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Technique guides are not considered high yield topics for orthopaedic standardized exams including ABOS, EBOT and RC.
A 55-year-old male patient presents with right shoulder pain that is worse with overhead activity. The patient works as a computer programmer and is a recreational swimmer and has noted worsening pain with his breaststroke. Figure A is the coronal T2 MRI arthrogram of the affected shoulder. The patient decides to undergo an arthroscopic repair. What factor is associated with repair failure?
Age greater than 36 years
Snyder type 2 lesion
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Figure A is the MR image of the left shoulder of an active 47-year-old painter who has been experiencing shoulder pain for 9 months. In addition to the finding shown in Figure A, MRI examination of the intra-articular portion of the biceps tendon shows fraying greater than 50%. He has not obtained relief from an 8 month course of non-operative management including non-steroidal anti-inflammatory medications, physical therapy and corticosteroid injection. What is the best next step in treatment?
New course of physical therapy
Activity shutdown with 6 weeks sling immobilization
Arthroscopic superior labrum anterior to posterior (SLAP) tear repair
Arthroscopic debridement and possible biceps tenotomy versus tenodesis
Arthroscopic rotator cuff repair and acromioplasty
Which of the following rehabilitation exercises is most appropriate immediately following the repair of the injury seen in figure A?
Passive external rotation at 90 degrees of abduction
Isotonic rotator cuff strengthening
Isokinetic resistive elbow flexion
Passive and active assisted flexion in scapular plane
Concentric latissimus pull down exercises
Figure A is an arthrosopic image from a right shoulder in the lateral decubitus position as viewed from the posterior portal. Which one of the following rehabilitation techniques should be avoided in the patient that is 2 weeks post-operative from the surgical repair shown in Figure A?
Active assisted elevation in the scapular plane
Passive forearm pronation
Passive external rotation at 90 degrees of abduction
Open chain passive elbow flexion
Passive assisted elevation in the scapular plane
A 47-year-old man presents to your clinic with chronic persistent deep-seated right shoulder pain. He is able to perform most daily activities but experiences sharp shooting pain within the anterior aspect of the shoulder whenever he thows a baseball with his son. His primary care physician referred him to physical therapy first, which resulted in limited improvement in his symptoms, but he remains dissatisfied. Examination reveals symmetric rotator cuff strength and no instability. Speed's and O'brien's tests are positive. His MRI is shown in Figure A. Which of the following is correct with respect to the pathologic structure?
Anchors the biceps tendon in a predominantly anterior position
Supplied by a single arterial source
The anterior superior portion is most susceptible to vascular insufficiency
Degeneration usually leads to cyst formation within the suprascapular notch
Repair should be accompanied by post-operative limitation in abduction and internal rotation
What percent of shoulders have a posterior or posterior dominant attachment of the long head of the biceps onto the glenoid?
A 26-year-old outfielder undergoes arthroscopic repair of a right shoulder type 2 SLAP tear with two labral anchors in the 11 and 1 o’clock positions. Postoperative rehabilitation for this SLAP repair should include:
Immediate full active range of motion that simulates sport-specific activities
Full-time sling wear with no active nor passive motion for at least 6 weeks until labral tissues heal
Rotator cuff strengthening by post-operative week two to prevent disuse atrophy and shoulder instability
Limited passive motion for 4 weeks then progressive active motion until 8 weeks followed by sport specific strengthening until at least 12 to 16 weeks postoperatively
Eccentric open chain biceps contraction exercises beginning at postoperative week 2 to retrain the biceps muscle and stimulate SLAP healing at the biceps anchor on the glenoid
Medial dislocation of the long head of the biceps tendon in the shoulder is most commonly caused by a
tear of the subscapularis tendon.
tear of the supraspinatus tendon.
tear of the transverse ligament.
type I SLAP tear.
congenitally shallow bicipital groove.
Which of the following is considered an advantage of arthroscopic distal clavicle excision compared with open distal clavicle excision?
Lower infection rate
Evaluation of the glenohumeral joint
Preservation of the inferior acromioclavicular ligament
Decreased surgical time
Which of the following best describes a Buford complex?
Normal anatomic variant characterized by a cord-like MGHL and an absent anterosuperior labrum
Normal anatomic variant characterized by a cord-like SGHL and an absent posterosuperior labrum
Abnormal arthroscopic finding characterized by a cord-like MGHL and an absent anterosuperior labrum
Abnormal arthroscopic finding characterized by a cord-like SGHL and an absent posterosuperior labrum
Normal anatomic variant characterized by a cord-like MGHL and a sublabral foramen at the anterosuperior labrum
A 32-year-old overhead athlete catches himself with his right hand while slipping on ice and injures his right shoulder. He fails to improve with therapy, anti-inflammatory medicines, and rest. His MRI is demonstrated in Figure A. What is the most likely diagnosis?