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Knee Sports MCQs

Practice Set 50 of 102

This practice set contains high-yield board review questions covering key concepts in Knee Sports. Each clinical scenario is designed to test your diagnostic and management skills relevant to this subspecialty.

Question 981

Topic: Knee Sports

Figure 51 shows an arthroscopic view of the patellofemoral joint from an inferolateral portal. The arrow points to which of the following structures?

. Loose body
. Plica
. Displaced meniscus tear
. Torn retinaculum
. Osteochondral defect

Correct Answer & Explanation

. Plica

Explanation

Synovial folds or plicae are the result of incomplete or partial resorption of the synovial membranes during fetal development of the knee. The arthroscopic view shows a medial patellar plica, which has been noted in 5% to 55% of all individuals but becomes symptomatic in only a small number of patients. Symptoms may include crepitus, pain, snapping, and swelling and often respond to nonsurgical management. Clarke HD, Scott WN, Insall JN: Anatomic aberrations, in Insall JN, Scott WN (eds): Surgery of the Knee, ed 4. Philadelphia, PA, Churchill Livingstone, 2006, vol 1, pp 67-85.

Question 982

Topic: Knee Sports

A surgeon is performing a posterolateral corner reconstruction of the knee and must drill tunnels for the anatomic femoral attachments of the fibular collateral ligament (FCL) and the popliteus tendon. What is the typical anatomic relationship of the popliteus femoral footprint relative to the FCL footprint?

. Proximal and posterior
. Proximal and anterior
. Distal and anterior
. Distal and posterior
. Directly superficial

Correct Answer & Explanation

. Distal and anterior

Explanation

The popliteus tendon inserts on the femur at the anterior aspect of the popliteal sulcus. This footprint is located just distal and anterior (typically 18.5 mm) to the femoral attachment of the fibular collateral ligament.

Question 983

Topic: Knee Sports

During an anatomic posterolateral corner reconstruction of the knee, the surgeon identifies the normal femoral attachment of the fibular collateral ligament (FCL). Where is this specific attachment located relative to the lateral epicondyle?

. Proximal and posterior
. Proximal and anterior
. Distal and posterior
. Distal and anterior
. Directly on the lateral epicondyle

Correct Answer & Explanation

. Proximal and posterior

Explanation

The femoral footprint of the fibular collateral ligament is located proximal and posterior to the lateral epicondyle. In contrast, the popliteus tendon inserts proximal and anterior to the lateral epicondyle.

Question 984

Topic: Knee Sports

The anteromedial (AM) bundle of the anterior cruciate ligament (ACL) is tightest in which of the following positions, and what is its primary function?

. Tightest in flexion and controls anterior tibial translation
. Tightest in extension and controls anterior tibial translation
. Tightest in flexion and controls rotational stability
. Tightest in extension and controls rotational stability
. Tightest in mid-flexion and controls valgus laxity

Correct Answer & Explanation

. Tightest in flexion and controls anterior tibial translation

Explanation

The AM bundle of the ACL is tightest in knee flexion and primarily restrains anterior tibial translation. The posterolateral (PL) bundle is tightest in extension and provides rotational stability.

Question 985

Topic: Knee Sports

A 24-year-old football player sustains a direct blow to the anteromedial aspect of his knee, resulting in a posterolateral corner (PLC) injury. Which of the following structures is considered one of the three primary static stabilizers of the PLC?

. Biceps femoris tendon
. Iliotibial band
. Popliteus tendon
. Lateral gastrocnemius tendon
. Arcuate ligament

Correct Answer & Explanation

. Popliteus tendon

Explanation

The three primary static stabilizers of the posterolateral corner (PLC) are the lateral collateral ligament (LCL), the popliteus tendon, and the popliteofibular ligament. The biceps femoris provides dynamic stability but is not a primary static stabilizer.

Question 986

Topic: Knee Sports

A 24-year-old athlete sustains a knee injury resulting in increased external tibial rotation at both 30 and 90 degrees of knee flexion. Which of the following anatomical structures are most likely completely ruptured?

. Anterior cruciate ligament
. Posterior cruciate ligament
. Popliteus tendon
. Fibular collateral ligament
. Posterior cruciate ligament and posterolateral corner structures

Correct Answer & Explanation

. Posterior cruciate ligament and posterolateral corner structures

Explanation

Isolated posterolateral corner (PLC) injuries typically present with increased external rotation at 30 degrees of flexion but normal rotation at 90 degrees. Increased external rotation at both 30 and 90 degrees of flexion indicates a combined PCL and PLC injury.

Question 987

Topic: Knee Sports

The anterior cruciate ligament (ACL) is composed of two primary bundles. In full knee extension, what is the anatomical status of the anteromedial (AM) bundle compared to the posterolateral (PL) bundle?

. The AM bundle is taut and the PL bundle is lax
. The AM bundle is relatively lax and the PL bundle is taut
. Both bundles are equally lax
. Both bundles are completely taut
. The AM bundle crosses anterior to the PL bundle

Correct Answer & Explanation

. The AM bundle is relatively lax and the PL bundle is taut

Explanation

The ACL consists of the anteromedial (AM) and posterolateral (PL) bundles. In full knee extension, the PL bundle is taut and the AM bundle is relatively lax, providing crucial rotational stability.

Question 988

Topic: Knee Sports

In reconstruction of the posterolateral corner of the knee, understanding the popliteus anatomy is crucial. Where does the popliteus tendon insert on the femur relative to the lateral collateral ligament (LCL) femoral attachment?

. Anterior and proximal
. Anterior and distal
. Posterior and proximal
. Posterior and distal
. Directly medial

Correct Answer & Explanation

. Anterior and distal

Explanation

The popliteus tendon inserts into the popliteal sulcus of the lateral femoral condyle. This footprint is located anterior and distal to the femoral attachment of the LCL.

Question 989

Topic: Knee Sports

The posterolateral corner (PLC) of the knee is a complex arrangement of static and dynamic stabilizers. Which of the following structures is considered a primary static stabilizer of the PLC?

. Popliteus muscle
. Biceps femoris tendon
. Popliteofibular ligament
. Iliotibial band
. Plantaris tendon

Correct Answer & Explanation

. Popliteofibular ligament

Explanation

The primary static stabilizers of the posterolateral corner of the knee include the lateral collateral ligament (LCL), the popliteofibular ligament, and the popliteus tendon. The biceps femoris and popliteus muscle belly act as dynamic stabilizers.

Question 990

Topic: Knee Sports

The popliteofibular ligament is a crucial static stabilizer of the posterolateral corner of the knee. It originates from the popliteus musculotendinous junction and inserts on the:

. Lateral femoral epicondyle
. Gerdy's tubercle
. Anterior aspect of the fibular head
. Posteromedial aspect of the fibular styloid
. Lateral tibial plateau

Correct Answer & Explanation

. Posteromedial aspect of the fibular styloid

Explanation

The popliteofibular ligament arises from the popliteus tendon and inserts onto the posteromedial aspect of the fibular styloid process. It plays a key role in resisting posterior translation, varus angulation, and external rotation.

Question 991

Topic: Knee Sports

A 22-year-old football player sustains a complete rupture of the anterior cruciate ligament (ACL). The femoral footprint of the anteromedial (AM) bundle of the ACL is best described as being located:

. High and deep on the medial wall of the lateral femoral condyle
. Low and shallow on the medial wall of the lateral femoral condyle
. High and deep on the lateral wall of the medial femoral condyle
. Low and shallow on the lateral wall of the medial femoral condyle
. Centrally on the intercondylar notch roof

Correct Answer & Explanation

. High and deep on the medial wall of the lateral femoral condyle

Explanation

The AM bundle of the ACL originates high and deep (proximal and posterior) on the medial aspect of the lateral femoral condyle. It is tight in flexion.

Question 992

Topic: Knee Sports



During surgical reconstruction of the posterolateral corner (PLC) of the knee, accurate femoral tunnel placement is required. What is the normal anatomic relationship of the femoral footprints of the fibular collateral ligament (FCL) and the popliteus tendon?

. The popliteus footprint is proximal and posterior to the FCL
. The popliteus footprint is distal and anterior to the FCL
. The popliteus footprint is directly posterior to the FCL
. The popliteus footprint is proximal and anterior to the FCL
. The popliteus and FCL share an identical footprint

Correct Answer & Explanation

. The popliteus footprint is distal and anterior to the FCL

Explanation

On the lateral femoral epicondyle, the popliteus tendon insertion is situated distal and anterior to the attachment of the fibular collateral ligament. Precise identification of these footprints is critical for anatomic PLC reconstruction.

Question 993

Topic: Knee Sports

Which of the following best describes the precise anatomic attachment of the popliteus tendon on the lateral femoral condyle relative to the fibular collateral ligament (FCL)?

. Proximal and posterior
. Proximal and anterior
. Distal and posterior
. Distal and anterior
. Directly deep to the FCL origin

Correct Answer & Explanation

. Distal and anterior

Explanation

The femoral footprint of the popliteus tendon is situated anterior and distal (inferior) to the origin of the fibular collateral ligament on the lateral femoral condyle. Understanding this relationship is critical for anatomical posterolateral corner reconstructions.

Question 994

Topic: Knee Sports

The anterior cruciate ligament (ACL) is composed of two primary bundles. Which statement accurately describes the tension pattern of these bundles during knee range of motion?

. The anteromedial bundle is tight in extension; the posterolateral bundle is tight in flexion
. The anteromedial bundle is tight in flexion; the posterolateral bundle is tight in extension
. Both bundles are equally tight in full flexion
. Both bundles are lax in full extension
. The posterolateral bundle restrains anterior translation exclusively in flexion

Correct Answer & Explanation

. The anteromedial bundle is tight in flexion; the posterolateral bundle is tight in extension

Explanation

The anteromedial (AM) bundle of the ACL is tight in flexion, whereas the posterolateral (PL) bundle is tight in extension. This biomechanical relationship is fundamental in assessing knee stability and performing anatomic ACL reconstructions.

Question 995

Topic: Knee Sports
In the anatomic reconstruction of the medial patellofemoral ligament (MPFL), the femoral tunnel placement is highly sensitive. The exact anatomic femoral insertion of the MPFL is located in which relation to bony landmarks?
. Just distal to the medial epicondyle
. Between the medial epicondyle and adductor tubercle
. Anterior to the adductor tubercle
. Posterior to the adductor tubercle
. On the superficial medial collateral ligament only

Correct Answer & Explanation

. Between the medial epicondyle and adductor tubercle

Explanation

The anatomic femoral origin of the MPFL (Schรถttle's point) is located in the saddle-shaped sulcus between the medial epicondyle and the adductor tubercle.

Question 996

Topic: Knee Sports
A patient presents with a combined grade III posterior cruciate ligament (PCL) injury and posterolateral corner (PLC) injury. During biomechanical testing, isolated sectioning of the popliteofibular ligament would result in maximum increased external tibial rotation at which knee flexion angle?
. 0 degrees
. 30 degrees
. 60 degrees
. 90 degrees
. 120 degrees

Correct Answer & Explanation

. 30 degrees

Explanation

The posterolateral corner structures are the primary restraint to external tibial rotation at 30 degrees of knee flexion. At 90 degrees, the PCL becomes an important secondary restraint to external rotation.

Question 997

Topic: Knee Sports

In an anatomic posterolateral corner (PLC) reconstruction using the LaPrade technique, the fibular attachment of the fibular collateral ligament (FCL) graft should be placed:

. Anterior and distal to the popliteofibular ligament attachment
. Posterior and proximal to the popliteofibular ligament attachment
. Directly on the tip of the fibular styloid
. Distal to the biceps femoris insertion
. On the medial aspect of the fibular head

Correct Answer & Explanation

. Anterior and distal to the popliteofibular ligament attachment

Explanation

The native FCL attaches to the lateral aspect of the fibular head, slightly anterior and distal to the attachment of the popliteofibular ligament and the fibular styloid. Anatomic graft placement here is crucial to restore native kinematics.

Question 998

Topic: Knee Sports

A 25-year-old male presents with lateral knee pain after a rugby tackle. The Dial test demonstrates 15 degrees of increased external rotation compared to the contralateral knee at 30 degrees of flexion, but symmetric rotation at 90 degrees of flexion. What is the most likely diagnosis?

. Isolated lateral collateral ligament (LCL) injury
. Isolated posterolateral corner (PLC) injury
. Combined PCL and PLC injury
. Isolated posterior cruciate ligament (PCL) injury
. Combined ACL and PLC injury

Correct Answer & Explanation

. Isolated posterolateral corner (PLC) injury

Explanation

A positive Dial test (>10 degrees of increased external rotation) at 30 degrees of flexion that normalizes at 90 degrees indicates an isolated posterolateral corner (PLC) injury. An increase at both 30 and 90 degrees suggests a combined PCL and PLC injury.

Question 999

Topic: Knee Sports
A 29-year-old male sustains a knee dislocation (KD-III) with complete disruption of the ACL, PCL, and MCL. After closed reduction, his ankle-brachial index (ABI) is 0.7. What is the most appropriate next step in management?
. Immediate multi-ligamentous reconstruction
. Observation and repeat ABI in 4 hours
. CT angiography of the lower extremity
. Application of a spanning external fixator and discharge
. Doppler ultrasound of the popliteal vein

Correct Answer & Explanation

. CT angiography of the lower extremity

Explanation

An ABI less than 0.9 following a knee dislocation indicates a high suspicion for a major arterial injury. CT angiography or a formal arteriogram is urgently indicated to accurately diagnose and localize popliteal artery injury before surgical exploration.

Question 1000

Topic: Knee Sports

A 25-year-old rugby player sustains a blow to the anteromedial aspect of his knee while it is fully extended and his foot is planted. Examination reveals a positive dial test at 30 degrees of knee flexion, but symmetric external rotation at 90 degrees compared to the contralateral side. Which structure is predominantly injured?

. Posterolateral corner (PLC)
. Posterior cruciate ligament (PCL)
. Both PLC and PCL
. Anterior cruciate ligament (ACL)
. Medial collateral ligament (MCL)

Correct Answer & Explanation

. Posterolateral corner (PLC)

Explanation

An isolated injury to the posterolateral corner (PLC) results in increased external rotation (positive dial test) at 30 degrees of flexion compared to the contralateral knee. If both the PLC and PCL were injured, external rotation would be increased at both 30 and 90 degrees of flexion.

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