5. Sports Medicine MCQs

A 24-year-old rock climber undergoes diagnostic arthroscopy for recurrent anterior shoulder instability. The surgeon identifies a deep, engaging posterolateral humeral head defect. To prevent this lesion from engaging the anterior glenoid rim during abduction and external rotation, the surgeon performs a Remplissage. Which structure is tenodesed into the humeral defect?

A 65-year-old man sustains a traumatic anterior shoulder dislocation. After closed reduction in the emergency department, he presents 2 weeks later complaining of inability to raise his arm. He has no numbness or tingling. Radiographs are normal. Physical examination reveals active forward elevation to 45 degrees and a positive drop arm test. What is the most appropriate next step in management?

A 45-year-old recreational tennis player has persistent shoulder pain despite 6 months of conservative management. An MRI arthrogram reveals an articular-sided partial-thickness supraspinatus tendon tear measuring 7 mm in depth (approximately 60% of the tendon thickness). What is the recommended surgical management?

A 45-year-old manual laborer presents with chronic shoulder weakness. MRI demonstrates a massive, retracted supraspinatus and infraspinatus tear with Goutallier grade 4 fatty infiltration. The subscapularis and teres minor are intact, and there is no glenohumeral arthritis. Which of the following is the most appropriate surgical option?

A 22-year-old rugby player has recurrent anterior shoulder instability. CT scan indicates 28% anterior glenoid bone loss.

What is the most appropriate management?

A 35-year-old man presents with a locked posterior shoulder dislocation after a seizure. CT scan confirms a reverse Hill-Sachs lesion involving 25% of the anterior articular surface. What is the most appropriate surgical treatment?

A 42-year-old recreational tennis player has persistent anterior shoulder pain. MRI shows a Type II SLAP tear. After 6 months of failed physical therapy, surgery is planned. Compared to SLAP repair, primary biceps tenodesis in this demographic is associated with:

A 62-year-old male presents with weakness in internal rotation. On physical exam, he is instructed to place his hand on his contralateral shoulder and resist the examiner's attempt to pull the hand away. Which specific structure is being isolated and tested?

A 45-year-old man presents with anterior shoulder pain and weakness after a fall with his arm externally rotated. He has a positive bear-hug test and increased passive external rotation compared to the contralateral side. What is the most likely diagnosis?

A 22-year-old rugby player has recurrent anterior shoulder instability. A CT scan reveals 26% anterior glenoid bone loss. Which of the following is the most appropriate surgical intervention?

A 35-year-old man presents to the ER after a generalized seizure. His arm is locked in internal rotation. Radiographs show a "lightbulb" sign on the AP view. What is the most common associated bony defect?

During an arthroscopic evaluation of a 25-year-old with recurrent anterior shoulder instability, the surgeon notes avulsion of the inferior glenohumeral ligament from the anatomic neck of the humerus.

What is this lesion called?

A 32-year-old volleyball player presents with insidious onset of posterior shoulder pain and profound isolated weakness in external rotation. Atrophy is noted in the infraspinatus fossa, while the supraspinatus fossa is normal. Where is the most likely site of nerve entrapment?

The rotator interval is a triangular space in the anterosuperior shoulder. Which of the following structures is anatomically located within the rotator interval?

A 26-year-old patient with recurrent anterior shoulder dislocations is found to have an "engaging" Hill-Sachs lesion during diagnostic arthroscopy. Which of the following procedures is most appropriate to combine with an arthroscopic Bankart repair?

A 22-year-old elite baseball pitcher presents with posterior shoulder pain during the late cocking phase of throwing. He has a positive Jobe relocation test and glenohumeral internal rotation deficit (GIRD).

What is the primary pathophysiologic mechanism?

A 30-year-old bodybuilder feels a sudden pop and pain in his anterior shoulder while performing a heavy bench press. Examination shows loss of the anterior axillary fold and weakness in internal rotation. MRI confirms a rupture of the pectoralis major at its humeral insertion. What is the recommended treatment?

Which type of Superior Labrum Anterior to Posterior (SLAP) tear is characterized by a bucket-handle tear of the superior labrum with the biceps anchor remaining solidly attached to the glenoid?

A 20-year-old male collegiate rugby player presents with recurrent anterior shoulder instability. A 3D CT scan reveals 28% anterior glenoid bone loss. Which of the following procedures provides the most reliable long-term stability for this patient?

A 35-year-old male presents to the emergency department with his arm locked in internal rotation following a generalized tonic-clonic seizure. An axillary radiograph confirms a posterior shoulder dislocation with an impaction fracture of the anteromedial humeral head involving 35% of the articular surface. What is the most appropriate surgical treatment?