Shoulder & Hip Sports MCQs

A 19-year-old collegiate wrestler undergoes MR arthrography after multiple anterior shoulder dislocations. The report describes an ALPSA lesion. How does an ALPSA lesion anatomically differ from a classic Bankart lesion?

A 22-year-old football player undergoes arthroscopy for recurrent anterior shoulder instability. The surgeon identifies an anterior capsulolabral injury where the labrum is stripped from the glenoid, but the underlying periosteum remains intact, allowing the labrum to displace medially and inferiorly. What is the specific term for this lesion?

A randomized controlled trial concludes that there is no difference in functional outcomes between two surgical techniques for rotator cuff repair. The authors report that the study was appropriately powered at 0.80. Statistical power is best defined as the probability of which of the following?

An overhead throwing athlete is diagnosed with a Type II SLAP tear. During arthroscopic repair, the surgeon evaluates the biceps anchor. The typical anatomy of a Type II SLAP tear involves detachment of the superior labrum and the origin of the long head of the biceps. Which structural variation must the surgeon be careful not to mistake for a pathologic labral tear during this procedure?

A 22-year-old collegiate baseball pitcher presents with posterior shoulder pain during the late cocking phase of throwing. Magnetic resonance imaging reveals a partial articular-sided tear of the supraspinatus and posterosuperior labral fraying. These findings are the hallmark of which of the following conditions?

A 15-year-old boy presented with inability to elevate his right shoulder and flex his elbow. He sustained a fall from an all-terrain vehicle 8 weeks ago. He landed on the right shoulder and twisted his neck. Radiographs of the skull, chest, cervical and thoracic spine, and shoulder were normal. There was no loss of consciousness, chest pain, or breathing difficulties. The patient was observed in the hospital until stable and referred for follow-up in the hand clinic at 4 weeks. An electromyelogram (EMG) was scheduled. Clinical examination revealed weakness of deltoid, supraspinatus, infraspinatus, teres minor, biceps, brachialis, brachioradialis, and extensor carpi radialis longus. The remainder of his forearm musculature was preserved and he could grasp, release, and pinch. Sensations were decreased along the distribution of the axillary nerve. There was 3 cm wasting of his arm and 2 cm of the forearm. Tinel's sign is positive around the clavicle. Horner's signs are absent and his arm lies against the body. The EMG report showed fibrillation potentials in the weak muscles. The patient can now flex his elbow. When asked to demonstrate, he flexes his wrist and pronates his forearm to swing his elbow into flexion. The least helpful test in further management of this patient is:

A 15-year-old boy presented with inability to elevate his right shoulder and flex his elbow. He sustained a fall from an all-terrain vehicle 8 weeks ago. He landed on the right shoulder and twisted his neck. Radiographs of the skull, chest, cervical and thoracic spine, and shoulder were normal. There was no loss of consciousness, chest pain, or breathing difficulties. The patient was observed in the hospital until stable and referred for follow-up in the hand clinic at 4 weeks. An electromyelogram (EMG) was scheduled. Clinical examination revealed weakness of deltoid, supraspinatus, infraspinatus, teres minor, biceps, brachialis, brachioradialis, and extensor carpi radialis longus. The remainder of his forearm musculature was preserved and he could grasp, release, and pinch. Sensations were decreased along the distribution of the axillary nerve. There was 3 cm wasting of his arm and 2 cm of the forearm. Tinel's sign is positive around the clavicle. Horner's signs are absent and his arm lies against the body. The EMG report showed fibrillation potentials in the weak muscles. The patient can now flex his elbow. When asked to demonstrate, he flexes his wrist and pronates his forearm to swing his elbow into flexion. The most important indication for early exploration in this patient is:

A 22-year-old rugby player presents with recurrent anterior shoulder instability. A 3D CT scan reveals 28% anterior glenoid bone loss. Which of the following surgical interventions is most appropriate to restore stability?

A 22-year-old collegiate wrestler suffers recurrent anterior shoulder dislocations. Advanced imaging reveals an 'off-track' Hill-Sachs lesion and a 25% anterior glenoid bone loss. What is the most appropriate definitive surgical intervention?

The 'horn blower's sign' (Patte's test) is used during a physical examination to evaluate the integrity of which of the following rotator cuff muscles?

A 24-year-old overhead athlete undergoes surgical stabilization for recurrent anterior shoulder instability. The surgeon performs a 'Remplissage' procedure to address a large, engaging Hill-Sachs defect. This procedure involves the capsulotenodesis of which structure into the humeral defect?

A 24-year-old rugby player undergoes evaluation for recurrent anterior shoulder instability. Advanced imaging reveals a large 'engaging' Hill-Sachs lesion and a glenoid bone loss measured at 28%. What is the most appropriate surgical intervention?

A 22-year-old baseball pitcher presents with posterior shoulder pain during the late cocking phase of throwing. MRI arthrogram reveals a 'peel-back' lesion of the superior labrum. What is the primary pathophysiologic mechanism of internal impingement in this athlete?

A 22-year-old football player with recurrent anterior shoulder dislocations is found to have 25% bipolar bone loss (glenoid and Hill-Sachs lesion). Which of the following is the most appropriate surgical intervention?

A 22-year-old rugby player undergoes preoperative evaluation for recurrent anterior shoulder instability. A 3D-CT scan reveals a large Hill-Sachs lesion. Based on the 'glenoid track' concept, what specific feature categorizes his Hill-Sachs lesion as 'engaging' (off-track)?

A 22-year-old rugby player has suffered multiple anterior shoulder dislocations. Pre-operative advanced imaging demonstrates 25% anterior glenoid bone loss. Which of the following surgical procedures is most appropriate to minimize recurrence?

A 50-year-old male sustains a traumatic anterior shoulder dislocation. After reduction, he continues to have severe anterior shoulder pain and significant weakness in internal rotation. Examination demonstrates a positive lift-off test. Given this specific injury pattern, which adjacent structure is at the highest risk for subluxation or instability?

A 22-year-old baseball pitcher presents with vague anterior shoulder pain. An MRI arthrogram reveals a SLAP tear. Which type of SLAP lesion involves detachment of both the superior labrum and the origin of the long head of the biceps tendon from the supraglenoid tubercle?

A 20-year-old athlete undergoes arthroscopic evaluation for recurrent anterior shoulder instability. An 'engaging' Hill-Sachs lesion is identified. What is the most appropriate concurrent procedure to perform alongside an arthroscopic Bankart repair?

The Instability Severity Index Score (ISIS) is used to predict the risk of recurrent anterior shoulder instability following arthroscopic Bankart repair. Which of the following is NOT a parameter evaluated in the ISIS?