Shoulder

Question 1

Passport/Gemini Cannulas

Answer 1

prevent removal of cannulas as work is done inside/outside shoulder allow ease of use and suture management

Question 2

fiber tape retriever

Answer 2

cylindrical tip helps decrease friction as suture is retrieved

Question 3

fast pass side loading scorpion

Answer 3

pass suture in medial row, allows easy loading and quick passing of fibertape loops with tails spliced together

Question 4

speedbridge kit comes w/:

Answer 4

2 preloaded 4.75 swivel locks
(1 w/ fibertape loop)
(1 w/ tiger tape loop)
2 original swivelocks
punch

Question 5

SpeedBridge Construct

Answer 5

knotless technique, maximum reconstruction of Rotator cuff footprint, maximize bone to tendon contract,
used for med/large tears

Question 6

SpeedFix Knotless Single Row Technique

Answer 6

ADV- quick procedure, low profile, no knots, great fixation strength, full contact with bone against tendon,
reliable for small tears

Question 7

what portal can provide better access to a RC tear?

Answer 7

more direct view of RC tear through lateral portal

Question 8

concominant pathology

Answer 8

addressed at time of surgery includes:
signs of impingement
fraying of CA lig.
AC Joint arthritis
slap or biceps tendon path
laberal Tear

Question 9

of anchors depend on size of tear..

Answer 9

tear < 1 cm :single anchor repair
Tear > 1 cm in diameter: double row construct
larger tears; expansion bridge if tissue is viable

Question 10

suture placement

Answer 10

sutures placed through RC tendon (dont over tension)

repair sutures placed 2-3 mm lateral to muscle tendon junction

Question 11

anchor placement

Answer 11

1 ancher per 1 cm of tear placed in medial row

Question 12

retracted tear

Answer 12

irreparable in setting of younger patient w/ minimal glenohumeral joint arthritis benefit from superior capsular recon

• complete RC tear
• retracted tissue
• loss of elasticity due to scarring
• muscle atrophy and fatty infilitration

Question 13

longitudinal or U shaped tears

Answer 13

long/narrow
medial to lateral length > anterior to posterior Width

Side to side sutures, followed by single/double row lateral anchor repair w/ in greater tuberosity

Question 14

L or Reversed L tears

Answer 14

long and narrow
length>width

side to side sutures, with lateral suture anchors
followed by single/double row lateral anchors with in greater tuberosity

Question 15

crescent shaped tears

Answer 15

most common tear, tear to supraspinatus
short and wide pattern
medial to lateral length< anterior to posterior width

single or double row repair

Question 16

Patient considerations prior to surgery:

Answer 16

1- failure of conservative treatment
2- age
3- size of RC tear
4- other medical issues
5- social support

Question 17

Massive Retracted Posterosuperior RC tear ( compress subscap nerve)
deteriation measured in :

Answer 17

goutallier

stage 0- normal muscle no fat
stage I- some fatty streaks present
stage II- more muscle than fat
stage III- equal muscle and fat
stage IV- more fat than muscle

Question 18

Psuedoparalysis

Answer 18

inability to perform more than 90 degrees of active forward elevation with fully intact passive ROM in absence of neurologic impairment

Question 19

Infraspinatus and Teres Minor

Answer 19

Origin: infraspinous fossa of scapula
Insert: greater tuberosity of humerus

Question 20

Infraspinatus RC Strength

Answer 20

22%

Question 21

Teres Minor RC strength

Answer 21

10%

Question 22

Concavity compression

Answer 22

compression of convex humeral head into concave surface of glenoid fossa

Question 23

Force Couple

Answer 23

2 or more muscles acting in different directions influence rotation of a joint in a specific direction

Question 24

Last Standard portal is the ____ portal.

Answer 24

Lat (lateral portal)

working/viewing portal with in a subacromial space in shoulder

Question 25

Posterior portal is established, surgeon can create ______ portals.

Answer 25

Anterior portals, standard portal AI (anteroinferior)

done under direct visualization using spinal needl

Question 26

All Arthroscopic procedures will start from the _____ portal.

Answer 26

P (posterior portal)
portal is made blind
gives access to GHJ and subacromial space

Question 27

Most common Arthroscopic portals used are :

Anatomic structure commonly outlines are:

Answer 27

P : Posterior, Lat: lateral, A: Anterior

1. clavicle
2. acromion
3. tip of coracoid

Question 28

Lateral decubitus Adv. and Dis.

Answer 28

lying on good side, arm above body
ADV- better visibility, less barriers to shoulder accessibility, no increases risk of cerebral perfusion

DIS- inc. risk of traction related injury, difficult conversion to open, non anatomic orientation, difficult reach for ant. portal

Question 29

Beach Chair ADV. and Dis.

Answer 29

ADV- ease of exam under anesthesia, easy conversion to open, improved mobility of arm

DIS- potential mechanical blocks, increased obstruction of view, increased risk of hypotension/bradycardia
- causing cerebral ischemia

Question 30

shoulder arthroscopy can be performed in the :

Answer 30

beach chair position

lateral decubitus position

Question 31

glenohumeral joint

Answer 31

articulation of glenoid fossa of scapula and head of humerus
ball in socket

Question 32

subscapularis

Answer 32

origin- subscapular fossa
insert- lesser tuberosity of humerus
RC strength- 53%

Question 33

Supraspinatus

Answer 33

origin- supraspinous fossa
insert- greater tuberosity
RC strength- 14%

Question 34

Acromioclavicular ligament

Answer 34

stabilized by 3 ligaments:

1) acromioclaviclaur lig.
2) coracoclavicular ligaments
- trapezoid lig
- conoid lig

Question 35

sternoclavicular joint

Answer 35

only true attachment of shoulder joint complex to bodys axial skeleton

Question 36

shoulder complex made up of 3 _____ joints.

name joints

Answer 36

synovial joints

• glenohumeral joint
• acromioclavicular joint
• sternoclavicular joint