5. Sports Medicine MCQs

A 15-year-old female presents with the ability to spontaneously dislocate her shoulder posteriorly without pain. She demonstrates this by bringing her arm into elevation and internal rotation, then easily reduces it. She has no history of trauma. What is the most appropriate initial management?

A 25-year-old rugby player has recurrent posterior shoulder instability despite a previous arthroscopic posterior labral repair. Preoperative CT imaging reveals excessive glenoid retroversion of 22 degrees and 25% posterior glenoid bone loss. What is the most appropriate surgical intervention?

During a physical examination for posterior instability, the examiner performs the Kim test to identify a concealed posteroinferior labral tear. Which combination of joint positions and forces best isolates the posteroinferior labrum during this specific test?

A 29-year-old tennis player complains of posterior shoulder pain during the follow-through phase of his serve. Exam reveals posterior joint line tenderness and a positive posterior apprehension sign. What is the primary pathoanatomic mechanism causing posterior labral shear during this specific athletic motion?

A 28-year-old male undergoes an open posterior capsulorrhaphy for refractory posterior shoulder instability. Postoperatively, he develops a severe limitation in forward elevation, cross-body adduction, and internal rotation. What is the most likely iatrogenic cause of this complication?

When performing an arthroscopic posterior Bankart repair, the surgeon needs an optimal trajectory to place suture anchors at the 7 o'clock position in a right shoulder. Which accessory portal is most commonly utilized to achieve the best approach angle for this region?

A 27-year-old military paratrooper suffers from recurrent posterior shoulder subluxations. Imaging demonstrates a posterior labral tear, 5% posterior glenoid bone loss, and 5 degrees of glenoid retroversion. After failing 6 months of non-operative management, what is the surgical treatment of choice?

Which imaging modality and specific measurement technique represent the gold standard for quantifying glenoid retroversion in a patient evaluated for recurrent posterior shoulder instability?

The Neer modification of the classic McLaughlin procedure is commonly used for chronic posterior shoulder dislocations with large anteromedial humeral head defects. This modification specifically involves the transfer of which anatomical structure into the defect?

A 40-year-old male presents with a locked posterior shoulder dislocation following a seizure. Computed tomography reveals an anteromedial humeral head defect (reverse Hill-Sachs lesion) involving 30% of the articular surface. The glenoid is intact. Which of the following is the most appropriate surgical management?

During diagnostic arthroscopy for chronic posterior shoulder pain and subtle instability, the surgeon notes an incomplete, concealed avulsion of the posteroinferior labrum. The articular margin of the labrum remains intact, but there is a distinct loss of normal labral height and retroversion. What is the correct diagnosis for this pathoanatomy?

A 30-year-old male undergoes an open posterior capsulorrhaphy for recurrent posterior shoulder instability. Postoperatively, he complains of significant restriction in his range of motion, significantly affecting his activities of daily living. Overtightening of the posterior capsule is most likely to restrict which of the following motions?

A 55-year-old male presents with chronic right shoulder pain 4 months after a prolonged seizure. Clinical examination reveals a rigid block to external rotation. Radiographs confirm a locked posterior dislocation. Which of the following findings is the strongest indication for proceeding with shoulder arthroplasty rather than a joint-preserving reconstruction?

A surgeon is performing an arthroscopic posterior stabilization for a reverse Bankart lesion. To achieve the most optimal trajectory for suture anchor insertion into the posteroinferior glenoid rim (7 o'clock to 9 o'clock positions), which of the following arthroscopic portals should be utilized?

A 6-year-old child with a history of an obstetric brachial plexus palsy (Erb's palsy) presents with an internal rotation contracture of the shoulder. Imaging reveals progressive posterior subluxation of the humeral head and early glenoid dysplasia. What is the most critical initial surgical intervention to halt the progression of this joint deformity?

A 42-year-old male undergoes surgery for a locked posterior shoulder dislocation with a 30% anteromedial humeral head defect. The surgeon performs an open reduction and transfers both the subscapularis tendon and the lesser tuberosity into the articular defect. Which eponymous procedure does this describe?

During a medial opening wedge high tibial osteotomy (HTO) for a varus knee, the anterior gap is inadvertently opened significantly more than the posterior gap. What is the expected biomechanical effect on the knee?

A 22-year-old athlete sustains a knee injury and subsequently walks with a "quadriceps avoidance gait," characterized by a forward trunk lean and maintenance of the knee in full extension during the loading response phase. This gait adaptation is most specific to a deficiency of which structure?