Knee Sports MCQs

A 14-year-old elite female gymnast presents with lateral elbow pain and catching. Radiographs show a radiolucency in the capitellum. MRI reveals an osteochondritis dissecans (OCD) lesion of the capitellum with intact articular cartilage, but there is a rim of T2 hyperintense fluid behind the lesion. What is the most appropriate management?

A 16-year-old female presents to the clinic after suffering a first-time lateral patellar dislocation while dancing. The patella was reduced in the emergency department. Which of the following is considered an absolute indication for acute surgical stabilization in this patient?

A 30-year-old male sustains a severe varus and hyperextension injury to his knee. Examination shows a positive dial test at 30 degrees of flexion, with a 15-degree increase in external rotation compared to the contralateral knee. However, the dial test is symmetric at 90 degrees of flexion. Which structure is most likely injured in isolation?

A 45-year-old recreational weightlifter feels a pop in the posterior aspect of his right knee while deep squatting. An MRI reveals a complete radial tear of the posterior root of the medial meniscus. If left untreated, what is the primary biomechanical consequence of this specific injury?

A 50-year-old woman reports feeling a 'pop' in her posterior knee while squatting to garden, followed by medial-sided knee pain and a mild effusion. MRI confirms a medial meniscus posterior root tear with no significant osteoarthritis. What biomechanical consequence is most likely if this injury is treated nonoperatively?

A 15-year-old female gymnast presents with an acute lateral patellar dislocation after an awkward landing. The patella is spontaneously reduced. On MRI, there is a full-thickness rupture of the primary soft-tissue restraint to lateral patellar translation. At what degree of knee flexion does this specific ligament provide the maximum proportional contribution to restraining lateral patellar displacement?

A 25-year-old football player sustains a direct blow to the anteromedial aspect of his proximal tibia while his foot is planted and the knee is in extension. He complains of lateral knee pain and instability. On physical examination, there is an asymmetric increase in external rotation on the dial test at 30 degrees of knee flexion, but the side-to-side difference resolves at 90 degrees of knee flexion.

Based on these findings, which of the following structures is most likely injured?

A 24-year-old male presents with knee stiffness 6 months after an anterior cruciate ligament (ACL) reconstruction using a bone-patellar tendon-bone autograft. On physical examination, he has full extension but lacks 30 degrees of terminal flexion compared to the contralateral knee. Which of the following technical errors during graft placement most likely accounts for this clinical presentation?

A 55-year-old physically active woman experiences a sudden 'pop' in her posterior knee while squatting. An MRI demonstrates a complete radial tear at the posterior root of the medial meniscus. If left untreated, biomechanical studies suggest this injury creates a knee environment most equivalent to which of the following?

A surgeon is planning a medial patellofemoral ligament (MPFL) reconstruction for a 17-year-old female with recurrent lateral patellar dislocations. To achieve anatomic reconstruction and isometric graft behavior, the femoral tunnel must be placed at Schöttle's point. Where is this landmark located radiographically on a true lateral view of the distal femur?

A 45-year-old active female reports a 'pop' in the posterior aspect of her knee while squatting, followed by acute posterior knee pain and mild effusion. Weight-bearing radiographs show no significant osteoarthritis. MRI reveals a radial tear at the posterior horn of the medial meniscus near its tibial attachment, accompanied by a 'ghost sign' on sagittal sequences and 4 mm of medial meniscal extrusion. What is the primary biomechanical consequence if this injury is left untreated?

A 24-year-old male presents 6 months after an anterior cruciate ligament (ACL) reconstruction using a bone-patellar tendon-bone autograft. He complains of pain at the anterior aspect of the knee during terminal extension. Physical examination reveals a 15-degree extension lag and a palpable, audible clunk when the knee is passively brought into full extension. Sagittal MRI shows a nodular soft-tissue mass anterior to the ACL graft. What is the most likely diagnosis?

A 22-year-old collegiate football player is struck on the anteromedial aspect of his knee. He presents with lateral knee pain and a feeling of instability. Physical examination demonstrates excessive external rotation of the tibia compared to the contralateral knee when evaluated at 30 degrees of knee flexion. However, external rotation is symmetric when tested at 90 degrees of knee flexion. Which of the following structures is primarily injured?

A 45-year-old female sustains sudden knee pain while deep squatting. An MRI is obtained, revealing a radial tear at the posterior horn of the medial meniscus, located 5 mm from its tibial attachment, accompanied by a 4 mm medial meniscal extrusion. Biomechanically, this specific injury profile is most equivalent to which of the following conditions?

A 13-year-old male presents with right knee pain and mechanical catching symptoms. Radiographs reveal an osteochondral lesion on the lateral aspect of the medial femoral condyle. MRI confirms the 1.5 cm lesion and demonstrates high T2 signal (fluid) interposing behind the lesion and the native subchondral bone, though the articular cartilage cap appears intact. His physes are wide open. What is the most appropriate initial surgical management?

A 16-year-old female experiences an acute lateral patellar dislocation while dancing. After reduction, she is evaluated for risk factors for recurrent instability. Which of the following radiographic parameters is considered a primary major anatomic risk factor for recurrent lateral patellar dislocation?

A 25-year-old male presents with recurrent knee instability 18 months after an anatomic single-bundle anterior cruciate ligament (ACL) reconstruction using a bone-patellar tendon-bone autograft. On physical examination, he has a positive pivot shift test but full range of motion. Radiographs demonstrate the femoral tunnel positioned too anteriorly (shallow) on the lateral femoral condyle. What is the most likely clinical consequence of an anteriorly placed femoral tunnel in ACL reconstruction?

A 19-year-old female presents with recurrent lateral patellar dislocations after failing 6 months of targeted physical therapy. Imaging demonstrates a normal trochlea, but a CT scan reveals a tibial tubercle-trochlear groove (TT-TG) distance of 22 mm and patella alta (Caton-Deschamps index 1.4). Which of the following surgical strategies is most appropriate to normalize her patellofemoral biomechanics?

A 30-year-old male sustains a direct blow to the anteromedial aspect of his proximal tibia while his knee is fully extended. He presents with posterolateral knee pain and a varus thrust during gait. Physical examination reveals a positive Dial test, demonstrating 15 degrees of increased external rotation of the tibia at 30 degrees of knee flexion compared to the contralateral side, but symmetric rotation at 90 degrees of flexion. Which of the following structures is most likely injured?

An 18-year-old football player sustains a contact injury to his knee resulting in a posterolateral corner (PLC) injury. During anatomical reconstruction of the PLC, the surgeon aims to reconstruct the three major static stabilizing structures. Which of the following structures must be reconstructed to restore normal biomechanics?