Written examination questionnaire
| Question | Answer | % Success test 1 | % Success test 2 | p value, paired t test |
|---|---|---|---|---|
| 1. A 21-year-old male football player (linebacker) suffers a traumatic anterior dislocation of his nondominant shoulder for the first time. If he continues to play football, what is the likelihood of him having a recurrent dislocation of his shoulder? a) < 20% b) 20 to 40% c) 41 to 60% d) > 60% | D | 90 | 89 | > 0.99 |
| 2. A 21-year-old male football player suffers a traumatic anterior dislocation of his nondominant shoulder for the first time while making a tackle. The mechanism of injury is one of forced abduction external rotation. What is the likelihood of him having a disruption of the antero-inferior glenoid labrum; i.e., a so-called Bankart lesion? a) < 25% b) 25 to 50% c) 51 to 75% d) > 75% | D | 71 | 79 | 0.058 |
| 3. The same patient was treated in a sling for 2 weeks, then rehabilitated his shoulder and tried to play, but his shoulder felt unstable. He sees you at the end of the season. His x-rays are normal. What is the evidence-based best treatment for this patient? a) Advise him to use an external rotation brace for 4 weeks to allow the shoulder to heal properly. b) Continue with active rehabilitation and advise him to have surgery only if he has a recurrent dislocation. c) Advise him to have an arthroscopic surgical repair at the next available time. d) Advise him to have an open Latarjet procedure at the next available time. | C | 62 | 68 | 0.252 |
| 4. A 19-year-old Junior A hockey player sees you at the end of his season wanting surgery to fix his unstable shoulder. He has had 3 documented anterior dislocations, each requiring a physician reduction and several subluxation episodes. He has a small but perceptible Hill Sachs lesion on his x-ray and the anterior contour of his glenoid is blunted, but there is no bony Bankart. What is the evidence-based, best surgical treatment for this patient? a) An arthroscopic Bankart repair. b) An arthroscopic Bankart repair with remplissage. c) An open Bankart repair. d) An arthroscopic Latarjet procedure. | C | 10 | 5 | 0.182 |
| 5. You decide to perform an arthroscopic Bankart repair of his right shoulder. He has a typical Bankart lesion based on preoperative planning. Which of the following portal positions would typically be considered the minimum to perform this procedure? a) A posterior and anterosuperior portal. b) A mid-anterior and an anterosuperior portal. c) A posterior and mid-anterior portal. d) An anterosuperior and a trans-subscapularis portal. | C | 34 | 61 | < 0.001 |
| 6. You decide to perform an arthroscopic Bankart repair of his right shoulder. You perform a diagnostic arthroscopy through a standard posterior portal. You identify a labral tear that extends from the 7 o’clock to the 3 o’clock position. What additional portals may be needed to perform an optimal arthroscopic repair? a) A mid-anterior and an anterosuperior portal. b) An anterosuperior and supplemental posterior portal. c) A supplemental posterior and trans-subscapularis portal. d) An anterosuperior and a trans-subscapularis portal. | C | 12 | 12 | > 0.99 |
| 7. You decide to perform an arthroscopic Bankart repair of his right shoulder. You confirm a typical Bankart lesion. Where would you place your first anchor using the glenoid clock face description as the reference point? a) At the 7 o’clock position. b) At the 5 o’clock position. c) At the 3 o’clock position. d) At the 1 o’clock position. | B | 64 | 95 | < 0.001 |
| 8. You place your first bio-absorbable anchor in the optimal position with respect to the glenoid clock face. With respect to the patho-anatomy, where should the anchor hole be made? a) Through bleeding bone on the glenoid neck. b) On the face of the articular cartilage. c) At the junction of the articular cartilage and the glenoid bone. d) At the position of the anterior labroligamentous periosteal sleeve avulsion lesion. | C | 88 | 93 | 0.182 |
| 9. When creating the hole for anchor placement, where should the angle of insertion be? a) Parallel to the glenoid surface. b) At 45° to the glenoid surface. c) At 90° to the glenoid surface. d) At 75° to the glenoid surface. | B | 79 | 98 | < 0.001 |
| 10. A patient comes to you with a history of recurrent anterior dislocations of his dominant shoulder. Which of the following would be considered a contraindication for an arthroscopic repair? a) A Hill–Sachs defect and a bony Bankart lesion. b) A Hill–Sachs defect and a Bankart lesion. c) A Hill–Sachs defect and an anterior labroligamentous periosteal sleeve avulsion lesion. d) A Hill–Sachs defect and a glenoid bony lesion. | D | 84 | 79 | 0.182 |
| Total | 59% ± 15% | 68% ± 12% | < 0.001 |