Remediation:
A. When well-fixed to the proximal aspect of the femur, fracture fixation may be performed without revision of the femoral prosthesis as fracture healing is what is needed and not restoration of stability of the femoral prosthesis.
B. When well-fixed to the proximal aspect of the femur (Vancouver B1), fracture fixation may be performed without revision of the femoral prosthesis.
C. A Vancouver B2 injury is one in which the femoral stem is loose within the proximal aspect of the femur. When the femoral prosthesis is loose, it should be revised with a long, porous-coated, distal-fitting stem with repair of the fracture. In this case, the femoral stem is stable in the proximal aspect of the femur.
D. In a Vancouver B2 injury, the femoral component is loose and must be revised in addition to repair of the fracture.

Remediation:
A. The patient has posteromedial impingement that has not responded to nonoperative management. Debridement and removal of loose bodies is indicated.
B. There is a negative moving valgus stress test. This is not an ulnar collateral ligament injury.
C. The computed tomography scan shows posteromedial impingement. The patient has failed nonoperative measures and surgery is now indicated.
D. The patient has posteromedial impingement and requires debridement and removal of loose bodies. There is no fracture requiring fixation.

Remediation:
A. Spinal stenosis decompression in patients >80 years old in the Spine Patient Outcomes Research Trial (SPORT) trial provided clinical benefits with a risk profile that was similar to that seen in younger patients. Advanced age did not increase the risk of reoperation.
B. This is a nebulous term that applies in some degree to essentially all octogenarians. For instance, diabetes does substantially increase the risk of infection, but it is not the greatest of the risks for reoperation listed.
C. Level I evidence (Forsth, et al.) shows that among patients with lumbar spinal stenosis, decompression plus fusion surgery did not result in better clinical outcomes at 2 years and 5 years than decompression alone. While some studies have shown no increased rate in reoperation following fusion, Deyo, et al. reviewing Medicare claims, identified that adding complex arthrodesis at the index operation was the greatest risk of reoperation at 4 years among the factors listed in this question.
D. Reoperation rate is more common after revision (17%) than primary (11%) surgery at 4 years postoperatively.

Remediation:
A. In a study showing the hierarchy for reducing an adduction deficit (scapular abutment and notching), an anatomic humeral neck-shaft angle of the humeral socket is the most important factor.
B. While a lateralized glenosphere reduces scapular notching, the most important factor is using an anatomic humeral neck-shaft angle of the humeral socket.
C. While inferior tilt of the baseplate can reduce scapular notching and reduce baseplate failure, the most important factor is the use of an anatomic neck-shaft angle of the humeral socket.
D. While this can lead to a reduced rate of scapular notching, the most important factor is the use of an anatomic neck-shaft angle of the humeral socket.

Remediation:
A. Observation is indicated in asymptomatic fibrous dysplasia lesions. This patient is having hip pain and therefore further treatment should be considered.
B. The clinical scenario suggests fibrous dysplasia, but a long differential remains for this particular patient. Biopsy is the first step in treatment of this bone lesion to confirm the diagnosis of fibrous dysplasia.
C. The clinical scenario suggests fibrous dysplasia, but a long differential remains for this particular patient. Biopsy is the first step in treatment of this bone lesion to confirm the diagnosis of fibrous dysplasia.
D. The clinical scenario suggests fibrous dysplasia, but a long differential remains for this particular patient. Biopsy is the first step in treatment of this bone lesion to confirm the diagnosis of fibrous dysplasia.
E. Wide-resection may be indicated in malignant bone lesions. Fibrous dysplasia is a non-malignant condition and rarely cured by wide resection. A definitive operative approach would involve prophylactic fixation.

Remediation:
A. The use of phenol is not justified due to systemic toxicity and lack of evidence that it provides any added benefit.
B. Local curettage with local adjuvant therapy provides adequate local control for most patients, and wide resection is not needed.
C. Denosumab may be considered for challenging or nonresectable tumors.
D. Giant cell tumor of bone has a high rate of local recurrence, which may be decreased by local adjuvant therapies such as high-speed bur, cryoablation, argon beam coagulation, or PMMA. The treatment of a contained local recurrence can often be effectively done with repeat intralesional treatment with further local adjuvant therapy.

Remediation:
A. Pediatric patients with trigger finger are treated with release of the A1 pulley and excision of a slip of the flexor digitorum superficialis.
B. Release of the A3 pulley is not routinely indicated in pediatric patients with trigger finger.
C. Excision of a slip of the flexor digitorum superficialis should be performed after A1 pulley release in a pediatric patient with a trigger finger.
D. Release of the lumbrical is not routinely indicated in pediatric patients with a trigger finger.

Remediation:
A. Type II deformity is characterized by lateral bowing of the 5th metatarsal.
B. Type III deformity is characterized by Increased 4-5 IMA (> 9°)
C. Type I deformity is characterized by an enlarged 5th metatarsal head, as demonstrated in the radiograph.
D. Marginal osteophyte formation may be found in arthritic disease. Type IV disease involves a combination of findings from types I-III and may be found in patients with rheumatoid arthritis.

Remediation:
A. AAOS reports inconclusive evidence for manual therapy.
B. According to the AAOS clinical practice guidelines, there is strong evidence for low-impact aerobic activity.
C. AAOS reports moderate evidence for weight loss in patients with a body mass index > 25 kg/m²
D. AAOS reports strong evidence against the use of acupuncture for osteoarthritis of the knee

Remediation:
A. Both a positive erythrocyte sedimentation rate and a positive C-reactive protein level constitute the strictest threshold for a periprosthetic joint infection. Thus, this response has the highest specificity as there are the fewest number of false positives.
B. Either a positive erythrocyte sedimentation rate or a positive C-reactive protein level is a broad criterion for a periprosthetic joint infection and though highly sensitive, is not very specific as there will be false positives.
C. A positive erythrocyte sedimentation rate in combination with a positive C-reactive protein level is more specific than a positive erythrocyte sedimentation rate alone.
D. A positive C-reactive protein level in combination with a positive erythrocyte sedimentation rate is more specific than a positive C-reactive protein level alone.