Sports Medicine and Arthroscopy
What you must understand
Know the biomechanics and injury patterns of the knee, shoulder, hip, and ankle. Master ACL, meniscal, rotator cuff, labral, and ankle instability pathology. Understand graft choices (hamstring, patellar tendon, quadriceps), tunnel positioning, and rehabilitation principles. Be fluent in shoulder instability (Bankart, Hill–Sachs, SLAP) and the difference between traumatic and atraumatic instability. Understand return-to-sport criteria and the role of cartilage repair (microfracture, ACI, osteochondral grafting).
Traps in questions
- The ACL is the primary restraint to anterior tibial translation; the PCL resists posterior translation.
- Meniscal tears: red–red zone (peripheral) heals; white–white zone (inner) does not - debridement rather than repair.
- Hill–Sachs is a humeral head impaction; Bankart is a labral avulsion - both in anterior instability.
- Rotator cuff tears: supraspinatus is most commonly involved; drop arm and external rotation lag signs indicate large tears.
- Return to sport after ACL reconstruction is typically 9–12 months with functional criteria, not time alone.
Worked rule of thumb
For shoulder instability, classify by direction, degree, and etiology (TUBS vs AMBRI). Traumatic unidirectional with Bankart benefits from stabilization; atraumatic multidirectional is managed with rehabilitation first.
Exam strategy
Questions often test the physical examination maneuver and its target structure - know the tests and what they mean.