5. Sports Medicine MCQs

A 45-year-old heavy laborer has a massive, retracted, and irreparable subscapularis tendon tear. He complains of severe weakness with lifting objects in front of his body. Which tendon transfer is the most appropriate primary option to restore function?

A 55-year-old physically active man presents with an irreparable posterosuperior rotator cuff tear (supraspinatus and infraspinatus). The subscapularis is completely intact, and there is no glenohumeral arthritis. He has a severe external rotation lag. Which tendon transfer is most appropriate?

The 'terrible triad' of the shoulder is a distinct clinical entity commonly seen in middle-aged or older patients following high-energy trauma. Which three injuries comprise this triad?

A 21-year-old collegiate rugby player presents with his fourth anterior shoulder dislocation. A 3D CT scan is obtained to evaluate bone stock.

The imaging reveals 25% anterior glenoid bone loss. What is the most appropriate definitive surgical management?

A 28-year-old offensive lineman presents with deep posterior shoulder pain and clicking during bench pressing. Examination reveals a positive jerk test. If an MRI arthrogram is obtained, it is most likely to show a labral tear at which clock-face location on the right glenoid?

A 45-year-old male presents with acute shoulder pain and weakness after falling on an outstretched arm while skiing. Physical examination demonstrates increased passive external rotation compared to the contralateral side and a positive belly-press test. Which of the following structures is most likely injured?

A 24-year-old male is undergoing arthroscopic evaluation for recurrent anterior shoulder instability. Diagnostic arthroscopy reveals an 'engaging' Hill-Sachs lesion, but pre-operative CT scan showed minimal glenoid bone loss (<10%). Which of the following is the most appropriate management strategy?

A 19-year-old gymnast presents with bilateral shoulder pain and a sensation of her shoulders 'slipping' during routines. She has a positive sulcus sign bilaterally and generalized ligamentous laxity. Supervised physical therapy has failed to improve her symptoms after 6 weeks. What is the next best step in management?

During an arthroscopic rotator cuff repair, the surgeon evaluates the normal anatomical footprint on the greater tuberosity. Which of the following best describes the normal insertion site of the supraspinatus tendon?

A 22-year-old rugby player has recurrent anterior shoulder instability. CT scan with 3D reconstruction demonstrates 25% anterior glenoid bone loss. What is the most appropriate definitive management?

A 70-year-old man presents with an inability to actively elevate his right arm above 45 degrees, though passive elevation is full. Radiographs show superior migration of the humeral head with an acromiohumeral interval of 3 mm. MRI confirms a massive, retracted rotator cuff tear with Goutallier grade 4 fatty infiltration of the supraspinatus and infraspinatus. What is the best treatment option?

A 34-year-old man has chronic posterior shoulder pain and limited external rotation following a seizure 3 months ago. Radiographs confirm a missed posterior dislocation with an associated reverse Hill-Sachs defect involving 35% of the articular surface. The joint is reducible but unstable in internal rotation. What is the most appropriate management?

A 45-year-old man presents with anterior shoulder pain and weakness after a forceful external rotation injury. He demonstrates increased passive external rotation compared to the contralateral side. Which physical examination test is most sensitive and specific for his likely injury?

In the setting of recurrent anterior shoulder instability, the addition of an arthroscopic remplissage (infraspinatus tenodesis) to a Bankart repair is most appropriately indicated for which of the following scenarios?

A 50-year-old laborer undergoes a latissimus dorsi tendon transfer for an irreparable posterosuperior rotator cuff tear. To function effectively, the transferred latissimus dorsi primarily replicates the function of which native muscle?

A 28-year-old volleyball player presents with posterior shoulder pain and weakness in external rotation. MRI reveals a paralabral cyst in the spinoglenoid notch and a superior labral tear. Which physical examination finding is most likely to be present?

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?