Remediation:
A. The initial evaluation of any patient with an extremity fracture includes assessment of the neurovascular status distal to the fracture to assess for possible vascular injury and compromise.
B. Assessing for open wounds is important to determine the need for and urgency of operative intervention.
C. The patient should be evaluated for any additional fractures or associated soft-tissue injuries.
D. Knee aspiration is not part of the initial examination of a trauma patient.
E. The patient has no injury to the head and had no loss of consciousness, so a head computed tomography scan is not indicated as part of the initial evaluation.

Remediation:
A. The patient has a large loose body that should be removed, and the fracture should be treated with fixation.
B. Same as A
C. Same as A
D. Same as A

Remediation:
A. Shorter operative and total operating room time, reduced costs, less blood loss, and fewer blood transfusions are the benefits of using a dedicated team in the operative management of AIS.
B. Improvements in patient satisfaction are not a benefit of using a dedicated team in the operative management of AIS. Shorter operative and total operating room time, reduced costs, less blood loss, and fewer blood transfusions are the benefits of a dedicated team in the operative management of AIS.
C. Same as A
D. Same as A
E. Fewer neuromonitoring changes intraoperatively are not a benefit of using a dedicated team in the operative management of AIS. Shorter operative and total operating room time, reduced costs, less blood loss, and fewer blood transfusions are the benefits of using a dedicated team in the operative management of AIS.
F. Improvements in HRQoL outcome scores are not a benefit of using a dedicated team in the operative management of AIS. Shorter operative and total operating room time, reduced costs, less blood loss, and fewer blood transfusions are the benefits of using a dedicated team in the operative management of AIS.

Remediation:
A. An early range-of-motion protocol after repair of a small-to-medium rotator cuff tear has shown improved range of motion and lower VAS pain scores when compared with a sling immobilization protocol.
B. An early range-of-motion protocol after repair of a small-to-medium rotator cuff tear has shown better patient satisfaction when compared with a sling immobilization protocol.
C. There is no difference in retear rates at 6 months following repair of a small-to-medium rotator cuff tear with a sling immobilization protocol when compared with an early range-of-motion protocol.
D. Sling immobilization after repair of a small-to-medium rotator cuff tear has shown slightly higher visual analog scale (VAS) pain scores at 6 months when compared with an early range-of-motion protocol.

Remediation:
A. A short-leg cast is less effective than a long-leg cast. Ponseti principles recommend long-leg casting.
B. A tibialis anterior tendon transfer is not recommended until about age 2.5 years, when the lateral cuneiform has ossified.
C. While an extensile posteromedial release may be necessary for some clubfoot recurrences, it is not recommended for a first-time recurrence.
D. Recasting using the Ponseti technique is recommended given the lack of compliance with bracing.

Remediation:
A. miRNAs may act to inhibit tumor suppressor genes. In doing so, they can promote tumor growth.
B. miRNAs can activate proto-oncogenes and may act as an oncogene, promoting cell division and cancer formation.
C. miRNAs are associated with cancer and have been proposed to be causative.
D. miRNAs tend to be biologically stable and reproducible. As such, they may be used as reliable biomarkers for diagnosis.
E. miRNAs are known to activate proto-oncogenes, promoting a cancer phenotype.

Remediation:
A. A first web-space deepening is not correct as the cleft must also be closed.
B. Cleft closure is performed first as the web-space deepening and thumb reconstruction will likely place incisions in the region where local flaps are needed for cleft closure, resulting in skin compromise.
C. A thumb is present in this case so index pollicization is not necessary.
D. A thumb is present in this case so a toe-to-thumb transfer is not necessary.

Remediation:
A. This is often referred to as a Hoffman-Clayton procedure and is most commonly used on a rheumatoid forefoot with recalcitrant arthritis and deformity, as seen in the image. The 1st MTP joint is fused for stability while the lesser metatarsal heads are resected (resection arthroplasty) to allow motion in the lateral foot.
B. With her degree of hallux overlap, the only option to maintain a stable 1st metatarsophalangeal joint is with a fusion. This also does not address the hammer toes.
C. This may be an option in a very low-demand elderly patient with pain under the 2nd and 3rd toes due to the overlapping hallux. It likely is not appropriate for this patient.
D. This will not address her forefoot deformities and is more commonly performed for a flat foot reconstruction.

Remediation:
A. Bracing in the absence of a ligament injury or instability has not been shown to reliably improve anterior knee pain.
B. Evidence in the efficacy of glucosamine-chondroitin supplementation is currently lacking.
C. The history and examination are consistent with patellofemoral pain. Low-impact exercises, weight loss, and activity modifications more consistently relieve pain and improve function in patients with symptomatic anterior knee pain.
D. There is no robust evidence supporting the use of stem cell therapies in the management of anterior knee pain in a young patient.
E. A medial heel wedge is most effective at unloading the medial compartment of the knee. It has no effect on anterior knee pain.

Remediaton:
A. Referral to a pain management specialist is the best way to optimize this patient prior to her procedure. A 2016 study of chronic opioid users with end-stage arthritis found that those who were successfully weaned prior to their procedures had better postoperative outcomes than those who were not. While patients may try to decrease their daily morphine equivalent intake on their own, a weaning program is best managed by a pain specialist.
B. Chronic opioid use has been associated with worse postoperative outcomes, but that in itself is not necessarily a reason to decline to perform a procedure for a patient with the appropriate indications for surgery who could benefit from undergoing THA.
C. While PCA infusions were common 5 to 10 years ago, multimodal pain regimens including acetaminophen, nonsteroidal anti-inflammatory drugs, anticonvulsants, and smaller doses of opioids are more commonly used now to minimize postoperative opioid addiction risk. Chronic opioid use is considered a modifiable risk factor and can be addressed with a preoperative weaning program under the direction of a pain management specialist.
D. Chronic opioid use is considered a modifiable risk factor that can be addressed with a preoperative weaning program under the direction of a pain management specialist. As an orthopaedic surgeon, you are under no obligation to write prescriptions for chronic opioids to treat arthritis, and according to the American Association of Orthopaedic Surgeons (AAOS) guidelines, opioids are not a recommended treatment for hip or knee arthritis.