knee! Quiz

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Questions and Answers
  • 1. 

    A study by Noble et al. (2005) concluded that patients who had TKA experience…

    • A.

      Substantial functional impairment when compared with their age and gender matched peers

    • B.

      Functional outcomes similar to that of their age and gender matched peers

    • C.

      Substantial functional improvement when compared with their age and gender matched peers

    • D.

      None of the above

    Correct Answer
    A. Substantial functional impairment when compared with their age and gender matched peers
    Explanation
    The correct answer is "Substantial functional impairment when compared with their age and gender matched peers." This conclusion is based on a study conducted by Noble et al. (2005). The study found that patients who had total knee arthroplasty (TKA) experienced significant functional impairment compared to individuals of the same age and gender who did not undergo the surgery. This suggests that TKA may not lead to functional improvement but rather result in functional limitations.

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  • 2. 

    Which factors contribute to the rationale for a kinematic knee?

    • A.

      Conventional knee designs do not replicate the normal anatomy of the knee and thus they are unable to restore normal kinematics and muscular efficiency

    • B.

      Conventional knee designs do not provide the same levels of satisfaction and return to function as seen in THA

    • C.

      The prevalence of younger more demanding patients

    • D.

      All of the above

    Correct Answer
    D. All of the above
    Explanation
    All of the factors mentioned in the options contribute to the rationale for a kinematic knee. Conventional knee designs do not replicate the normal anatomy of the knee, which hinders the restoration of normal kinematics and muscular efficiency. Additionally, these designs do not provide the same satisfaction and return to function as seen in total hip arthroplasty (THA). Moreover, the prevalence of younger and more demanding patients further emphasizes the need for a kinematic knee to meet their specific requirements.

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  • 3. 

    A key characteristic to understand in relation to the native knee anatomy is that it is… 

    • A.

      Asymmetrical

    • B.

      Symmetrical

    • C.

      Convex on both sides

    • D.

      None of the above

    Correct Answer
    A. Asymmetrical
    Explanation
    The native knee anatomy is asymmetrical, meaning that it is not the same on both sides. This means that the structures and components of the knee joint are not identical on the left and right sides of the body. Understanding this characteristic is important in order to accurately diagnose and treat knee-related conditions and injuries.

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  • 4. 

    When reviewing the articular geometry of the femur and tibia which of the following can be observed? 

    • A.

      The distal condylar radius of the medial femoral condyle is rounder than that of the lateral femoral condyle

    • B.

      The distal condylar radius of the medial femoral condyle is flatter than that of the lateral femoral condyle

    • C.

      The medial femoral condyle has a larger posterior offset than that of the lateral femoral condyle

    • D.

      The lateral tibial condyle is concave in shape and the medial tibial condyle is convex in shape (no constraint on AP motion)

    • E.

      The medial tibial condyle is concave in shape and the lateral tibial condyle is convex in shape (no constraint on AP motion)

    Correct Answer(s)
    A. The distal condylar radius of the medial femoral condyle is rounder than that of the lateral femoral condyle
    C. The medial femoral condyle has a larger posterior offset than that of the lateral femoral condyle
    E. The medial tibial condyle is concave in shape and the lateral tibial condyle is convex in shape (no constraint on AP motion)
    Explanation
    The articular geometry of the femur and tibia can be observed by examining the shape and offset of the condyles. In this case, the correct answer states that the distal condylar radius of the medial femoral condyle is rounder than that of the lateral femoral condyle. This means that the medial condyle has a larger curvature compared to the lateral condyle. Additionally, the correct answer mentions that the medial femoral condyle has a larger posterior offset than the lateral femoral condyle. This means that the medial condyle extends further back compared to the lateral condyle. Finally, the correct answer states that the medial tibial condyle is concave in shape and the lateral tibial condyle is convex in shape, with no constraint on anterior-posterior motion.

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  • 5. 

    The knee is one of the most complicated joints in the body with six degrees of freedom.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    The knee joint is indeed one of the most complex joints in the body, with six degrees of freedom. This means that it can move in multiple directions, including flexion and extension (bending and straightening), abduction and adduction (moving away from and towards the midline), and rotation. The six degrees of freedom allow for a wide range of movement and flexibility in the knee joint, making it an important joint for activities such as walking, running, and jumping.

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  • 6. 

    The articular geometry, in part, contributes to the kinematics of the knee during motion. Additionally, the articular geometry gives rise to a…

    • A.

      1 degree joint line present in the normal knee

    • B.

      5 degree joint line present in the normal knee

    • C.

      3 degree joint line present in the normal knee

    • D.

      None of the above

    Correct Answer
    C. 3 degree joint line present in the normal knee
    Explanation
    The articular geometry of the knee plays a role in its kinematics during motion. This means that the shape and structure of the joint surfaces affect how the knee moves. One specific aspect of the articular geometry is the presence of a 3 degree joint line in the normal knee. This suggests that the joint surfaces are aligned at a slight angle, which can influence the range of motion and stability of the knee joint. The other options, a 1 degree joint line or a 5 degree joint line, are not supported by the given information.

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  • 7. 

    In extension an angle is formed between the quadriceps and patella tendon, this angle is known as the ___ angle.

    Correct Answer
    Q
    q
    Q angle
    Explanation
    The Q angle is the correct answer because it is the angle formed between the quadriceps muscle and the patella tendon. This angle is used to assess the alignment of the lower extremities and can be helpful in diagnosing conditions such as patellofemoral pain syndrome and patellar instability.

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  • 8. 

    The Q angle, which ranges from 14-17°, affects…

    • A.

      Quadriceps efficiency

    • B.

      The efficiency of flexor muscles

    • C.

      Medial/lateral translation of the knee

    • D.

      A & B

    Correct Answer
    A. Quadriceps efficiency
    Explanation
    The Q angle, which ranges from 14-17°, refers to the angle formed between the quadriceps muscle and the patellar tendon. This angle affects the efficiency of the quadriceps muscle. A larger Q angle can result in increased stress on the patella, leading to conditions such as patellofemoral pain syndrome. Therefore, the correct answer is Quadriceps efficiency.

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  • 9. 

    In extension, the knee adopts the screw home position, which is a position of stability. In this position which of the following can be observed? 

    • A.

      Femur internally rotated 5° (achieved by ACL pull)

    • B.

      Femur externally rotated 5° (achieved by ACL pull)

    • C.

      Slightly more posterior femoral overhang

    • D.

      Knee joint is more congruent and quadriceps activity is not required

    • E.

      Quadriceps activity increases utilized to stabilize the knee

    Correct Answer(s)
    A. Femur internally rotated 5° (achieved by ACL pull)
    D. Knee joint is more congruent and quadriceps activity is not required
    Explanation
    In the screw home position, the femur is internally rotated by 5°, which is achieved by the pull of the anterior cruciate ligament (ACL). This position allows for increased congruence of the knee joint, meaning that the surfaces of the femur and tibia fit together more securely. In this position, the quadriceps muscles do not need to be as active to stabilize the knee, as the congruence of the joint provides stability. Therefore, the correct answer is that the femur is internally rotated 5° and the knee joint is more congruent, and quadriceps activity is not required.

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  • 10. 

    Which of the following occurs during mid flexion (1-90°)?

    • A.

      Automatic internal rotation of the femur out of the screw home position

    • B.

      Automatic external rotation of the femur out of the screw home position

    • C.

      Q-angle minimized to almost 0 degrees (increased quadriceps efficiency)

    • D.

      The lateral femoral condyle is held in the concave tibial surface and the medial femoral condyle is free to move over the convex medial tibial surface. This results in a lateral pivot (rollback + femoral external rotation)

    • E.

      The medial femoral condyle is held in the concave tibial surface and the lateral femoral condyle is free to move over the convex lateral tibial surface. This results in a medial pivot (rollback + femoral external rotation)

    Correct Answer(s)
    B. Automatic external rotation of the femur out of the screw home position
    C. Q-angle minimized to almost 0 degrees (increased quadriceps efficiency)
    E. The medial femoral condyle is held in the concave tibial surface and the lateral femoral condyle is free to move over the convex lateral tibial surface. This results in a medial pivot (rollback + femoral external rotation)
    Explanation
    During mid flexion (1-90°), the femur undergoes automatic external rotation out of the screw home position. This is accompanied by a minimization of the Q-angle to almost 0 degrees, which increases quadriceps efficiency. Additionally, the medial femoral condyle is held in the concave tibial surface while the lateral femoral condyle is free to move over the convex lateral tibial surface. This results in a medial pivot, which involves rollback and femoral external rotation.

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  • 11. 

    Which of the following occurs during full flexion (90-155°)?

    • A.

      Point of contact shifts anteriorly during flexion

    • B.

      The femur rolls and slides simultaneously (posterior translation) to provide clearance with the posterior tibia and space for the tissue behind the knee to allow deep flexion

    • C.

      Axial rotation retained (not needed anymore as Q angle is near 0 degrees)

    • D.

      Point of contact shifts posteriorly during flexion

    • E.

      Axial rotation continues until maximum extension is reached

    Correct Answer(s)
    B. The femur rolls and slides simultaneously (posterior translation) to provide clearance with the posterior tibia and space for the tissue behind the knee to allow deep flexion
    C. Axial rotation retained (not needed anymore as Q angle is near 0 degrees)
    D. Point of contact shifts posteriorly during flexion
    Explanation
    During full flexion (90-155°), the femur rolls and slides simultaneously (posterior translation) to provide clearance with the posterior tibia and space for the tissue behind the knee to allow deep flexion. Additionally, axial rotation is retained because the Q angle is near 0 degrees. The point of contact also shifts posteriorly during flexion.

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  • 12. 

    Satisfaction levels and return to functional activity following TKA are the same as that of THA.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    The statement is false because satisfaction levels and return to functional activity following Total Knee Arthroplasty (TKA) are generally lower compared to Total Hip Arthroplasty (THA). TKA involves replacing the knee joint, which is a more complex and weight-bearing joint, leading to a longer and more challenging recovery process. THA, on the other hand, involves replacing the hip joint, which is a more stable joint and typically results in better outcomes and higher patient satisfaction. Therefore, the satisfaction levels and return to functional activity are not the same for TKA and THA.

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  • 13. 

    What paradoxical motion can occur as a result of conventional knee design?

    • A.

      The lack of ACL function leads to paradoxical anterior sliding of the femur during flexion

    • B.

      During flexion the knee may pivot laterally, as opposed to the naturally occurring medial pivot

    • C.

      During flexion the knee may pivot medially, as opposed to the naturally occurring lateral pivot

    • D.

      A & B

    Correct Answer
    D. A & B
    Explanation
    The correct answer is A & B. The lack of ACL function can lead to paradoxical anterior sliding of the femur during flexion, causing the knee to pivot laterally instead of the naturally occurring medial pivot. This paradoxical motion is a result of the conventional knee design.

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  • 14. 

    Pitfalls of conventional knee design include?

    • A.

      Asymmetrical femoral and tibial condyles, resulting in a 3° joint line

    • B.

      No replication of ACL function of PS designs – lack of AP stability

    • C.

      AP sulcus position is more posterior to allow deep flexion

    • D.

      All of the above

    • E.

      B & C

    Correct Answer
    E. B & C
    Explanation
    The correct answer is B & C. This means that the pitfalls of conventional knee design include the lack of replication of ACL function of PS designs, resulting in a lack of anterior-posterior (AP) stability, and the more posterior position of the AP sulcus to allow for deep flexion. These factors can contribute to decreased stability and potentially limit the range of motion in the knee joint.

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Quiz Review Timeline +

Our quizzes are rigorously reviewed, monitored and continuously updated by our expert board to maintain accuracy, relevance, and timeliness.

  • Current Version
  • Mar 17, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Oct 30, 2014
    Quiz Created by
    SmithNephew1

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