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SPORTS Flashcards

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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
ACL fibers AM bundle tight in ___ PL bundle tight in __
AM tight in flexion | PL tight in extension
26
PCL deficient knee incr risk of early OA where
medial | patellofemoral compartments
27
Cytotoxin that defines CA-MRSA
PVL
28
suture anchor vs transosseous suture repair for quad rupture higherload to failure? less gap formation?
suture anchor repair better
29
over the top position for ACL graft results in
lax flexion tight extension b/c femoral portion of graft more posterior than anatomic origin of ACL
30
if ACL graft too anterior
tight in flexion | loose in extension
31
MPFL primary restraint
first 30 deg knee flexion
32
where is osteochodral fx typically in lateral patellar dx
medial patella
33
FAI head neck ratio femoral offset ante or retroversion
decr head neck ratio decr fem offset retroversion
34
saphenous n injury most common w which medial meniscus repair
inside-out
35
anteromedial portal for femoral tunnel better than transtibial portal b/c
more anatomic graft placement but shorter fem tunnel, incr risk to lateral fem cartilage (transtibial = more vertical)
36
elevated sulcus angle assoc w what
>140 deg = flattening of trochlea
37
risk factor for failure of MPFL recon
trochlear dysplasia incr TT TG decr age less than 20
38
factors assoc w OA in ACL deficient knee
meniscal lesion osteochondral lesion malalignment concomitant lig path
39
highest risk of persistent patellar instability
previous patellar instability event
40
Q angle measures
ASIS to patella and patella to tibial tubercle
41
mc problem w tunnel malposition
too anterior in front of lateral intercondylar ridge -- graft impingement and failure
42
mechanism of pivot
extension - lateral tib plateau sublux w IR/valgus, lateral tib plateau reduces
43
tx compression (inferior) sided fem neck fx
protected weightbearing
44
fxn of popliteus
internal tibial torsion
45
wear assoc w chronic PCL occurs
patellofem and medial compartment
46
Ways to decr graft-screw divergence (should be less than 30 deg)
1) insert screw/drill from same portal 2) hyp`erflex knee when insert screw 3) use guide wire to help gauge mismatch
47
predisposing factors to patellar instability
xs femoral IR, tibial ER, LFC hypoplasia, insufficiency of VMO, incr Q angle, tight lateral retinaculum, patella alta, patella tilt
48
with ACL injury, what are knee kinematics
absence of normal femoral IR during terminal swing phase & decr anterior translation of tibia in late swing
49
nl knee movement 1) during heel strike 2) during midstance
1) IR of femur relative to tibia | 2) flexion of knee, ER of femur relative to tibia
50
PL bundle of ACL resists rotation in knee flexion or extension
knee extension
51
factros assoc w failure of HS autograft for ACL
graft size less than 8 mm age less than 20 yrs
52
valgus producing HTO addresses PCL and PLC injury by
incr tibial slope | shift tibia anterior to femur
53
stinger mc affects
biceps deltoid rotator cuff muscles
54
bursal vs articular sided tears which higher risk of progression
bursal
55
bursal vs articular sided tears bursal usu due to
extrinsic causes - AC arthritis, acromial cysts
56
bursal vs articular sided tears articular usu due
intrinsic causes - degenerate weakening of tendon
57
bursal vs articular sided tears bursal sided tendon repair when
more than 25% tendon depth
58
bursal vs articular sided tears articular sided tendon repair when
more than 50% tendon depth
59
bennett lesion = posterior-inferior glenoid mineralization seen in what population
baseball players
60
Posteromedial elbow pain worse on ball release/decel + TTP over PM olecranon
valgus extension overload tx = flexor-pronator strengthening
61
rTSA moves COR in what direction
medial which incr moment arm of deltoid
62
mUCL at greatest stress during what phase of throwing
late cocking/early accel
63
in posterior capsular contracture of shoulder, humerus translates in what direction during cocking phase
posterior superior
64
scapular notching occurs due to
superior placement of glenoid component
65
POSITIVE pivot shift after ACL recon
failure to reconstruct PL bundle of ACL with femoral tunnel [vertical tunnel at 12:00]
66
incr AP instability after ACL recon
failure to reconstruct AM bundle of ACL
67
tib tunnel too anterior causes
knee tight in flexion w impingement
68
tib tunnel too posterior
knee instability w +Lachman/pivot shift
69
risk factors for re-rupture
female small fem notch small lig girth incr Q angle
70
ACL tear assoc w lateral or medial meniscus
lateral
71
fem tunnel position in R vs L knee
``` right = 1030 left = 130 ```
72
mc tunnel error
tibial or fem tunnel too anterior causing graft impingement
73
if graft too anterior causes
decr flexion
74
if graft too posterior
decr extension
75
tendon w highest load to failure
quadruple hamstring
76
during pivot shift IT band does what
reduction of lateral tib plateau w flexion
77
how to avoid graft screw divergene
put screw/drill in same portal, hyper flexing knee when insert screw , use guidewire to gauge mismatch
78
which bundle of ACL loose flexion
PL bundle
79
landmark for accurate tibial tunel placement
11 mm anterior to anterior border of PCL
80
what marks anterior extent of ACL fem insertion
lateral intercondylar ridge = resident ridge
81
what separates AM and PL bundle
bifurcate ridge
82
secondary restraint to anterior tibial translation
posterior horn MM
83
saphenous n injury during medial meniscus repair MC with which technique
inside out repair
84
which has more mobility medial or lateral meniscus
lateral b/c less attachments
85
best way to tx bucket handle meniscus tear
inside out vertical mattress
86
mc long term complication after meniscal transplant
meniscal graft tear 2/2 acellularity of graft tissue
87
good prognostic factors for meniscal repair
vertical longitudinal tears red-red small rim width
88
how to reduce axillary n risk during anterior labral repair
put arm in abduction, ER

ORTHOBULLETS (9 decks)

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