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ORTHOBULLETS > SPORTS > Flashcards

SPORTS Flashcards

1
Q

Tx ACL + medial compartment OA

A

HTO, medial opening wedge w decr tibial slope

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2
Q

Loss of what motion with FAI

A

decr flexion, IR

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3
Q

Tension sided femoral neck fx tx (superolateral femoral neck)

A

CRPP

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4
Q

what is assoc with lateral meniscal cysts

A

middle 1/3 lateral meniscus tears

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5
Q

crossover sign means

A

FAI, pincer lesion

excess acetabular retroversion

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6
Q

FAI return to sports in

A

7 months

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7
Q

Vertical ACL graft causes what effect

A

failure to reconstruct posterolateral bundle

instability with cutting activity

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8
Q

exam assoc with stinger

A

positie Spurling sign

resolves in 1-2 min

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9
Q

athletic pubalgia is overuse assoc with what movmeent

A

hip extension ABDuction

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10
Q

bone bruise location for ACL

A

posterolateral tibia

lateral femoral condyle

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11
Q

excess anterior femoral tunnel placement causes

A

loss of knee flexion
graft overstretch, failure
interference screw divergence

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12
Q

tx quad contusin

A

immobilization in knee hyperflexion

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13
Q

positive DIAL at 30 deg means vs at 30+90 deg

A

at 30 ONLY = PLC

at 30 + 90 = PLC + PCL

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14
Q

what defines anterior edge of ACL

what separates AM and PL bundles

A

anterior edge ACL = lateral intercondylar ridge = resident’s ridge

separates AM/PL bundle = bifurcate ridge

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15
Q

PCL

AL bundle tight in __
PM bundle tight in __

A

AL tight in flexion

PM tight in extension

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16
Q

angle used to determine if lateral retinacular release useful

A

lateral patellofemoral angle

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17
Q

tx for bucket handle tears

A

inside-out vertical mattress sutures

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18
Q

LCL relative to lateral femoral epicondyle

A

proximal

posterior

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19
Q

type 1 muscle fibers
type
recruit order

A

slow oxidative

recruit first

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20
Q

type 2 muscle fibers

A

fast glycolytic

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21
Q

initial exercise for PCL tear

A

quad (not hamstring strengthening) and ROM in prone to limit posterior sag

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22
Q

risk factor for poor arthro hip surgery

A

acetab subchondral cyst (hip OA), Tonnis grade 2

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23
Q

deep interval for inside-out meniscal repair

A

btwn medial head of gastroc and joint capsule

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24
Q

nerve at risk with inside-out meniscal repair

A

saphenous nerve

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25
Q

ACL fibers

AM bundle tight in ___
PL bundle tight in __

A

AM tight in flexion

PL tight in extension

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26
Q

PCL deficient knee incr risk of early OA where

A

medial

patellofemoral compartments

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27
Q

Cytotoxin that defines CA-MRSA

A

PVL

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28
Q

suture anchor vs transosseous suture repair for quad rupture

higherload to failure?
less gap formation?

A

suture anchor repair better

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29
Q

over the top position for ACL graft results in

A

lax flexion
tight extension

b/c femoral portion of graft more posterior than anatomic origin of ACL

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30
Q

if ACL graft too anterior

A

tight in flexion

loose in extension

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31
Q

MPFL primary restraint

A

first 30 deg knee flexion

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32
Q

where is osteochodral fx typically in lateral patellar dx

A

medial patella

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33
Q

FAI

head neck ratio
femoral offset
ante or retroversion

A

decr head neck ratio
decr fem offset
retroversion

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34
Q

saphenous n injury most common w which medial meniscus repair

A

inside-out

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35
Q

anteromedial portal for femoral tunnel better than transtibial portal b/c

A

more anatomic graft placement but shorter fem tunnel, incr risk to lateral fem cartilage

(transtibial = more vertical)

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36
Q

elevated sulcus angle assoc w what

A

> 140 deg = flattening of trochlea

37
Q

risk factor for failure of MPFL recon

A

trochlear dysplasia
incr TT TG
decr age less than 20

38
Q

factors assoc w OA in ACL deficient knee

A

meniscal lesion
osteochondral lesion
malalignment
concomitant lig path

39
Q

highest risk of persistent patellar instability

A

previous patellar instability event

40
Q

Q angle measures

A

ASIS to patella and patella to tibial tubercle

41
Q

mc problem w tunnel malposition

A

too anterior in front of lateral intercondylar ridge – graft impingement and failure

42
Q

mechanism of pivot

A

extension - lateral tib plateau sublux

w IR/valgus, lateral tib plateau reduces

43
Q

tx compression (inferior) sided fem neck fx

A

protected weightbearing

44
Q

fxn of popliteus

A

internal tibial torsion

45
Q

wear assoc w chronic PCL occurs

A

patellofem and medial compartment

46
Q

Ways to decr graft-screw divergence (should be less than 30 deg)

A

1) insert screw/drill from same portal
2) hyp`erflex knee when insert screw
3) use guide wire to help gauge mismatch

47
Q

predisposing factors to patellar instability

A

xs femoral IR, tibial ER, LFC hypoplasia, insufficiency of VMO, incr Q angle, tight lateral retinaculum, patella alta, patella tilt

48
Q

with ACL injury, what are knee kinematics

A

absence of normal femoral IR during terminal swing phase & decr anterior translation of tibia in late swing

49
Q

nl knee movement

1) during heel strike
2) during midstance

A

1) IR of femur relative to tibia

2) flexion of knee, ER of femur relative to tibia

50
Q

PL bundle of ACL resists rotation in knee flexion or extension

A

knee extension

51
Q

factros assoc w failure of HS autograft for ACL

A

graft size less than 8 mm

age less than 20 yrs

52
Q

valgus producing HTO addresses PCL and PLC injury by

A

incr tibial slope

shift tibia anterior to femur

53
Q

stinger mc affects

A

biceps deltoid rotator cuff muscles

54
Q

bursal vs articular sided tears

which higher risk of progression

A

bursal

55
Q

bursal vs articular sided tears

bursal usu due to

A

extrinsic causes - AC arthritis, acromial cysts

56
Q

bursal vs articular sided tears

articular usu due

A

intrinsic causes - degenerate weakening of tendon

57
Q

bursal vs articular sided tears

bursal sided tendon repair when

A

more than 25% tendon depth

58
Q

bursal vs articular sided tears

articular sided tendon repair when

A

more than 50% tendon depth

59
Q

bennett lesion = posterior-inferior glenoid mineralization seen in what population

A

baseball players

60
Q

Posteromedial elbow pain worse on ball release/decel + TTP over PM olecranon

A

valgus extension overload

tx = flexor-pronator strengthening

61
Q

rTSA moves COR in what direction

A

medial which incr moment arm of deltoid

62
Q

mUCL at greatest stress during what phase of throwing

A

late cocking/early accel

63
Q

in posterior capsular contracture of shoulder, humerus translates in what direction during cocking phase

A

posterior superior

64
Q

scapular notching occurs due to

A

superior placement of glenoid component

65
Q

POSITIVE pivot shift after ACL recon

A

failure to reconstruct PL bundle of ACL with femoral tunnel [vertical tunnel at 12:00]

66
Q

incr AP instability after ACL recon

A

failure to reconstruct AM bundle of ACL

67
Q

tib tunnel too anterior causes

A

knee tight in flexion w impingement

68
Q

tib tunnel too posterior

A

knee instability w +Lachman/pivot shift

69
Q

risk factors for re-rupture

A

female
small fem notch
small lig girth
incr Q angle

70
Q

ACL tear assoc w lateral or medial meniscus

A

lateral

71
Q

fem tunnel position in R vs L knee

A 
right = 1030
left = 130
72
Q

mc tunnel error

A

tibial or fem tunnel too anterior causing graft impingement

73
Q

if graft too anterior causes

A

decr flexion

74
Q

if graft too posterior

A

decr extension

75
Q

tendon w highest load to failure

A

quadruple hamstring

76
Q

during pivot shift IT band does what

A

reduction of lateral tib plateau w flexion

77
Q

how to avoid graft screw divergene

A

put screw/drill in same portal, hyper flexing knee when insert screw , use guidewire to gauge mismatch

78
Q

which bundle of ACL loose flexion

A

PL bundle

79
Q

landmark for accurate tibial tunel placement

A

11 mm anterior to anterior border of PCL

80
Q

what marks anterior extent of ACL fem insertion

A

lateral intercondylar ridge = resident ridge

81
Q

what separates AM and PL bundle

A

bifurcate ridge

82
Q

secondary restraint to anterior tibial translation

A

posterior horn MM

83
Q

saphenous n injury during medial meniscus repair MC with which technique

A

inside out repair

84
Q

which has more mobility

medial or lateral meniscus

A

lateral b/c less attachments

85
Q

best way to tx bucket handle meniscus tear

A

inside out vertical mattress

86
Q

mc long term complication after meniscal transplant

A

meniscal graft tear 2/2 acellularity of graft tissue

87
Q

good prognostic factors for meniscal repair

A

vertical longitudinal tears
red-red
small rim width

88
Q

how to reduce axillary n risk during anterior labral repair

A

put arm in abduction, ER

ORTHOBULLETS (9 decks)

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