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  • Print publication year: 2012
  • Online publication date: November 2012

Chapter 2 - Hip structured oral questions

from Section 2 - Adult Elective Orthopaedics and Spine


All viva questions outlined here are examples of actual questions asked in the FRCS (Tr & Orth) exam. Currently each viva question lasts 5 minutes and examiners are advised against switching to another topic earlier even if a candidate knows the subject well. Therefore to give a more realistic 5-minute viva question some topics have been combined from several smaller disjointed accounts from the old-style viva.

We have aimed the candidates’ answers for a 7–8 score so they are significantly more detailed than what would be required for a bare pass. Aiming for the minimum to pass will generally be unsuccessful and is not recommended. On a few occasions we have answered questions in a less detailed manner so as to allow readers to gauge the differences in potential scores.

Structured oral examination question 1

EXAMINER: This is a radiograph of a 77-year-old woman who sustained a displaced intracapsular fractured neck of femur 3 years earlier managed with a hemiarthroplasty of the hip (see Figure 2.1). She was admitted onto the orthopaedic ward last night because of increasing left hip pain and difficulty mobilizing.

CANDIDATE: This is an anteroposterior (AP) radiograph of the pelvis taken on the 11/5/11 demonstrating a cemented Thompson’s hemiarthroplasty of the left hip. The neck cut is straight down on to the lesser trochanter. The prosthesis seems to have sunk below the lesser trochanter and there are radiolucencies in Gruen zones 1, 4, 5 and 7. There appears to be a faint rim of calcification in the soft tissues, adjacent to the lateral cortex of the femur. The femoral head size would seem to match the acetabulum so it is not under or oversized and the femoral stem orientation appears neutral, neither excessively anteverted nor retroverted. I would like to see immediate postoperative radiographs to confirm whether there has been a change in stem position fromthe time of the original surgery and would also like to see an up-to-date lateral radiograph of the hip.