5. Sports Medicine MCQs

A 55-year-old laborer has an irreparable posterosuperior rotator cuff tear with an intact subscapularis and no glenohumeral arthritis. He has intact forward elevation but profound weakness in external rotation and a positive Hornblower's sign. Which tendon transfer is most appropriate?

A 22-year-old collegiate baseball pitcher complains of posterior shoulder pain during the late cocking phase of throwing. MRI arthrogram reveals a partial articular-sided supraspinatus tendon avulsion (PASTA) and a superior labral tear. Which of the following is the primary underlying pathomechanism?

A 60-year-old man falls on an outstretched arm and experiences anterior shoulder pain. He has a positive bear-hug test and increased passive external rotation compared to the contralateral side.

What other structure is most commonly injured with this specific tendon tear?

A 55-year-old man sustains an anterior shoulder dislocation. Post-reduction radiographs show a reduced joint but a displaced greater tuberosity fracture that is migrated 8 mm superiorly. What is the most appropriate management?

A 55-year-old active male presents with a massive, irreparable posterosuperior rotator cuff tear. He has an intact subscapularis, a Hamada grade 1 shoulder on radiographs, and good deltoid function. He undergoes a superior capsular reconstruction (SCR). What is the primary biomechanical goal of this procedure?

A 22-year-old collegiate baseball pitcher complains of posterior shoulder pain during the late cocking phase of throwing. Examination shows a significant glenohumeral internal rotation deficit (GIRD). MRI reveals an articular-sided partial tear of the posterior supraspinatus and anterior infraspinatus. What is the primary mechanical mechanism underlying this specific injury?

A 24-year-old rugby player presents after his fourth anterior shoulder dislocation. A 3D CT scan demonstrates 25% anterior glenoid bone loss and a deep, engaging Hill-Sachs lesion. Which of the following is the most appropriate surgical intervention to minimize the risk of recurrence?

A 32-year-old professional volleyball player presents with vague, deep posterior shoulder pain and weakness. Clinical examination reveals isolated atrophy of the infraspinatus fossa, while the supraspinatus bulk and strength are completely normal. She has notable weakness in external rotation. An MRI is obtained. At which of the following anatomic locations is a paralabral cyst most likely compressing the involved nerve?

A 22-year-old professional rugby player presents with recurrent anterior shoulder instability. A 3D CT scan reveals 25% anterior glenoid bone loss. A Latarjet procedure is planned. During the approach, which muscle must be longitudinally split to access the glenohumeral joint?

A 28-year-old volleyball player presents with insidious onset of posterior shoulder pain and weakness in external rotation. Examination shows isolated atrophy of the infraspinatus fossa. The supraspinatus has normal bulk and strength. MRI is most likely to reveal a paralabral cyst in which of the following locations?

A 55-year-old laborer has a massive, irreparable posterosuperior rotator cuff tear. He maintains active forward elevation to 130 degrees but has severe external rotation lag. A latissimus dorsi tendon transfer is planned.

Which of the following is a primary contraindication to performing an isolated latissimus dorsi transfer in this patient?

A 22-year-old collegiate rugby player presents with recurrent anterior shoulder instability. A 3D CT scan reveals 25% anterior glenoid bone loss and an engaging Hill-Sachs lesion.

What is the most appropriate definitive management to minimize the risk of recurrent dislocation?

A 45-year-old manual laborer presents with persistent anterior shoulder pain. He has a positive O'Brien test, and an MRI arthrogram reveals an isolated type II SLAP tear. After 6 months of failed nonoperative management, what is the most reliable surgical treatment?

A 28-year-old elite volleyball player complains of vague posterior shoulder pain and isolated weakness with external rotation. Forward elevation and internal rotation strength are completely normal. An MRI demonstrates a paralabral cyst.

Where is the most likely anatomic location of the nerve compression?

A 60-year-old man falls on an outstretched arm, experiencing a popping sensation in his shoulder followed by isolated weakness with internal rotation. Which of the following physical examination tests is considered the most sensitive for diagnosing a partial tear involving the upper border of the subscapularis tendon?

During a Latarjet procedure for recurrent anterior shoulder instability, the coracoid process is osteotomized and transferred. To avoid iatrogenic injury to the musculocutaneous nerve during the deep dissection, the surgeon must remember that the nerve typically enters the conjoint tendon at what distance distal to the coracoid tip?

A 45-year-old manual laborer presents with a chronic, massive, irreparable tear of the posterosuperior rotator cuff. He demonstrates profound weakness in external rotation (horn blower's sign) but has an intact subscapularis. Which tendon transfer is biomechanically most appropriate to restore external rotation and elevation?

A 32-year-old weightlifter presents with vague posterior shoulder pain and profound weakness in external rotation, with preserved abduction strength. EMG confirms an isolated nerve entrapment at the spinoglenoid notch. Which finding is expected on MRI?

A 55-year-old laborer with an irreparable posterosuperior rotator cuff tear and an intact subscapularis undergoes a lower trapezius tendon transfer. The transferred tendon is typically augmented with an allograft and inserted onto which of the following structures?

In performing a Latarjet procedure for recurrent anterior shoulder instability, the coracoid process is transferred to the anterior glenoid. The dynamic "sling effect" of this procedure is primarily provided by which of the following structures?