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Orthobullets > OITE - Sports > Flashcards

OITE - Sports Flashcards

1
Q

Tunnel malposition, if ACL loose extension and tight in flexion?

A

Femoral tunnel too anterior

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2
Q

Tunnel malposition, if ACL has blowout potential (ie tight in ext, loose in flexion)?

A

femoral tunnel too posterior

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3
Q

Tunnel malposition, if ACL has rotational instability?

A

Femoral tunnel too vertical (in coronal plane)

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4
Q

Where should the tibial tunnel be in line with, for ACL recon?

A

In line with anterior horn of lateral meniscus

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5
Q

Tunnel malposition, if having notch impingement?

A

Tibial tunnel too anterior

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6
Q

Tunnel malposition, if having PCL impingement?

A

Tibial tunnel too posterior

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7
Q

Prevention of ACL injury focuses on what?

A
  • Biomechanics and neuromuscular training.

- Instruct to land more in flexion (rather than in pivot/valgus)

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8
Q

In biomechanical testing, which ACL graft has highest maximum load to failure?

A

Quadruple semi-T and gracilis tendons (ie hamstring) - 2400 N

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9
Q

What is maximum load to failure of native ACL?

A

2200 N

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10
Q

What exercise do you avoid in early ACL rehab?

A

Avoid open kinetic chain knee extension 0-30deg

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11
Q

Acute hemarthrosis in ACL “pop” injury, caused by bleeding from what?

A

Branches of middle geniculate artery

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12
Q

Pop with effusion in non-contact pivoting, has what likelihood of ACL injury?

A

> 60-70%

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13
Q

Most common bone bruise pattern in acute ACL tear?

A
  • Lateral fem condyle (middle third)

- Lateral tibial plateau (posterior third)

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14
Q

What would you consider in irreparable cuff tears in young active patients?

A 
Tendon transfers (latissimus)
Fat atrophy is a bad sign
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15
Q

Prevalence of asymptomatic uff tears in patients > 60?

A

30-55% (half partial, half full-thickness)

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16
Q

What item on hx is poor indicator for successful non-op mgt, with cuff tears?

A

Night pain

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17
Q

What is avg med-to-lateral distance of supraspinatous tendon insertion at its footprint on GT?

A

14-16 mm

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18
Q

Anterior traumatic shoulder dislocation associated with which MRI finding most commonly?

A

Antero-inferior labral tear (soft tissue Bankart tear)

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19
Q

Older patient with shoulder dislocation, associated with what other injury?

A

Rotator cuff tear

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20
Q

Failure to recognize HAGL injury, can lead to what, in shoulder repair?

A

Recurrent instability

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21
Q

GLAD?

A

Glenoid labrum articular disruption

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22
Q

ALPSA?

A

Anterior labral periosteal sleeve avulsion

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23
Q

HAGL?

A

Humeral avulsion of the glenohumeral ligament

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24
Q

TUBS?

A

Traumatic anterior shoulder instability

Traumatic Unilateral Dislocations with Bankart lesion requiring Surgery

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25
Q

What is the best view to identify a hill-sachs defect?

A
  • Stryker notch view
  • patient supine, arm/elbow flexed toward ceiling, hand placed on top of head
  • xray beam directed AP with 10deg cephalic angulation
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26
Q

Xray to pickup a Bony Bankart?

A

West point view

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27
Q

On OITE, which 2 views (besides stryker notch) are asked for Hill-sachs lesion?

A

AP and internal rotation

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28
Q

What CVS parameter does dynamic exercise increase? Via which mechanism?

A

Increased cardiac output via increased SV (stroke volume)

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29
Q

What is iontophoresis (in physical therapy)

A

Electrical current to drive charged molecules of medicine through skin to deeper tissue

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30
Q

What does isometric exercise mean?

A

Constant resistance, no change in length

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31
Q

What is isoinertial exercise?

A

Variable resistance (like free weights)

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32
Q

What is isotonic?

A
  • Constant resistance
  • Concentric (shortens)
  • Eccentric (lengthens)
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33
Q

Isokinetic exercise?

A

-Constant velocity (speed)

34
Q

Plyometric exercise?

A

Plyometric (power)

-rapid shortening eccentric

35
Q

What two tests do you use to assess for posterior shoulder instability?

A

-Jerk test
-Kim test
(97% sensitivity when combined)

36
Q

What is the light-bulb sign on an AP shoulder xray, suggest?

A

Posterior shoulder dislocation

37
Q

Superior baseplate placement in RSA, causes what?

A

Inferior scapular notching

38
Q

What must a patient have to be indicated for an RSA?

A

Adequate deltoid/acromion function

39
Q

In chronic PCL-PLC injury, what must you correct first?

A

Alignment (varus)

-obtain long leg alignment films

40
Q

Dial test with Increased ER at 30 deg knee flexion = ?

A

isolated PLC injury

41
Q

Dial test with Increased ER at 30 and 90 deg knee flexion= ?

A

Combined PLC/PCL injury

42
Q

What is the relationship of the Popliteus tendon to the LCL (in postero-lateral corner)?

A

Popliteus is deep (medial), distal, and more anterior

43
Q

Where does biceps insert relative to LCL on fibular head?

A

Posterior to LCL

44
Q

What are contraindications to total shoulder arthroplasty?

A
  • cuff arthropathy
  • deltoid dysfunction
  • insufficient glenoid stock
  • infection, -brachial plexus palsy
45
Q

With delto-pec open approach, what do you protect in post op period?

A

Subscap repair

-early PT no active IR , or ER past 30deg

46
Q

In PCL alignment correction, want to increase or decrease tibial slope?

A

Increase tibial slope, shift tibia more anterior

47
Q

Isolated PCL tear, tx with op or non op? Exception?

A

Non-op (Quad rehab, prone ROM). ALWAYS

Exception: bony avulsion

48
Q

Suprascapular neuropathy, 2 possible spots?

A 
Suprascapular notch (affects both supra+infraspinatous)
Spinoglenoid notch (affects only infraspinatous)
-Think Volleyball players (traction injury)
49
Q

What is the most important bundle in Medial UCL?

A

-Anterior oblique ligament
-Isometric with ROM
(is most common answer to med UCL questions)

50
Q

What is little leaguer’s elbow?

A
  • Medial epicondyle stress fx (apophysitis)

- Repetitive Valgus stress and tension overload

51
Q

Most common meniscal tear?

A

Medial > lateral

in ACL, lateral more often

52
Q

On arthroscopy, how can you differentiate between lat and medial meniscus?

A
  • Medial meniscus takes up less SA of tibia than lateral meniscus
  • Look at notch, and orientation of ACL
53
Q

In biceps tendon rupture, what side of distal attachment does a partial tear begin?

A
  • Partial tear beings on radial side

- (tendon must wrap around radius as it attaches to posteriorly situated rad tuberosity)

54
Q

Most commonly injured nerve in surgical repair of biceps tendon.

A

Two incision repair: LABCN (more common)

One incision repair: PIN

55
Q

What structure is most commonly disrupted in acute lateral patellar dislocation

A

MPFL soft tissue avulsion off medial side

56
Q

ACute lateral patellar dislocation, which side of patella is bruised most often?

A

Medial facet of patella

57
Q

MDI (multi-directional shoulder instability), AMBRI?

A

AMBRI: atraumatic, multi-directional, rehab, inferior capsular shift sx)

58
Q

What side effect is more common with creatine

A

Muscle cramping

59
Q

Side effects with testosterone?

A

Testicular atrophy, acne, male pattern baldness, impotence

60
Q

Patient with inflammatoy arthritis compared with OA of shoulder, what is more likely?

A
  • Medialization of G-H joint line (centralized narrowing of the joint)
  • fewer osteophytes
61
Q

Wilson sign for diagnosis of OCD?

A

Reproduction of pain with internal rotation of tibia during extension of the knee.

62
Q

Skeletal immature patient with OCD, initial management?

A

Conservative, NWB x 6-12 weeks

63
Q

Most common OCD lesion

A

Lateral aspect of medial femoral condyle (MFC)

64
Q

Post op rehab protocol for SLAP repair?

A
  • Sling + Passive ROM only! early
  • Advance to closed kinetic chain with scap/cuff strengthening
  • (passive, to active assisted, to active)
65
Q

What nerve roots are involved with long thoracic nerve?

A

C5, 6, 7

66
Q

How can you treat medial scapular winging?

A

Pec transfer

67
Q

How to treat lateral scapular winging?

A

Edan Lange - lateralize lavator scapulae and rhomboids

68
Q

What structures pass through the rotator interval?

A

CHL, SGHL, biceps

69
Q

Static stabilizers of the shoulder?

A
  • SGHL (resists anterior translation in adducted arm)
  • MGHL (in 45 deg abduction/ER)
  • IGHL (in full abduction)
70
Q

What is sleeper stretch? indicated for?

A
  • Posterior capsular stretch

- GIRD

71
Q

Repetitive overuse type injury (long distance runner), think what?

A

Stress fracture

72
Q

What bones are at right risk for stress fractures?

A
  • tibial shaft
  • femoral neck (tension side)
  • 5th metatarsal, navicular
73
Q

Which AROM exercise most appropriate in immediate post-op patellar tendon repair?

A
  • Heel slide (closed chain)
  • active flexion (of hamstrings)
  • passive extension (gravity for quads)
74
Q

Tx of type 1 or 2 ACJ separation?

A

Non-op

75
Q

Tx for Type IV-VI ACJ sep?

A

operative

76
Q

Tx for Type 3 ACJ injury?

A

Controversial, non-op unless labor/athlete and dominant arm

77
Q

What is the “PSI” mnemonic for ACJ separation?

A

For Type 4 to 6 ACJ seps, PSI tire of someone who falls of bike.
4 - posterior
5 - subcutaneous
6 - inferior to coracoid

78
Q

What is the essential lesion in adhesive capsulitis?

A
  • CHL

- Rotator interval capsule

79
Q

Treatment for MRSA skin pustule?

A

Topical mupirocin

80
Q

What is the most common cause of graft failure following ACL reconstruction

A

Tunnel malpositioning

Orthobullets (6 decks)

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