Computer-Assisted Surgery

Computer-Assisted Surgery Indian Medical PG Question 1: Which intervention has shown the highest return on investment in national STI control programs?

• A. Mobile testing units
• B. Online partner notification
• C. Integration with HIV services (Correct Answer)
• D. Mass media campaigns

Computer-Assisted Surgery Explanation: ***Integration with HIV services*** - This approach offers the **highest return on investment** for national STI control programs as it leverages existing infrastructure and funding for HIV services, maximizing resource utilization. - **Syndromic management of STIs integrated with HIV care** allows for efficient screening, diagnosis, and treatment of both conditions simultaneously, reaching high-risk populations effectively. - **India's National AIDS Control Programme (NACP)** successfully demonstrates this model, with STI/RTI services integrated into HIV testing and counseling centers, reducing duplication and operational costs. - **WHO guidelines strongly recommend** this integration strategy as the most cost-effective approach for national STI control programs, particularly in resource-limited settings. *Mobile testing units* - While helpful for reaching underserved populations, **mobile units have high operational costs** including staffing, vehicle maintenance, and equipment, which significantly limit their overall return on investment. - Their effectiveness is often localized and may not provide broad, sustainable impact across an entire national program compared to integrated services. *Online partner notification* - This method's reach is limited by **digital literacy and access barriers**, potentially excluding high-risk groups without internet access, particularly relevant in the Indian context. - While it can improve partner tracing in certain populations, the initial setup costs and limited universal applicability reduce its overall cost-effectiveness compared to integrated clinical services. *Mass media campaigns* - These campaigns require **significant financial investment** for broadcast time and creative development, with outcomes that are difficult to quantify in terms of direct STI reduction. - While effective for raising general awareness, they generate less measurable return on investment for direct STI control services compared to targeted clinical interventions like integrated service delivery.

Computer-Assisted Surgery Indian Medical PG Question 2: The operative procedure known as "microfracture" is done for the

• A. Delayed union of femur
• B. Osteochondral defect of femur (Correct Answer)
• C. Non union of tibia
• D. Loose bodies of ankle joint

Computer-Assisted Surgery Explanation: ***Osteochondral defect of femur*** - **Microfracture** is a surgical technique used to stimulate the growth of **fibrocartilage** in areas of damaged articular cartilage, such as an **osteochondral defect**. - It involves creating small holes in the **subchondral bone** to allow stem cells and growth factors from the bone marrow to form a new reparative tissue. *Delayed union of femur* - **Delayed union** typically involves an extended time for fracture healing, which is often managed through prolonged immobilization, **bone grafting**, or sometimes revision surgery. - Microfracture specifically targets cartilage repair, not the process of **bony union** after a fracture. *Non union of tibia* - **Non-union** refers to the failure of a fractured bone to heal within a reasonable timeframe, often requiring surgical intervention with **bone grafts** or **internal fixation**. - This condition involves bone healing problems, distinct from cartilage defects that microfracture addresses. *Loose bodies of ankle joint* - **Loose bodies** in a joint are typically removed surgically, often arthroscopically, to relieve pain and prevent joint damage. - This procedure does not involve the repair of cartilage defects, which is the primary goal of microfracture.

Computer-Assisted Surgery Indian Medical PG Question 3: The most common approach for total hip arthroplasty is

• A. Anteromedial
• B. Posteromedial
• C. Anterolateral
• D. Posterolateral (Correct Answer)

Computer-Assisted Surgery Explanation: ***Posterolateral*** - The **posterolateral approach** is the most widely adopted and versatile surgical technique for **total hip arthroplasty (THA)**. - It offers excellent exposure of the hip joint, allowing for efficient component placement and often results in **lower blood loss** compared to other approaches. *Anteromedial* - The **anteromedial approach** is rarely used for THA due to poor exposure of the acetabulum and femoral canal. - It carries a higher risk of injury to crucial neurovascular structures, such as the **femoral artery** and **vein**. *Posteromedial* - The **posteromedial approach** is not a standard or commonly recognized surgical approach for total hip arthroplasty. - Surgical approaches are typically classified as anterior, anterolateral, direct lateral, or posterolateral. *Anterolateral* - The **anterolateral approach** involves splitting the **tensor fascia lata** and detaching the **gluteus medius** from the greater trochanter. - While it has a lower risk of posterior dislocation, it can be associated with a higher incidence of **abductor muscle weakness** and limping post-operatively.

Computer-Assisted Surgery Indian Medical PG Question 4: Investigation of choice for intramedullary SOL is -

• A. MRI (Correct Answer)
• B. USG
• C. CT
• D. X-ray

Computer-Assisted Surgery Explanation: ***MRI*** - **Magnetic Resonance Imaging (MRI)** is the investigation of choice for intramedullary lesions due to its superior **soft tissue contrast** and ability to visualize the **spinal cord** parenchyma. - It provides detailed information on lesion size, location, and internal characteristics, which is crucial for diagnosis and surgical planning. *USG* - **Ultrasound (USG)** has limited utility for intramedullary lesions as a primary diagnostic tool because **bone impedes sound waves**, making it difficult to visualize structures within the spinal canal. - It might be used for neonatal spinal screening or intraoperative guidance, but not for definitive diagnosis of intramedullary lesions in adults. *CT* - **Computed Tomography (CT)** excels at visualizing **bone structures** and calcifications, but it provides less detailed information about soft tissue elements like the spinal cord compared to MRI. - While it can identify bony changes associated with intramedullary lesions, it is not the preferred initial imaging modality for characterizing the lesion itself. *X-ray* - **X-rays** provide basic imaging of bone but offer essentially **no visualization of soft tissues** such as the spinal cord or intramedullary lesions. - They are primarily used to identify gross bony abnormalities like fractures or severe degenerative changes, not for subtle intraspinal pathologies.

Computer-Assisted Surgery Indian Medical PG Question 5: All of the following are described surgical procedures for CTE V except -

• A. Dwyer's osteotomy
• B. Salter's osteotomy (Correct Answer)
• C. Posteromedial soft tissue release
• D. Triple Arthrodesis

Computer-Assisted Surgery Explanation: ***Salter's osteotomy*** - **Salter's osteotomy** is a procedure primarily used for treating **developmental dysplasia of the hip (DDH)**, aiming to redirect the acetabulum. - It is not a described surgical procedure for the correction of **congenital talipes equinovarus (CTEV)**. *Dwyer's osteotomy* - **Dwyer's osteotomy** is a surgical procedure performed on the **calcaneus** to correct **hindfoot varus**, typically seen in CTEV. - It involves removing a wedge of bone from the lateral aspect of the calcaneus. *Posteromedial soft tissue release* - This is a common and traditional surgical procedure for correcting severe **CTEV** by addressing the contracted soft tissues on the medial and posterior aspects of the foot. - It involves releasing structures such as the **tibial tendon**, **flexor digitorum longus**, **flexor hallucis longus**, and the **posterior ankle joint capsule**. *Triple Arthrodesis* - **Triple arthrodesis** is a salvage procedure that involves fusing three joints in the foot: the **talonavicular**, **calcaneocuboid**, and **subtalar** joints. - It is used in older children or adolescents with severe, rigid, or recurrent CTEV, often after failed conservative or primary surgical treatments.

Computer-Assisted Surgery Flashcard 1 of 5

Question: The components of Mirels scoring system are _____, Pain, Size and Lesion

Answer: Site

Computer-Assisted Surgery Flashcard 2 of 5

Question: _____ system of classification is used for staging Benign Musculoskeletal tumors.

Answer: Enneking

Computer-Assisted Surgery Flashcard 3 of 5

Question: _____ is the creation of the scaffold to support the ingrowth of blood vessels, perivascular tissue, and osteoprogenitor cells.

Answer: Osteoconduction

Computer-Assisted Surgery Flashcard 4 of 5

Question: _____ gait is seen in SCFE

Answer: Outward facing toe

Computer-Assisted Surgery Flashcard 5 of 5

Question: _____ can be used with ilizarov technique and also for internal fixation of small bones

Answer: K-wire (K-wire/Steinmann pin)