Knee Sports MCQs

An AP radiograph of a 22-year-old skier's acutely injured knee demonstrates an elliptic bony avulsion fragment just distal to the lateral tibial plateau. This finding is highly pathognomonic for an injury to which structure, and what associated major ligamentous tear is likely present?

During a medial patellofemoral ligament (MPFL) reconstruction for recurrent patellar instability, the surgeon uses fluoroscopy to identify the femoral attachment point (Schöttle's point). This radiographic landmark is located:

A surgeon is performing a PCL reconstruction and chooses an open tibial inlay technique over a transtibial tunnel technique. The primary biomechanical advantage of the tibial inlay technique is:

A 24-year-old football player sustains a direct blow to the anteromedial aspect of his knee. Examination shows a positive dial test with 15 degrees of increased external rotation at 30 degrees of knee flexion, but symmetric external rotation compared to the contralateral knee at 90 degrees. Which structure is most likely injured?

Six months following an uncomplicated bone-patellar tendon-bone ACL reconstruction, a patient complains of a painful "clunk" and an inability to achieve terminal knee extension. MRI shows a nodular mass anterior to the ACL graft. What surgical error is the most common cause of this complication?

A 9-year-old boy (Tanner stage I) with widely open physes sustains a mid-substance ACL tear. His parents wish to proceed with surgical management due to recurrent instability episodes. Which surgical technique is most appropriate?

During an ACL reconstruction, a systematic arthroscopic evaluation is performed. Viewing from the anterolateral portal through the intercondylar notch reveals a tear at the meniscocapsular junction of the posterior horn of the medial meniscus. What is this specific lesion called?

To address residual anterolateral rotatory instability during an ACL reconstruction, an anterolateral ligament (ALL) reconstruction is planned. Which of the following describes the correct anatomic origin and insertion of the ALL?

When comparing the tibial inlay technique to the transtibial tunnel technique for posterior cruciate ligament (PCL) reconstruction, the tibial inlay technique specifically avoids which of the following biomechanical issues?

A 48-year-old woman experiences a sudden "pop" in the posterior aspect of her knee while squatting. MRI reveals a posterior medial meniscal root tear with 4 mm of meniscal extrusion. Which of the following best describes the biomechanical consequence of this injury if left untreated?

A 26-year-old soccer player sustains a twisting injury to his knee. On examination, the dial test reveals 15 degrees of increased external rotation of the tibia at 30 degrees of knee flexion compared to the contralateral side. At 90 degrees of flexion, the side-to-side difference in external rotation is less than 5 degrees. Which of the following injuries is most likely present?

A 25-year-old rugby player sustains a direct blow to the anteromedial aspect of his knee. Examination reveals increased external rotation of the tibia at 30 degrees of knee flexion, but symmetric external rotation at 90 degrees compared to the contralateral side. Which structure is the primary deficient restraint responsible for this examination finding?

A 25-year-old rugby player presents with a twisting knee injury. On examination, the dial test demonstrates 15 degrees of increased external rotation compared to the contralateral normal knee at 30 degrees of knee flexion, but symmetrical external rotation at 90 degrees of flexion. Which structure is most likely injured?

During a medial patellofemoral ligament (MPFL) reconstruction for recurrent patellar instability, the surgeon uses fluoroscopy to identify the femoral attachment site. According to Schöttle's method, where is the anatomic femoral origin of the MPFL located?

A 28-year-old man sustains a twisting injury to his knee. Examination reveals 15 degrees of increased external rotation on the dial test at 30 degrees of knee flexion compared to the contralateral side. At 90 degrees of knee flexion, the external rotation is equal bilaterally. Which structure is most likely injured?

A 28-year-old skier sustains an acute knee injury and presents with a positive dial test at 30 degrees of flexion, which normalizes to the contralateral side at 90 degrees of flexion. Which of the following structures is most likely injured?

A 16-year-old female experiences recurrent patellar dislocations. Physical exam reveals apprehension with lateral patellar translation. What is the primary soft-tissue restraint to lateral patellar translation at 20 degrees of knee flexion?

Which bundle of the anterior cruciate ligament (ACL) is the primary restraint to anterior tibial translation when the knee is in 90 degrees of flexion?

A 19-year-old football player sustains a valgus blow to his knee. Exam reveals a grade III MCL injury and an ACL tear. What is the recommended treatment strategy?

A patient presents with a chronic posterolateral corner (PLC) deficient knee resulting in a varus thrust during gait. Radiographs show mechanical axis falling medial to the knee center and no advanced osteoarthritis. What is the most appropriate initial surgical management?