WHat are the cutoffs for PCL and PCL + PLC on posterior stress xrays?
10 - 12 mm = PCL
> 12 mm = PCL and PLC
What two ligaments form a complex that marks the superolateral margin of the subscapularis tendon?
SGHL and CH
2 indications for surgical intervention in hamstring ruptures
1) Athletes when all of the hamstring tendons have avulsed off their origin or
2) Two tendons have avulsed and retracted more than 2 cm.
3 contraindications to hamstrings graft in ACL reconstruction
ligamentous laxity (pathologic graft)
previous hamstrings injury (pathologic graft)
Sprinter (they need it)
In the UE, which artery is dominant?
Ulnar in 88% of population
Median in the rest
What abnormal motion of the humerus on the glenoid will there be in a patient with an internal rotation deficit of his shoulder?
What degree of flexion is best for rehab of ACL when doing:
a) Hamstring isometric
b) Isometric quads
c) Active ROM
a) Any angle
b) greater 60
c) between 35 and 90
Most common sites for osteochondral injury in lateral patellar dislocation
Medial patellar facet
Lateral trochlear ridge
Muscles most commonly affected by Parsonage-Turner syndrome?
Shoulder Motor: muscles (RTC)
Sensory: lateral antebrachial cutaneous nerve
4 elbow problems in the overhead throwing athlete
Valgus extension overload
Ulnar neuropathy (cubital tunnel)
No mention of ulnohumeral arthritis
2 Options for treating medial winging
Operative: Pec major transfer: sternal head transferred to scapula
What's an Eden Lange Transfer?
Transfer of rhomboids from medial to lateral border of scapula for treating lateral scapular winging
What type of muscles are more at risk for muscle strains?
Ones that cross 2 joints
Management algorithm for a chronic anterior shoulder dislocation with boney bankart.
When the glenoid defect is greater than 20-30% then bony augmentation is indicated.
The humeral head defect should be addressed if engaging or 20-40% head loss
Hemiarthroplasty should be considered if >40% of the head is involved.
Most common location for hip labral tear.
What nerve is at risk with a posterior capsular releas ein shoulder?
Inferior suprascapular nerve
Physical findings of shoulder instability?
+ Load and shift
What is the arthroscopic landmark to the iliopsoas?
Can use as a guide for arthorscopic release
Describe provocative test for posterior labral tear.
Pain if hip is brought from a flexed, adducted, and internally rotated position to one of abduction, external rotation, and extension.
Three reasons to consider open Bankart repair
1. large boney bankart
2. engaging hills sachs
3. HAGL lesion
What is the exam finding of someone with scapulothoracic dyskinesis and what is the main treatment?
1. low, protracted scapula
2. Physio with emphasis on coordination of scapular motion with trunk and hip movements
Normal TT-TG ratio?
Normal: Less than 15mm (ie 14mm or less)
Abnormal not until greater than 20mm
In between is a grey zone
What is the most common variant of attachment site of Biceps to glenoid?
Posterior attachment (70%)
6 contraindications to TSA?
insufficient glenoid bone stock
rotator cuff arthropathy
irreparable rotator cuff :
- hemiarthroplasty or reverse total shoulder are preferable
- risk of loosening of the glenoid prosthesis is high ("rocking horse" phenomenon)
brachial plexus palsy
What is the Thessaly test?
Patient stands at 20 degrees of flexed knee and twists.
Positive test is discomfort or clicking and suggests a meniscal injury.
What sort of osteotomy is helpful in a chronic PCL injury?
Medial opening wedge with an increase of tibial slope
Usually have a varus deformity
3 things that cause decreased knee flexion
- (Yes. Or excessive tightening of the extensor mechanism).
Adhesions in medial/lateral gutters/Arthrofibrosis
- (Yes. Arthrofibrosis anywhere in the joint can lead to stiffness).
- (Yes. Patella baja usually secondary joint line elevation. > 10 mm joint line elevation found to result in significantly less flexion).
Cyclops lesion will NOT. It will cause decreased EXTENSION
What causes Os Acromiale?
Failure of fusion between the meso-acromion and meta-acromion.
What is a STIR sequence on MRI?
T1 with fat suppression
What are cruciate cysts associated with?