Knee Sports MCQs

A 21-year-old athlete undergoes revision ACL reconstruction. Preoperative CT scan shows an expanded tibial tunnel measuring 16 mm in diameter. What is the preferred surgical strategy in this setting?

A 25-year-old man presents with knee pain after a twisting injury. Physical examination reveals an asymmetric increased external rotation of the tibia of 15 degrees at 30 degrees of knee flexion, but no difference compared to the contralateral knee at 90 degrees of flexion. Which of the following structures is most likely injured?

During an anterior cruciate ligament (ACL) reconstruction, the surgeon evaluates the anatomy of the native ACL footprint. Which of the following statements correctly describes the biomechanics of the two main bundles of the ACL?

A 28-year-old dashboard-injury victim presents with a positive posterior drawer test and a posterior sag sign. MRI confirms an isolated Grade II posterior cruciate ligament (PCL) tear. What is the most appropriate initial management?

An 8-year-old girl (Tanner stage 1) sustains a midsubstance anterior cruciate ligament (ACL) tear. She experiences recurrent instability despite bracing and physical therapy. What is the most appropriate surgical technique to minimize the risk of physeal growth arrest?

A 26-year-old rugby player sustains a direct blow to the proximal tibia with the knee flexed at 90 degrees. Examination demonstrates a posterior sag sign and 8 mm of posterior translation of the tibia on the femur at 90 degrees of flexion, but normal translation at 30 degrees. The dial test is negative. What is the most appropriate initial management?

A 31-year-old soccer player sustains a hyperextension and varus injury to his knee. On examination, he has 15 degrees of increased external tibial rotation at 30 degrees of knee flexion compared to the contralateral side. This asymmetry completely resolves when tested at 90 degrees of flexion. Which structure is most likely injured?

Anterior cruciate ligament (ACL) reconstruction is planned. When evaluating graft placement, a femoral tunnel positioned too anteriorly (shallow) in the intercondylar notch will result in a graft that is biomechanically:

A 22-year-old collegiate football player undergoes anterior cruciate ligament (ACL) reconstruction using a bone-patellar tendon-bone autograft. During the procedure, the femoral tunnel is drilled too anteriorly. Which of the following complications is most likely to occur?

A 30-year-old man sustains a severe varus and hyperextension injury to his knee. Examination shows a positive dial test at 30 degrees of flexion but normal rotation at 90 degrees. What is the primary injured structure?

A 16-year-old girl experiences recurrent lateral patellar dislocations. Imaging shows a normal Tibial Tubercle-Trochlear Groove (TT-TG) distance and normal patellar height. She is scheduled for medial patellofemoral ligament (MPFL) reconstruction. The anatomic femoral attachment of the MPFL is located:

A 14-year-old boy presents with vague right knee pain and catching. Radiographs

reveal an osteochondritis dissecans (OCD) lesion. What is the most common anatomic location for an OCD lesion in the knee?

An 18-year-old female soccer player sustains a non-contact valgus and twisting injury to her knee, resulting in an ACL tear. During anatomic single-bundle ACL reconstruction, the surgeon specifically evaluates the femoral footprint. The posterolateral (PL) bundle of the anterior cruciate ligament is under its greatest tension in which of the following positions?

A 25-year-old football player sustains a direct blow to the anteromedial aspect of his proximal tibia. Physical examination reveals increased external tibial rotation at 30 degrees of knee flexion, but symmetrical external rotation at 90 degrees compared to the contralateral knee. This isolated physical examination finding strongly indicates injury to the:

A 55-year-old woman experiences a sudden popping sensation in the back of her knee while squatting to garden. An MRI reveals a medial meniscus posterior root tear. Biomechanically, this isolated injury is equivalent to which of the following?

A 22-year-old athlete undergoes an anterior cruciate ligament (ACL) reconstruction. At his 3-month postoperative visit, he lacks 15 degrees of full extension. A lateral radiograph demonstrates that the tibial tunnel is placed anterior to the intersection of Blumensaat's line and the tibial plateau. What is the most likely biomechanical consequence of this tunnel malposition?

A 26-year-old soccer player sustains a twisting injury to his knee. Physical examination reveals a positive posterior sag sign. A Dial test is performed, demonstrating a 15-degree increase in external rotation of the tibia compared to the contralateral leg at 30 degrees of knee flexion, but symmetrical external rotation at 90 degrees of knee flexion. These findings indicate an isolated injury to which structure?

A 16-year-old female experiences an acute lateral patellar dislocation while dancing. She is evaluated in the emergency department and reduced. Which of the following describes the most common anatomic location of injury to the medial patellofemoral ligament (MPFL) in this setting?

During an anatomic reconstruction of the posterolateral corner (PLC) of the knee, careful dissection is required to protect the common peroneal nerve. To avoid iatrogenic injury, the surgeon must consistently identify the nerve in relation to which primary anatomic landmark?

A football running back sustains a blow to the anteromedial aspect of his knee. Physical examination reveals 15 degrees of increased external rotation at both 30 and 90 degrees of knee flexion compared to the contralateral side. A posterior sag sign is also present. Which structures are most likely injured?