100+ Free ABPS Orthopedic Surgery Practice Questions

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Question 1

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A 68-year-old undergoes primary total hip arthroplasty (THA) via the posterior approach. Which combination of acetabular component position is generally considered the Lewinnek 'safe zone' to minimize dislocation risk?

Inclination 20-30 degrees, anteversion 0-5 degrees

Inclination 30-50 degrees, anteversion 5-25 degrees

Inclination 55-65 degrees, anteversion 30-40 degrees

Inclination 70-80 degrees, anteversion 40-50 degrees

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2026 Statistics

Key Facts: ABPS Orthopedic Surgery Exam

~15%

Adult Reconstruction Weight

Largest single domain alongside trauma in BCOS blueprint

~15%

Orthopedic Trauma Weight

Largest single domain alongside adult reconstruction

100

FREE Practice MCQs

OpenExamPrep ABPS Orthopedic Surgery question bank

1 hour

Antibiotic Goal in Open Fractures

EAST/OTA/ACS guidelines for open long-bone fractures

<30 mmHg

Compartment Syndrome Delta P Threshold

Diastolic minus compartment pressure cutoff for fasciotomy

ABPS != ABMS

Credentialing Note

ABPS-BCOS is independent; ABOS (ABMS) is the more recognized orthopedic board

The ABPS Orthopedic Surgery Certification Exam (BCOS) is a multi-section computer-based test for MD/DO orthopedic surgeons with completed orthopedic training. The blueprint covers Adult Reconstruction, Trauma, Spine, Sports/Arthroscopy, Hand/Upper Extremity, Foot/Ankle, Pediatric Orthopaedics, Oncology, Basic Science, Infections, and Perioperative Complications. ABPS is independent of ABMS — the ABMS-affiliated ABOS is a different and more historically recognized credential, so verify hospital privileging and payer requirements before pursuing this pathway.

Sample ABPS Orthopedic Surgery Practice Questions

Try these sample questions to test your ABPS Orthopedic Surgery exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 68-year-old undergoes primary total hip arthroplasty (THA) via the posterior approach. Which combination of acetabular component position is generally considered the Lewinnek 'safe zone' to minimize dislocation risk?

A.Inclination 20-30 degrees, anteversion 0-5 degrees

B.Inclination 30-50 degrees, anteversion 5-25 degrees

C.Inclination 55-65 degrees, anteversion 30-40 degrees

D.Inclination 70-80 degrees, anteversion 40-50 degrees

Explanation: The classic Lewinnek safe zone for acetabular cup position is 40 +/- 10 degrees of inclination (30-50) and 15 +/- 10 degrees of anteversion (5-25). Position outside this range increases dislocation risk, although recent literature shows the zone is not absolute and spinopelvic mobility matters.

2A 72-year-old with primary osteoarthritis of the knee fails 6 months of nonoperative care. The MOST appropriate definitive surgical treatment is:

A.Arthroscopic debridement and lavage

B.High tibial osteotomy

C.Total knee arthroplasty

D.Knee arthrodesis

Explanation: Total knee arthroplasty (TKA) is the gold-standard definitive treatment for end-stage tricompartmental knee osteoarthritis in older patients who fail nonoperative care. Arthroscopic debridement provides no benefit for OA (Moseley NEJM 2002). HTO is reserved for younger active patients with isolated unicompartmental disease.

3Which bearing surface combination has the LOWEST volumetric wear rate in total hip arthroplasty?

A.Metal-on-conventional polyethylene

B.Metal-on-highly cross-linked polyethylene

C.Ceramic-on-ceramic

D.Metal-on-metal

Explanation: Ceramic-on-ceramic bearings have the lowest volumetric wear rate (<1 mm^3/year) of all THA bearings. Highly cross-linked polyethylene reduced wear dramatically over conventional PE, but ceramic-on-ceramic remains lowest. Concerns include squeaking and ceramic fracture (rare with modern fourth-generation ceramics).

4The MOST common organism cultured from acute periprosthetic joint infection (PJI) within 4 weeks of total joint arthroplasty is:

A.Cutibacterium acnes

B.Staphylococcus aureus (including MRSA) and coagulase-negative staphylococci

C.Pseudomonas aeruginosa

D.Candida albicans

Explanation: Staphylococci (S. aureus including MRSA, and coagulase-negative staph such as S. epidermidis) account for the majority of acute and chronic PJIs. Cutibacterium acnes is most common in shoulder PJI. Acute PJI within 4 weeks may be treated with debridement, antibiotics, and implant retention (DAIR) plus modular component exchange.

5According to the 2018 ICM (International Consensus Meeting) criteria for periprosthetic joint infection, which of the following is a MAJOR criterion that establishes the diagnosis on its own?

A.ESR >30 mm/hr

B.Two positive cultures of the same organism OR a sinus tract communicating with the joint

C.Synovial WBC >3,000/uL

D.Elevated CRP >10 mg/L

Explanation: Per 2018 ICM/MSIS major criteria, PJI is established by either (1) two positive periprosthetic cultures with the same organism, or (2) a sinus tract communicating with the joint or visualized prosthesis. Other findings (ESR, CRP, synovial WBC, alpha-defensin, leukocyte esterase, histology) are minor criteria that contribute points to a weighted score.

6An open tibial shaft fracture with extensive soft-tissue loss requiring rotational or free flap coverage is classified as which Gustilo-Anderson type?

A.Type I

B.Type II

C.Type IIIA

D.Type IIIB

Explanation: Gustilo-Anderson IIIB is an open fracture with extensive soft-tissue loss and periosteal stripping that requires flap coverage. IIIA has adequate local soft tissue. IIIC has associated arterial injury requiring vascular repair. Type I is <1 cm clean, Type II is 1-10 cm without extensive soft-tissue damage.

7The current evidence-based timing recommendation for IV antibiotic administration in an open long-bone fracture is:

A.Within 24 hours

B.As soon as possible, ideally within 1 hour of presentation

C.Only after operative debridement

D.Only if there is gross contamination

Explanation: Antibiotics should be given as early as possible, ideally within 1 hour of presentation (EAST, OTA, ACS guidelines). First-generation cephalosporin (cefazolin) is standard for type I and II; add aminoglycoside (or piperacillin-tazobactam) for type III; add penicillin for farm/soil contamination (anti-clostridial). Tetanus prophylaxis is also required.

8In the treatment of femoral shaft fractures in a hemodynamically stable adult, the gold-standard fixation is:

A.Long leg cast

B.Plate and screws

C.Antegrade reamed intramedullary nail

D.External fixation as definitive treatment

Explanation: Antegrade reamed intramedullary nailing is the gold-standard treatment for adult femoral shaft fractures, with union rates >95% and low complication rates. Reaming improves union by enhancing endosteal blood supply mediators. External fixation is used for damage-control orthopaedics in unstable polytrauma patients (later converted to IMN).

9A polytrauma patient with bilateral femur fractures, pulmonary contusion, and lactate of 5 mmol/L is BEST managed initially with:

A.Immediate bilateral antegrade reamed IMN (early total care)

B.Damage-control orthopaedics with external fixation, delayed definitive fixation when physiology improves

C.Skeletal traction for both femurs for 6 weeks

D.Bilateral plate fixation under tourniquet

Explanation: Damage-control orthopaedics (DCO) is favored in 'borderline' or unstable polytrauma patients (e.g., elevated lactate, base deficit, hypothermia, coagulopathy, severe chest injury). Temporary external fixation minimizes the second hit, with conversion to IMN once resuscitation parameters normalize, reducing ARDS and multi-organ failure risk.

10An anterior cruciate ligament (ACL) tear is MOST commonly associated with which mechanism in athletes?

A.Direct lateral blow to the knee

B.Non-contact pivoting/cutting with valgus and internal tibial rotation

C.Hyperextension only

D.Pure varus stress

Explanation: The classic non-contact ACL injury occurs during deceleration, pivoting, or landing with knee valgus and internal tibial rotation (or external rotation). Female athletes have a 2-8x higher rate. The 'unhappy triad' includes ACL, MCL, and medial meniscus (classically lateral meniscus is more commonly torn acutely with ACL).

About the ABPS Orthopedic Surgery Exam

The ABPS Orthopedic Surgery Certification Examination, administered by the Board of Certification in Orthopedic Surgery (BCOS) under the American Board of Physician Specialties (ABPS), validates the broad knowledge base required of practicing orthopedic surgeons. Content spans adult reconstruction (hip and knee arthroplasty, bearing surfaces, periprosthetic infection management), orthopedic trauma (open and closed fractures, polytrauma, damage-control orthopaedics, pelvic ring injuries, compartment syndrome), spine (cervical/thoracic/lumbar disorders, myelopathy, scoliosis, cauda equina), sports medicine and arthroscopy (ACL/PCL, meniscus, rotator cuff, shoulder instability, Latarjet, UCL), hand and upper extremity (carpal/cubital tunnel, scaphoid, flexor tendon zones, distal radius), foot and ankle (Lisfranc, Achilles, Charcot, hallux valgus, syndesmosis), pediatric orthopaedics (DDH, SCFE, Perthes, Salter-Harris, supracondylar fractures, septic vs transient synovitis), musculoskeletal oncology (osteosarcoma, Ewing, GCT, metastatic disease, Mirels score), basic science (collagen types, Wolff law, RANKL/OPG, BMP, fracture healing), infections (periprosthetic joint infection diagnostic criteria, septic arthritis), and perioperative complications (VTE prophylaxis, multimodal analgesia, TXA, heterotopic ossification, fat embolism). IMPORTANT: ABPS-BCOS is independent of ABMS; the ABOS (ABMS) is a different credential. Confirm hospital privileging and payer requirements before pursuing this certification pathway.

Questions

250 scored questions

Time Limit

~6-8 hours CBT (multi-session blueprint)

Passing Score

Criterion-referenced scaled score set by BCOS (modified Angoff standard)

Exam Fee

Application + examination fees in the multi-thousand-dollar range (ABPS/BCOS 2026 — verify current schedule) (American Board of Physician Specialties (ABPS) — Board of Certification in Orthopedic Surgery (BCOS). NOTE: ABPS is a separate certifying body from ABMS; the ABMS-affiliated American Board of Orthopaedic Surgery (ABOS) is a different and historically more recognized credential — verify hospital privileging requirements before pursuing.)

ABPS Orthopedic Surgery Exam Content Outline

~15%

Adult Reconstruction (Hip & Knee Arthroplasty)

Primary and revision total hip and knee arthroplasty, indications and contraindications, surgical approaches (posterior, direct anterior, anterolateral), Lewinnek safe zone (40 +/- 10 inclination, 15 +/- 10 anteversion) and spinopelvic mobility, bearing surfaces (highly cross-linked PE, ceramic-on-ceramic, metal-on-PE), femoral neck vs intertrochanteric fracture management, hemiarthroplasty vs THA, reverse total shoulder for cuff-tear arthropathy, fragility fracture secondary prevention, periprosthetic fracture (Vancouver), instability and dislocation management.

~15%

Orthopedic Trauma

Open fracture classification (Gustilo-Anderson I/II/IIIA/B/C), early antibiotic and tetanus prophylaxis, debridement timing, Gustilo-IIIB flap coverage, intramedullary nailing of femur and tibia, plate vs nail vs external fixation, damage-control orthopaedics in unstable polytrauma (lactate, base deficit, coagulopathy), pelvic ring injuries with hemodynamic instability (binder, MTP, angio-embolization, preperitoneal packing), distal radius ORIF (volar locking plate), Galeazzi/Monteggia, supracondylar humerus, calcaneus extensile lateral approach risks, terrible-triad elbow, axillary nerve in shoulder dislocation, compartment syndrome (4-compartment leg fasciotomy).

~10%

Spine

Cervical clearance (NEXUS, Canadian C-spine Rule), Hangman fracture (bilateral C2 pars), odontoid fractures, spinal cord syndromes (anterior, central, Brown-Sequard, posterior, conus, cauda equina), high-dose methylprednisolone NOT recommended routinely (AANS/CNS, AOSpine), cervical myelopathy (Hoffmann, hyperreflexia, gait), lumbar disc herniation (paracentral L4-L5 compresses traversing L5 root), cauda equina syndrome as a surgical emergency (decompression within 24-48 h), adolescent idiopathic scoliosis Cobb angle thresholds (BrAIST trial bracing 25-45 deg), spondylolysis/spondylolisthesis.

~12%

Sports Medicine & Arthroscopy

ACL injury (non-contact pivot, Lachman most sensitive, pivot-shift most specific), PCL and posterolateral corner (dial test at 30 vs 90), meniscus vascular zones (red-red 10-25%), rotator cuff (Hawkins-Kennedy, Neer, painful arc 60-120, supraspinatus most commonly torn), shoulder instability (Bankart, Hill-Sachs, Latarjet for >20-25% glenoid bone loss), posterior shoulder dislocation after seizure (lightbulb sign), UCL Tommy John repair/reconstruction, lateral epicondylitis (ECRB tendinosis), stress fracture imaging (MRI vs bone scan), concussion graduated return-to-play, RED-S/female athlete triad.

~9%

Hand & Upper Extremity

Carpal tunnel syndrome (median nerve, splinting/injection then release), cubital tunnel syndrome (ulnar nerve at elbow, Osborne ligament), De Quervain tenosynovitis (1st dorsal compartment APL/EPB, EPB subsheath), trigger finger (A1 pulley, steroid then release), Verdan flexor tendon zones (zone II 'no man's land'), scaphoid waist fracture (retrograde blood supply, headless compression screw for displaced/proximal pole), distal radius volar locking plate, Galeazzi (DRUJ), rheumatoid hand deformities (ulnar drift, swan-neck, boutonniere).

~9%

Foot & Ankle

Lisfranc injury (weight-bearing AP, fleck sign, ORIF or primary arthrodesis), plantar fasciitis (stretching/orthotics first), Achilles rupture (Thompson test; surgical or functional bracing equivalent), Charcot vs osteomyelitis (ulcer/probe-to-bone, MRI, biopsy gold standard), hallux valgus surgical algorithm (chevron vs proximal vs Lapidus by IMA/HVA), syndesmotic 'high ankle' sprain (squeeze, ER stress test, suture-button vs screws), Ottawa ankle/foot rules, calcaneus extensile lateral approach wound complications, peroneal subluxation, posterior tibial tendon dysfunction stages (Johnson-Strom).

~8%

Pediatric Orthopaedics

Developmental dysplasia of the hip (Ortolani/Barlow neonatal, Galeazzi after 3 months, Pavlik harness <6 months, closed/open reduction with spica then femoral/pelvic osteotomies after 18 months), SCFE (obese adolescent, Klein line, in situ percutaneous screw), Legg-Calve-Perthes (4-8 yo, lateral pillar Herring), Kocher criteria for septic arthritis (NWB, T>38.5, ESR>40, WBC>12,000), supracondylar humerus Gartland classification with CRPP for type III, Salter-Harris physeal classification (I-V), toddler fracture (spiral distal tibia 9 mo-3 yr), clubfoot Ponseti method.

~7%

Musculoskeletal Oncology

Most common primary malignant bone tumor in children/adolescents = osteosarcoma (metaphyseal, sunburst, Codman triangle), Ewing sarcoma (diaphyseal, onion-skin, EWS-FLI1 t(11;22)), giant cell tumor (epiphyseal after physeal closure, denosumab/curettage), aneurysmal bone cyst (Enneking aggressive benign), osteoid osteoma (night pain, NSAID-relieved, RFA), osteochondroma (most common benign; MHE syndrome), classic five bone metastasis primaries (breast, prostate, lung, kidney, thyroid — embolize renal/thyroid before surgery), Mirels scoring (>=9 prophylactic fixation), biopsy principles (longitudinal incisions, contamination of soft tissue planes).

~7%

Basic Science (Anatomy, Biomechanics, Biology)

Bone biology: cortical vs trabecular, Haversian remodeling, Wolff law, RANKL/RANK/OPG axis (denosumab anti-RANKL), BMPs (osteoinduction, BMP-2/7), VEGF, PDGF, TGF-beta. Fracture healing phases (inflammation, soft callus, hard callus via endochondral ossification, remodeling). Collagen types (Type I in bone/tendon/ligament; Type II in articular cartilage; Type III early healing). Articular cartilage avascular/aneural/alymphatic — chondrocyte nutrition via diffusion. Crystal arthropathy: gout (MSU, negative birefringent needles) vs CPPD (positive birefringent rhomboids). ABPS vs ABMS/ABOS distinction.

~5%

Musculoskeletal Infections

Acute hematogenous osteomyelitis (Staph aureus most common across pediatric ages; Kingella in <4 yo; Salmonella in sickle cell; Pseudomonas in puncture wound through sneaker), septic arthritis (synovial WBC >50,000, surgical drainage emergency, hip via open arthrotomy), 2018 ICM/MSIS criteria for periprosthetic joint infection (major: 2 positive cultures of same organism OR sinus tract; minor weighted score), DAIR vs two-stage revision (antibiotic-laden cement spacer + 4-6 wk IV antibiotics + reimplantation), Cutibacterium acnes in shoulder PJI.

~3%

Perioperative Complications & Optimization

VTE prophylaxis after THA/TKA (AAOS evidence-based — risk-stratified aspirin 81 mg BID 30-35 days for standard risk, LMWH/DOAC for high risk, mechanical compression), tranexamic acid (IV/topical equivalent, no increased VTE in selected patients), preoperative cefazolin within 60 min (vancomycin within 120 min for MRSA/severe allergy), modifiable PJI risk factors (HbA1c >7-8%, tobacco, BMI >40, malnutrition, MRSA colonization), ERAS multimodal analgesia (acetaminophen, NSAIDs, peripheral nerve blocks, periarticular injection), heterotopic ossification prophylaxis (indomethacin 6 wk OR 700-800 cGy XRT within 24-72 h), atypical femur fracture on long-term bisphosphonate, sciatic nerve in posterior THA, fat embolism syndrome (Gurd triad).

How to Pass the ABPS Orthopedic Surgery Exam

What You Need to Know

Passing score: Criterion-referenced scaled score set by BCOS (modified Angoff standard)
Exam length: 250 questions
Time limit: ~6-8 hours CBT (multi-session blueprint)
Exam fee: Application + examination fees in the multi-thousand-dollar range (ABPS/BCOS 2026 — verify current schedule)

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

ABPS Orthopedic Surgery Study Tips from Top Performers

1Master open fracture management end-to-end: Gustilo-Anderson classification (I <1 cm clean; II 1-10 cm; IIIA adequate soft tissue; IIIB flap needed; IIIC vascular repair), antibiotics within 1 hour (cefazolin for I/II; add aminoglycoside or piperacillin-tazobactam for III; add penicillin for soil/farm contamination), tetanus, urgent debridement, and timing of definitive fixation (early total care vs damage-control orthopaedics based on physiology — lactate, base deficit, coagulopathy, chest injury).

2Memorize the 2018 ICM (International Consensus Meeting) MSIS criteria for periprosthetic joint infection. MAJOR criteria (each diagnostic alone): two positive periprosthetic cultures of the same organism OR sinus tract communicating with the joint. MINOR criteria are weighted (elevated CRP/D-dimer/ESR, synovial WBC, alpha-defensin, leukocyte esterase, intraoperative purulence, histology). Two-stage revision remains the gold standard for chronic PJI: explant + antibiotic spacer, 4-6 weeks IV culture-directed antibiotics, then reimplantation.

3Drill VTE prophylaxis after primary THA/TKA per AAOS evidence-based guidance: standard-risk patients receive aspirin 81 mg BID for ~30-35 days plus mechanical compression (PEPPER trial supports aspirin for standard risk); high-risk patients receive LMWH or DOACs (rivaroxaban, apixaban). Modifiable PJI risk factors to optimize preoperatively: HbA1c <7-8%, tobacco cessation >=4 weeks, BMI <40 if possible, albumin >=3.5 g/dL, MRSA decolonization (mupirocin + CHG bath).

4Pediatric pearls: Kocher criteria for septic hip (non-weight-bearing, T >38.5 C, ESR >40, WBC >12,000) — 4 of 4 = ~99% probability; Pavlik harness for DDH <6 months (Ortolani/Barlow neonatal exam); SCFE in obese adolescents with Klein line failing to intersect epiphysis → urgent in situ percutaneous screw; supracondylar humerus Gartland III → urgent CRPP with assessment of AIN and brachial artery (pulseless pink hand can usually be observed; pulseless poorly perfused = open exploration).

5Cauda equina syndrome (saddle anesthesia, urinary retention/incontinence, bilateral lower extremity weakness, bowel incontinence) is a SURGICAL EMERGENCY requiring decompression within 24-48 hours of symptom onset. Routine high-dose IV methylprednisolone (NASCIS) for acute SCI is NO LONGER recommended by AANS/CNS and AOSpine guidelines as standard of care due to lack of clear functional benefit and real risks (infection, GI bleed, hyperglycemia).

6Know the ABPS vs ABMS/ABOS distinction cold — this comes up on practice context. The American Board of Physician Specialties (ABPS) is INDEPENDENT of ABMS. The ABMS-affiliated American Board of Orthopaedic Surgery (ABOS) is the more historically recognized orthopedic credential. ABPS-BCOS exists as an alternative pathway, but hospital privileging, network credentialing, and payer recognition vary by institution — always verify acceptance before pursuing this route.

7Mirels score predicts impending pathologic fracture in metastatic bone lesions (site, pain, lesion type, size; max 12 points). Score >=9 → prophylactic fixation (cephalomedullary nail for proximal femur) BEFORE radiation. Score <=7 → radiation alone. The classic five primary tumors metastasizing to bone are breast, prostate, lung, kidney (renal cell), and thyroid — embolize renal cell and thyroid metastases preoperatively due to vascularity.

8Compartment syndrome high-yield: PAIN out of proportion to injury (especially with passive stretch) is the EARLIEST sign — pulses are typically present until late. Delta P (diastolic minus compartment pressure) <30 mmHg confirms diagnosis. Four compartments of the leg = anterior, lateral, superficial posterior, deep posterior — released via two-incision (anterolateral and posteromedial) fasciotomy. Missing compartment syndrome is the classic high-stakes clinical scenario tested on every orthopedic exam.

Frequently Asked Questions

What is the ABPS Orthopedic Surgery Certification Examination?

The ABPS Orthopedic Surgery Certification Examination is administered by the Board of Certification in Orthopedic Surgery (BCOS) under the American Board of Physician Specialties (ABPS). It assesses knowledge across the full breadth of orthopedic surgery — adult reconstruction, trauma, spine, sports/arthroscopy, hand/upper extremity, foot/ankle, pediatric orthopaedics, musculoskeletal oncology, basic science, infections, and perioperative complications. IMPORTANT: ABPS is independent of ABMS; the ABMS-affiliated American Board of Orthopaedic Surgery (ABOS) is a different and historically more recognized credential — verify hospital privileging requirements before pursuing this pathway.

Who is eligible to take the BCOS Orthopedic Surgery exam?

Eligibility generally requires an MD or DO degree with a valid unrestricted medical license, completion of an ACGME, AOA, or ABPS-recognized orthopedic surgery residency (or equivalent training pathway approved by BCOS), letters of reference from peers or training directors, and adherence to ABPS Code of Ethics. Always verify current eligibility, application requirements, and any required practice-experience criteria directly on the ABPS website before applying.

What is the format of the exam?

The BCOS Orthopedic Surgery exam is a computer-based test of single-best-answer multiple-choice questions blueprinted across the orthopedic content outline. Items cover adult reconstruction (~15%), trauma (~15%), sports/arthroscopy (~12%), spine (~10%), hand/upper extremity (~9%), foot/ankle (~9%), pediatric orthopaedics (~8%), oncology (~7%), basic science (~7%), infections (~5%), and perioperative complications (~3%). Testing is at secure CBT centers. Confirm the exact item count and time limits in the current ABPS/BCOS candidate handbook.

How much does the 2026 exam cost?

ABPS/BCOS publishes specific application and examination fees on its website; total cost for orthopedic surgery board examinations is typically in the multi-thousand-dollar range. Always verify current fees directly with ABPS before applying. Candidates should also budget for board-prep resources (textbooks, question banks, review courses) and ongoing Continuous Certification (CC) fees after passing.

How is the exam scored?

BCOS uses criterion-referenced scaled scoring with a passing standard set by content-expert subject-matter experts using the modified Angoff method. A candidate's pass/fail result depends on performance relative to the fixed cut-score, not on other candidates. Score reports typically include domain-level feedback so candidates know their strongest and weakest content areas.

How is ABPS Orthopedic Surgery (BCOS) different from ABOS?

The American Board of Physician Specialties (ABPS) is an independent multi-specialty certifying body that is SEPARATE from the American Board of Medical Specialties (ABMS). The American Board of Orthopaedic Surgery (ABOS) is the ABMS-member board for orthopedic surgery and is the more historically recognized credential by hospitals, insurers, and most academic institutions. The ABPS-BCOS pathway exists as an alternative, but recognition for hospital privileging, network credentialing, and payer enrollment varies — verify acceptance with your specific hospital and payers before pursuing this pathway.

What are the highest-yield topics?

Highest-yield topics include: open fracture Gustilo-Anderson classification with antibiotic timing; compartment syndrome (pain with passive stretch is the earliest sign; 4-compartment leg fasciotomy); damage-control orthopaedics in polytrauma; cauda equina as surgical emergency; pediatric DDH/SCFE/Perthes/Kocher criteria; ACL Lachman/pivot-shift; rotator cuff and reverse TSA indications; periprosthetic joint infection 2018 ICM criteria and two-stage revision; Mirels score for impending pathologic fracture; Wolff law and RANKL/BMP biology; VTE prophylaxis (aspirin BID 30-35 days for standard-risk THA/TKA); cefazolin prophylaxis within 60 minutes; tranexamic acid use; and the ABPS vs ABMS/ABOS distinction.

How should I study for this exam?

Use a structured 6-12 month plan. Map to the BCOS content outline, drilling adult reconstruction and trauma first (largest weights), then sports, spine, hand, foot/ankle, peds, oncology, basic science, infections, and perioperative. Use core textbooks (Miller's Review of Orthopaedics, Campbell's Operative Orthopaedics, AAOS OKU series, Rockwood and Green's Fractures), high-volume MCQ practice (OrthoBullets, AAOS SAE), and at least 2-3 timed full-length mock exams. Map clinical experience and recent operative cases to corresponding blueprint topics each week.