Shoulder & Hip Sports MCQs

The concept of the "suspension bridge" model of the rotator cuff, described by Burkhart, emphasizes the importance of which intact structures in maintaining normal glenohumeral kinematics despite a supraspinatus tear?

A 45-year-old man sustains a severe fracture-dislocation of the proximal humerus. During an open reduction through a deltopectoral approach, brisk arterial bleeding is encountered near the inferior border of the subscapularis. Which vessel is most likely injured?

In performing a superior capsular reconstruction (SCR) for an irreparable supraspinatus tear, the graft is typically attached medially to the superior glenoid and laterally to the greater tuberosity. What is the primary biomechanical goal of this procedure?

During a Latarjet procedure, the coracoid process is osteotomized and transferred to the anterior glenoid. Which muscle tendon units are transferred with the coracoid to provide a dynamic "sling" effect?

A 22-year-old rugby player presents with recurrent anterior shoulder dislocations. Advanced imaging demonstrates 25% glenoid bone loss and an engaging Hill-Sachs lesion. What is the most appropriate definitive surgical management?

A 55-year-old laborer suffers from chronic shoulder pain and pseudoparalysis of external rotation. MRI reveals a massive, retracted, and fatty-infiltrated tear of the supraspinatus and infraspinatus with an intact subscapularis. Which of the following tendon transfers is most appropriate for restoring active external rotation?

A 45-year-old male presents with shoulder pain and weakness in internal rotation after a fall. Which of the following physical examination tests is most sensitive and specific for evaluating a tear of the upper border of the subscapularis tendon?

A 30-year-old weightlifter presents with vague posterior shoulder pain and a positive jerk test. Nonoperative management has failed. Imaging shows a posterior labral tear without significant glenoid bone loss. What is the most appropriate surgical intervention?

A 22-year-old throwing athlete experiences posterior shoulder pain during the late cocking phase. An MRI arthrogram reveals a partial articular-sided supraspinatus tendon tear and posterosuperior labral fraying. This condition is primarily associated with which of the following pathomechanics?

A 32-year-old athlete presents with isolated weakness in external rotation of the shoulder. MRI reveals a paralabral cyst causing nerve compression. Where is the cyst most likely located and which muscle will demonstrate isolated atrophy?

A 72-year-old man presents with progressive pseudoparalysis and severe glenohumeral osteoarthritis secondary to a massive rotator cuff tear. Which of the following is an absolute contraindication to performing a reverse total shoulder arthroplasty in this patient?

A 65-year-old male undergoes an arthroscopic biceps tenotomy for a symptomatic superior labral tear and associated biceps tendinopathy. Compared to biceps tenodesis, biceps tenotomy is associated with a significantly higher incidence of which of the following?

A 22-year-old rugby player presents with recurrent anterior shoulder instability. CT evaluation demonstrates a 25% anteroinferior glenoid bone loss (an "inverted pear" glenoid). What is the most appropriate surgical management?

During an arthroscopic stabilization for recurrent shoulder instability, an engaging Hill-Sachs lesion is noted with minimal glenoid bone loss. Which of the following procedures is indicated to address the humeral defect?

A 35-year-old man presents with shoulder pain and a locked arm in internal rotation after a first-time seizure. Radiographs reveal a posterior shoulder dislocation with an anteromedial humeral head defect (reverse Hill-Sachs lesion) involving 35% of the articular surface. What is the most appropriate surgical treatment?

A 55-year-old male sustains an acute traumatic anterior shoulder dislocation. After successful reduction, he complains of profound weakness in internal rotation. Which of the following physical examination tests is most sensitive for diagnosing an upper subscapularis tendon tear?

A 30-year-old professional volleyball player presents with posterior shoulder pain and isolated weakness in external rotation. MRI reveals a paralabral cyst located in the spinoglenoid notch. This finding is most commonly associated with which of the following concomitant labral pathologies?

A 22-year-old collegiate rugby player presents with recurrent anterior shoulder instability. A 3D CT scan demonstrates a 28% anterior glenoid bone defect. Which of the following is the most appropriate surgical treatment?

The stability of the glenohumeral joint relies heavily on balanced force couples. Which of the following muscular combinations forms the critical force couple that provides a compressive force across the joint in the transverse (axial) plane?

A 30-year-old overhead athlete presents with insidious onset, vague posterior shoulder pain. Examination reveals normal strength in forward elevation and internal rotation, but objective weakness in external rotation. An MRI reveals a paralabral cyst in the spinoglenoid notch. What is the underlying pathology causing this weakness?