MSC #811 - Sports Medicine Final

(T/F) Subluxation is the same as dislocation?

False

What is the definition of a Mumford?

Distal clavicle resection or removal

Which of the 2 coracovlavicular ligament bands sits more medial?

Conoid (Medial)

Trapezoidal (Lateral)

Locate the Rotator Cuff muscles:

-Subscapularis

-Supraspinatus

-Infraspinatus

-Teres Minor

Locate the ligaments in the shoulder:

What is another term for Acromioplasty?

Subacromial Decompression (SAD)

What is a subacromial decompression?

-When inflamed bursa and overhanging bone is removed utilizing a shaver and/or ablation wand

-Opens the subacromial space

Where is the first incision in a shoulder arthroscopy made?

1. Posterior

2. Anterior

3. Lateral

What is the definition of subluxation?

Shoulder slips slightly out of socket, then comes immediately back in place

What is the definition of dislocation?

Head of the humerus completely comes out of the socket; usually with a traumatic event the first time

(T/F) 90-95% of all dislocations are done anteriorly

True

What does a SLAP tear stand for?

-Superior Labrum Anterior Posterior tear

(11-1 o' clock tear)

-Anterior Superior primary portal

What is the most common form of anterior dislocation?

Bankart Lesion

What are the two options for patient positioning during a shoulder arthroscopy?

-Beach Chair

-Lateral Decubitus

Identify a beach chair approach using an arthroscopic camera:

Beach chair approach

What is the rotator cuff interval?

-Triangular portion of the anterior capsule

-Lies between supraspinatus & subscapularis

What is the primary portal for a Bankart repair?

Anteroinferior portal

In what portion of the anterior shoulder is the diagnostic portal established?

Rotator Cuff Interval

Where is the posterior portal placed?

Two finger breadths inferior & one finger breadth medial to the posterior lateral corner of the acromion

What are the advantages of knotless anchor technology?

-Faster procedures

-Stong constructs

-Low profile repairs

What is the chronological order of the history of anchor materials?

-Metal

-PEEK

-Bio Absorbable

-Bio Composite

-All Suture

What does PEEK stand for?

Poly Ether Ether Ketone

What does UHMWPE stand for?

Ultra High Molecular Weight Polyethylene

What is a major weakness of bio composite screws?

Tend to be brittle

What is the main benefit of a cannulated anchor design?

Allows for blood and bone marrow integration

What is a Bankart tear?

-Anterior inferior tear of the labrum (3 to 6 oclock)

-Commonly occurs with anterior dislocation of GH joint

What is the most common mechanism of injury for a SLAP tear

FOOSH (Fall on OutStrectched Hand)

Overhead activity

Sports injuries

What are the most commonly injured rotator cuff muscles?

1. Supraspinatus

2. Infraspinatus

What is the simplest rotator cuff tear?

Crescent tears

What is a mattress stitch?

Both limbs passed through tissue

What is a simple stitch?

One limb passed through tissue

What nerve is believed to be the source of RC pain and why?

Subscapular nerve

(Innervates supraspinatus & infraspinatus)

What other soft tissue structure would the surgeon want to inspect that can contribute to SLAP pathology?

Long head of biceps tendon

What is a Remplissage procedure?

-Arthroscopic procedure placing anchors into a Hill-Sachs defect

-Creates new articular margin

(French for "fill in")

What is a Hill-Sachs lesion?

Defect on posterior aspect of humeral head, caused by anterior glenoid

What screws are used for the Laterjet procedure?

2 AO screws

What type of material would be utilized in an All-Suture repair?

UHMWPE

Which fixation technique gives greatest compression footprint, and is the fastest to complete

-Double Row

-Suture Tape

-Knotless Anchor

What is the primary function of the deltoid, supraspinatus, and subscapularis?

Humeral head depressor

The subscapular nerve innervates:

-Supraspinatus

-Infraspinatus

(Source of pain)

What is the instrument used in the Alpsa procedure to free the labrum?

Liberator

What kind of cartilage is the labrum made of?

Fibrocartilage

What is the buford complex?

Absent anterior/superior labrum (1-3 o'clock)

What are advantages of all-suture anchors?

-Bone preservation

-Strong fixation

-Ease of handling

What tendon is being transferred in a Laterjet procedure?

Section of the coracoid process

What does TOE stand for?

TransOsseous Equivalent

Why would a surgeon use a fully cannulated suture anchor?

Increased insertion torque

What other implant is used besides suture anchors in SCR?

Allograft or xenograft trampoline

What can the surgeon do to create better compression?

-Double-Row

-Knotless anchors

-Mattress Sutures

What is margin convergence?

Process of bringing together the edges (margins) of a tissue defect, incision, or wound to facilitate healing

What is the conjoined tendon

-short head of bicep

-coracobrachialis

What areas can you reattach the long head of the biceps in a tenodesis?

1. High Groove

2. Low Groove

3. Supra Pectoral

4. Sub Pectoral

What two implants are used in a distal bicep tension slide repair?

Cortical button

Interference screws

What is the Rockwood scale?

Grading system for severity of separated shoulders

Graded 1-6

What is a type III AC joint separation?

BOTH the AC and CC ligaments torn; visible clavicle elevation (up to 100% displacement)

What is the most common suture size used in sports medicine?

#2 Suture

Which side of the meniscus is more prone to tearing?

Medial

What is the Sartorius tendon?

-Sartorius fans out as a covering

for three other hamstring tendons

on the medial side

Where is the third portal placed in a knee arthroscopy?

Suprapatellar pouch

What is an OATS procedure?

Mosaicplasty

Autologous articular cartilage graft

What are the two main options for a surgeon when addressing a meniscal tear?

Partial Menisectomy

Complete Menisectomy

What is the gold standard for meniscal repair?

Inside-out

Red-Red vs. Red-White vs. White-White

-Classification of meniscal tears

-Red-Red has ability to heal

What is the most common mechanism of injury for ACL tears?

Non-contact pivot

What condyle does the ACL originate from?

Lateral condyle

What condyle does the PCL originate from?

Medial condyle

What are the two main fixation options used in ACL reconstruction?

-Aperture

-Suspensory

What are the autograft options for an ACL reconstruction?

-Semitendinosus

-Gracilis

-Patella tendon (BTB)

-Quadricep

(T/F) The femoral fixation is more paramount than the tibial fixation

True

What is the main disadvantage of BTB autograft?

Anterior knee pain

What are the disadvantages of using an allograft in an ACL reconstruction?

Risk of Failure

Higher cost

Slower healing

What is the function of the AM and PL ACL bundles

-AM (Anterior Translation)

-PM (Posterior Translation)

What are the two meniscal femoral ligaments and where are they located in relationship to PCL?

Ligament of Humphry (Anterior)

Ligament of Wrisberg (Posterior)

What is the difference between antegrade and retrograde?

-Antegrade - normal/forward

-Retrograde - opposite/backward

What are the two main disadvantages of using a suspensory fixation for ACL reconstruction in the femur?

Tunnel widening (windshield effect)

Loosening

What does FAI stand for?

Femoroacetabular impingement

What are the ideal portal positions for femoral socket in ACL reconstruction

Anteromedial portal

Anterolateral portal

Transtibial portal

Where does the distal biceps tendon attach?

Distal radius

What is the largest size lesion an OATS procedure would be appropriate for?

2cm x 2cm

Where are OCD lesions commonly found?

Lateral side of medial femoral condyle

What is the goal of a microfracture procedure?

Bone marrow stimulation

What is the best meniscal repair approach for an anterior tear?

Oustide-in approach

What is the most common drill used for an all-inside repair?

Flip-cutter

To what direction does the patella sublux?

Lateral

Where is the first portal placed in a hip arthroscopy?

1. Anterolateral

2. Anterior

3. Posterior

What is the most common scope angle used in arthroscopies?

30 degree scope

How can you create hemostasis in arthroscopic procedure?

Pump flow pressure

What are the 3 goals of fluid management?

1. Irrigate

2. Joint Distention

3. Hemostasis

For an RF ablation device, what do the blue and yellow pedals stand for?

Blue = Coagulation

Yellow = Cutting

For a drill chuck, what do red and blue stand for?

-Red = loosen or unlock

-Blue = tighten or lock

What direction does an oscillating saw move?

Back & Forth (Anterior - Posterior)

(T/F) Dual pump fluid management devices maximize disposals

True

Identify anatomy of lateral view of the shoulder: