5. Sports Medicine MCQs

A 35-year-old male suffers a seizure and presents with his shoulder locked in internal rotation. A CT scan confirms an irreducible posterior shoulder dislocation with a reverse Hill-Sachs lesion (anteromedial humeral head impaction) involving 35% of the articular surface. What is the most appropriate surgical management for this humeral head defect to prevent recurrent instability?

A 30-year-old volleyball player presents with isolated weakness in external rotation of the shoulder. MRI reveals a paralabral cyst. Compression of the suprascapular nerve at the spinoglenoid notch will typically result in denervation of which of the following muscles?

A 25-year-old male undergoes a Latarjet procedure for recurrent anterior shoulder instability. Postoperatively, he has profound weakness in elbow flexion and decreased sensation over the lateral forearm. Which nerve was most likely injured during coracoid retraction?

A 22-year-old rugby player has recurrent anterior shoulder instability. CT evaluation reveals anterior glenoid bone loss. The glenoid width measures 30 mm, and the anterior defect measures 6 mm. According to the glenoid track concept, what is the calculated width of this patient's glenoid track?

During a Latarjet procedure for anterior shoulder instability, the coracoid process is osteotomized and transferred to the anterior glenoid rim. Which nerve is at greatest risk of injury during the medial retraction of the conjoined tendon?

A 31-year-old elite volleyball player presents with insidious onset of posterior shoulder pain and weakness. Physical examination demonstrates normal external rotation strength in adduction, but profound weakness in external rotation with the arm abducted. Muscle atrophy is noted exclusively in the infraspinatus fossa. Where is the most likely location of a paralabral cyst in this patient?

A 65-year-old man presents with pseudoparalysis of the shoulder, an inability to actively externally rotate, and a positive hornblower's sign. Imaging reveals a massive, retracted, irreducible tear of the supraspinatus, infraspinatus, and teres minor. The subscapularis is fully intact. He wishes to undergo a tendon transfer. Which of the following tendon transfers is most appropriate for restoring his external rotation and forward elevation?

During the physical examination of a patient with a suspected rotator cuff tear, you wish to isolate the function of the inferior (lower) portion of the subscapularis muscle. Which of the following provocative tests is most specific for assessing the lower subscapularis?

A 24-year-old professional baseball pitcher complains of right shoulder pain during the late cocking phase of throwing. He exhibits a significant Glenohumeral Internal Rotation Deficit (GIRD). If diagnostic arthroscopy is performed for suspected internal impingement, what is the most characteristic pattern of pathology observed?

In the surgical evaluation for a Superior Capsular Reconstruction (SCR) in a patient with a massive, irreparable posterosuperior rotator cuff tear, which of the following preoperative findings is considered an absolute contraindication to the procedure?

During a Latarjet procedure, the coracoid bone block is secured to the anterior glenoid neck with two screws. If the screws are directed too far medially (e.g., greater than 15 degrees medial to the glenoid articular surface), which neurologic structure is at the greatest risk of iatrogenic injury from the prominent screw tips posteriorly?

A 20-year-old collegiate baseball pitcher presents with symptomatic Glenohumeral Internal Rotation Deficit (GIRD). Which of the following anatomic changes is considered the primary driver of GIRD in the overhead throwing athlete?

A 45-year-old male presents with severe, unremitting right shoulder pain that awoke him from sleep. The acute pain subsided after two weeks, but he now has profound weakness in forward elevation and external rotation. If an MRI is obtained, what is the most likely finding?

In the surgical management of anterior shoulder instability, a 'remplissage' procedure involves tenodesis of the infraspinatus tendon and posterior capsule into a humeral head defect. Which of the following is the most appropriate indication for performing a remplissage in conjunction with an arthroscopic Bankart repair?

A 24-year-old rugby player undergoes a Latarjet procedure. Postoperatively, he has weakness in elbow flexion and decreased sensation over the lateral forearm. Improper retractor placement under which of the following structures is the most likely cause of this complication?

A 62-year-old male laborer presents with profound weakness in shoulder external rotation and a positive Hornblower's sign. MRI reveals a massive, retracted, and irreparable tear of the supraspinatus, infraspinatus, and teres minor. The subscapularis is intact. Which of the following tendon transfers provides the most biomechanically advantageous line of pull to restore external rotation?

A 28-year-old elite volleyball player complains of vague posterior shoulder pain and isolated weakness in external rotation. Forward elevation and internal rotation strength are normal. MRI reveals a paralabral cyst. Where is this cyst most likely located?

A 22-year-old collegiate baseball pitcher presents with vague shoulder pain and decreased throwing velocity. Physical examination reveals a 25-degree loss of glenohumeral internal rotation compared to the contralateral side, but total arc of motion is symmetric. What is the primary pathophysiologic cause of this internal rotation deficit?

In an overhead throwing athlete, a Type II SLAP tear is often generated by the 'peel-back' mechanism. During which phase of the throwing motion does the maximal peel-back force occur on the superior labrum?

A latissimus dorsi tendon transfer is being considered for a 55-year-old male with a massive, irreparable posterosuperior rotator cuff tear. Which of the following preoperative findings is considered an absolute contraindication to performing this specific tendon transfer?