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Knee Sports MCQs

Practice Set 72 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 1421

Topic: Knee Sports

The posterior horn of the lateral meniscus is stabilized by two meniscofemoral ligaments. Which of the following describes the anatomical course of the Ligament of Wrisberg?

. It passes anterior to the posterior cruciate ligament (PCL).
. It passes posterior to the posterior cruciate ligament (PCL).
. It passes anterior to the anterior cruciate ligament (ACL).
. It connects the anterior horns of the medial and lateral menisci.
. It passes between the popliteus tendon and the fibular collateral ligament.

Correct Answer & Explanation

. It passes posterior to the posterior cruciate ligament (PCL).

Explanation

The meniscofemoral ligaments connect the posterior horn of the lateral meniscus to the medial femoral condyle. The Ligament of Humphrey passes anterior to the PCL, while the Ligament of Wrisberg passes posterior to the PCL.

Question 1422

Topic: Knee Sports

Which structure acts as the primary static restraint to valgus stress of the knee when tested at 30 degrees of flexion?

. Posterior oblique ligament
. Superficial medial collateral ligament
. Deep medial collateral ligament
. Anterior cruciate ligament
. Semimembranosus tendon

Correct Answer & Explanation

. Superficial medial collateral ligament

Explanation

The superficial medial collateral ligament (sMCL) is the primary restraint to valgus load at all angles of knee flexion, but its role is most isolated and prominent at 30 degrees. The posterior oblique ligament provides more resistance near full extension.

Question 1423

Topic: Knee Sports

In reconstructing the posterolateral corner of the knee, anatomic placement of the femoral tunnels is critical to restore proper biomechanics. Which of the following best describes the femoral attachment of the popliteus tendon relative to the femoral attachment of the lateral collateral ligament (LCL)?

. Proximal and posterior
. Proximal and anterior
. Distal and anterior
. Distal and posterior
. Directly medial

Correct Answer & Explanation

. Distal and anterior

Explanation

On the lateral femoral condyle, the popliteus tendon inserts in the popliteal sulcus, which is located distal and anterior to the femoral attachment of the lateral collateral ligament. Accurate reproduction of this relationship is key to preventing postoperative stiffness and laxity.

Question 1424

Topic: Knee Sports

Anatomic reconstruction of the posterolateral corner (PLC) of the knee requires precise tunnel placement. The femoral footprint of the fibular collateral ligament (FCL) is situated in what position relative to the popliteus tendon insertion on the lateral femoral condyle?

. Proximal and posterior
. Proximal and anterior
. Distal and posterior
. Distal and anterior
. Directly medial

Correct Answer & Explanation

. Proximal and posterior

Explanation

The FCL femoral footprint is located roughly 18.5 mm proximal and posterior to the popliteus tendon insertion on the lateral femoral condyle. Proper anatomic recognition of this relationship is essential to restore physiologic knee kinematics during PLC reconstructions.

Question 1425

Topic: Knee Sports

During an anatomic reconstruction of the posterolateral corner of the knee, the surgeon must accurately identify the femoral footprints of the fibular collateral ligament (FCL) and the popliteus tendon (PT). On the lateral femoral epicondyle, what is the anatomic relationship of the PT insertion relative to the FCL origin?

. Anterior and proximal
. Anterior and distal
. Posterior and proximal
. Posterior and distal
. Directly superior

Correct Answer & Explanation

. Anterior and distal

Explanation

The popliteus tendon insertion is situated approximately 18.5 mm anterior and distal to the origin of the fibular collateral ligament on the lateral femoral epicondyle. Accurate tunnel placement here is critical for restoring normal posterolateral kinematics.

Question 1426

Topic: Knee Sports

During reconstruction of the posterolateral corner of the knee, a graft is placed at the anatomical femoral attachment of the fibular collateral ligament (FCL). Relative to the lateral epicondyle, where is the precise origin of the FCL?

. Distal and anterior to the lateral epicondyle
. Distal and posterior to the lateral epicondyle
. Proximal and anterior to the lateral epicondyle
. Directly over the lateral epicondyle
. Proximal and posterior to the lateral epicondyle

Correct Answer & Explanation

. Proximal and posterior to the lateral epicondyle

Explanation

The fibular collateral ligament originates 1.4 mm proximal and 3.1 mm posterior to the lateral epicondyle of the femur. The popliteus tendon inserts 18.5 mm anterior and distal to the FCL.

Question 1427

Topic: Knee Sports

Anatomical femoral tunnel placement is critical during reconstruction of the posterolateral corner (PLC) of the knee. Relative to the fibular collateral ligament (FCL) femoral attachment, where is the femoral footprint of the popliteus tendon located?

. 18.5 mm proximal and posterior
. 18.5 mm anterior and distal
. 8 mm anterior and distal
. 8 mm proximal and posterior
. Directly medial to the FCL footprint

Correct Answer & Explanation

. 18.5 mm anterior and distal

Explanation

According to the anatomical studies by LaPrade et al., the popliteus femoral insertion is located approximately 18.5 mm anterior and distal to the femoral insertion of the FCL.

Question 1428

Topic: Knee Sports

The anterior cruciate ligament (ACL) consists of two distinct functional bundles. Which of the following statements correctly describes the kinematic behavior of the anteromedial (AM) bundle?

. It is tightest in extension and acts as the primary restraint to internal rotation
. It is tightest in flexion and acts as the primary restraint to anterior translation at 30 degrees
. It is tightest in flexion and acts as the primary restraint to anterior translation at 90 degrees
. It provides negligible resistance to anterior translation compared to the posterolateral bundle
. It is solely responsible for rotational stability in full extension

Correct Answer & Explanation

. It is tightest in flexion and acts as the primary restraint to anterior translation at 90 degrees

Explanation

The anteromedial (AM) bundle of the ACL is tense in flexion and is the primary restraint to anterior tibial translation at 90 degrees of knee flexion. The posterolateral (PL) bundle is tighter in extension and restrains rotation.

Question 1429

Topic: Knee Sports

When reconstructing the posterolateral corner of the knee, anatomic placement of the popliteus tendon on the femur is critical. What is the normal anatomic relationship of the popliteus femoral attachment relative to the lateral collateral ligament (LCL) attachment?

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

Correct Answer & Explanation

. Distal and anterior

Explanation

The popliteus tendon footprint on the lateral femoral condyle is located approximately 18.5 mm distal and anterior to the femoral attachment of the lateral collateral ligament (LCL). Accurate identification of this relationship is essential for isometric posterolateral corner reconstruction.

Question 1430

Topic: Knee Sports

During surgical reconstruction of a multi-ligamentous knee injury, the surgeon must anatomically restore the posterolateral corner (PLC). When identifying the native femoral footprint of the fibular collateral ligament (FCL) to place a graft, where is this attachment site located relative to the lateral femoral epicondyle?

. Proximal and posterior
. Proximal and anterior
. Distal and posterior
. Distal and anterior
. Directly over the apex of the lateral epicondyle

Correct Answer & Explanation

. Proximal and posterior

Explanation

The anatomic femoral attachment of the fibular collateral ligament (FCL) is located approximately 1.4 mm proximal and 3.1 mm posterior to the lateral femoral epicondyle. The popliteus tendon insertion is situated approximately 18.5 mm anterior and distal to the FCL attachment. Precise anatomic knowledge is critical to prevent non-isometric graft placement during PLC reconstruction.

Question 1431

Topic: Knee Sports

During surgical reconstruction of the posterolateral corner of the knee, the surgeon must identify the popliteofibular ligament. Which of the following accurately describes the anatomy of the popliteofibular ligament?

. It originates from the fibular styloid and inserts on the lateral femoral epicondyle.
. It originates from the anterior aspect of the fibular head and inserts on the popliteus muscle belly.
. It originates from the popliteus tendon and inserts on the posteromedial aspect of the fibular head.
. It originates from the lateral meniscus and inserts on the popliteus tendon.
. It originates from the popliteus tendon and inserts on the posteromedial tibia.

Correct Answer & Explanation

. It originates from the popliteus tendon and inserts on the posteromedial aspect of the fibular head.

Explanation

The popliteofibular ligament is a critical static stabilizer of the posterolateral corner of the knee. It originates from the musculotendinous junction of the popliteus and inserts on the posteromedial aspect of the fibular head. Its primary function is to resist excessive external rotation of the tibia and provide varus stability.

Question 1432

Topic: Knee Sports

A 24-year-old football player sustains a contact injury to his knee, resulting in a varus and hyperextension moment. He complains of lateral knee pain and instability. Physical examination reveals a positive dial test at 30 degrees of flexion, which normalizes at 90 degrees. Which of the following structures is the primary static restraint to external rotation at 30 degrees of knee flexion?

. Anterior cruciate ligament
. Posterior cruciate ligament
. Popliteofibular ligament
. Iliotibial band
. Lateral collateral ligament

Correct Answer & Explanation

. Popliteofibular ligament

Explanation

A positive dial test at 30 degrees of knee flexion that normalizes at 90 degrees indicates an isolated injury to the posterolateral corner (PLC). The primary restraints to external tibial rotation at 30 degrees of knee flexion are the popliteus complex (including the popliteofibular ligament) and the lateral collateral ligament (LCL). However, biomechanical studies demonstrate that the popliteofibular ligament is specifically the most critical static restraint to external rotation in this position.

Question 1433

Topic: Knee Sports

During a posterolateral corner (PLC) reconstruction of the knee, the surgeon isolates the fibular collateral ligament (FCL) to prepare for anatomic graft placement. Which of the following best describes the precise anatomic footprint of the FCL on the lateral femoral condyle relative to the popliteus tendon insertion?

. Proximal and posterior
. Proximal and anterior
. Distal and posterior
. Distal and anterior
. Directly medial

Correct Answer & Explanation

. Proximal and posterior

Explanation

On the lateral femoral condyle, the footprint of the fibular collateral ligament (FCL) is located proximal and posterior to the attachment of the popliteus tendon. Recognizing this specific anatomic relationship is essential for accurate tunnel placement during anatomic posterolateral corner reconstructions.

Question 1434

Topic: Knee Sports

A 22-year-old collegiate football player undergoes reconstruction of a multi-ligament knee injury. MRI confirms complete rupture of the primary static stabilizers of the posterolateral corner (PLC). The surgeon identifies the popliteofibular ligament for anatomical reconstruction. What are the correct origin and insertion sites of the native popliteofibular ligament?

. Originates from the popliteus musculotendinous junction and inserts on the posteromedial down-slope of the fibular styloid.
. Originates from the lateral femoral epicondyle and inserts on the fibular head.
. Originates from the popliteus muscle belly and inserts on the lateral tibial plateau.
. Originates from the posterior horn of the lateral meniscus and inserts on the fibular head.
. Originates from the fabella and inserts on the fibular head.

Correct Answer & Explanation

. Originates from the popliteus musculotendinous junction and inserts on the posteromedial down-slope of the fibular styloid.

Explanation

The major static stabilizers of the posterolateral corner are the fibular collateral ligament (LCL), the popliteus tendon, and the popliteofibular ligament (PFL). The PFL originates from the musculotendinous junction of the popliteus and runs distally to insert on the posteromedial aspect (down-slope) of the fibular styloid. It acts as a crucial restraint to posterior translation, varus opening, and external rotation.

Question 1435

Topic: Knee Sports
A surgeon is utilizing Schöttle's point on a true lateral fluoroscopic view of the knee to determine the precise femoral attachment for a medial patellofemoral ligament (MPFL) reconstruction graft. According to Schöttle's radiographic landmarks, the correct femoral attachment is located:
. 1 mm anterior to the posterior cortex line, 2.5 mm distal to the posterior origin of the medial femoral condyle, and proximal to Blumensaat's line
. 5 mm posterior to the posterior cortex line, on Blumensaat's line
. 10 mm anterior to the posterior cortex line, distal to Blumensaat's line
. 2 mm posterior to the posterior cortex line, 5 mm proximal to the joint line
. Distal to the medial epicondyle and anterior to the adductor tubercle

Correct Answer & Explanation

. 1 mm anterior to the posterior cortex line, 2.5 mm distal to the posterior origin of the medial femoral condyle, and proximal to Blumensaat's line

Explanation

Schöttle's point establishes the strict radiographic location of the femoral footprint of the MPFL. On a perfect lateral radiograph, it is found 1 mm anterior to a line extending the posterior femoral cortex, 2.5 mm distal to the posterior perpendicular line originating from the posterior-most point of the medial femoral condyle, and just proximal to Blumensaat's line. Placing the graft here ensures near-isometric behavior during knee flexion.

Question 1436

Topic: Knee Sports

A 24-year-old rugby player sustains a severe contact injury to his knee, resulting in a grade 3 posterolateral corner (PLC) tear. The surgeon plans an anatomical reconstruction. Which of the following correctly describes the normal anatomical relationship of the fibular collateral ligament (FCL) and the popliteus tendon (PT) at their femoral insertions on the lateral epicondyle?

. The FCL inserts proximal and posterior to the PT
. The FCL inserts distal and anterior to the PT
. The FCL inserts proximal and anterior to the PT
. The FCL inserts distal and posterior to the PT
. The FCL and PT share a conjoined origin on the lateral epicondyle

Correct Answer & Explanation

. The FCL inserts proximal and posterior to the PT

Explanation

According to the anatomical studies by LaPrade et al., on the lateral femoral condyle, the origin of the fibular collateral ligament (FCL) is situated 18.5 mm proximal and posterior to the origin of the popliteus tendon (PT). The popliteus inserts in the anterior portion of the popliteal sulcus. Understanding this spatial relationship is critical for accurate tunnel placement during anatomical posterolateral corner reconstructions.

Question 1437

Topic: Knee Sports

A 25-year-old professional football player requires an anatomic posterolateral corner (PLC) reconstruction of the knee. During the preparation of the femoral tunnel for the popliteus tendon, the surgeon must be aware of its anatomic relationship to the origin of the lateral collateral ligament (LCL). What is the classic anatomic position of the popliteus insertion relative to the LCL femoral attachment?

. Proximal and posterior
. Proximal and anterior
. Distal and posterior
. Distal and anterior
. Directly medial

Correct Answer & Explanation

. Distal and anterior

Explanation

On the lateral femoral condyle, the insertion of the popliteus tendon is consistently located in the popliteus sulcus, which is anterior and distal (inferior) to the origin of the lateral collateral ligament (LCL). Recognizing this relationship is critical for accurate tunnel placement during posterolateral corner reconstruction.

Question 1438

Topic: Knee Sports

A 22-year-old football player sustains a direct blow to the anteromedial aspect of his knee, resulting in a posterolateral corner (PLC) injury. During surgical reconstruction of the PLC, the surgeon dissects near the fibular head. Where is the common peroneal nerve most vulnerable to iatrogenic injury in this region?

. As it passes superficial to the lateral collateral ligament
. As it courses deep to the popliteus tendon
. As it wraps around the fibular neck, deep to the peroneus longus fascia
. Within the substance of the biceps femoris muscle belly
. Posterior to the lateral head of the gastrocnemius

Correct Answer & Explanation

. As it wraps around the fibular neck, deep to the peroneus longus fascia

Explanation

The common peroneal nerve descends obliquely along the lateral side of the popliteal fossa to the head of the fibula. It lies posterior to the biceps femoris tendon, then winds around the lateral surface of the fibular neck, deep to the peroneus longus muscle. This subfascial course around the fibular neck makes it highly vulnerable to injury during procedures addressing the posterolateral corner or proximal fibula.

Question 1439

Topic: Knee Sports

A 28-year-old soccer player undergoes surgical reconstruction of the posterior cruciate ligament (PCL) after a dashboard injury. The surgeon plans a double-bundle reconstruction to restore the native biomechanics of the PCL. During graft tensioning, at which degree of knee flexion should the anterolateral (AL) bundle and posteromedial (PM) bundle be tensioned, respectively?

. AL bundle at 90 degrees; PM bundle at 0 degrees
. AL bundle at 0 degrees; PM bundle at 90 degrees
. AL bundle at 30 degrees; PM bundle at 90 degrees
. AL bundle at 90 degrees; PM bundle at 90 degrees
. AL bundle at 0 degrees; PM bundle at 30 degrees

Correct Answer & Explanation

. AL bundle at 90 degrees; PM bundle at 0 degrees

Explanation

The PCL is composed of two main bundles: the anterolateral (AL) bundle and the posteromedial (PM) bundle. Biomechanically, the AL bundle is the larger, primary restraint and is tightest in knee flexion (around 90 degrees). The PM bundle is smaller and is tightest in knee extension (0 degrees). Therefore, in a double-bundle PCL reconstruction, the AL bundle is typically tensioned in roughly 90 degrees of flexion, while the PM bundle is tensioned in full extension.

Question 1440

Topic: Knee Sports

A 25-year-old football player sustains a direct blow to the anteromedial aspect of the knee while hyperextended. Examination reveals increased external tibial rotation at 30 degrees of knee flexion but symmetrical external rotation at 90 degrees compared to the contralateral knee. Which of the following structures is most likely injured?

. Posterior cruciate ligament alone
. Posterolateral corner structures alone
. Anterior cruciate ligament and posterolateral corner
. Posterior cruciate ligament and posterolateral corner
. Medial collateral ligament and posterior oblique ligament

Correct Answer & Explanation

. Posterior cruciate ligament and posterolateral corner

Explanation

The Dial test evaluates external tibial rotation to diagnose injuries to the posterolateral corner (PLC) and posterior cruciate ligament (PCL). Increased external rotation at 30 degrees of knee flexion, with symmetrical rotation at 90 degrees, indicates an isolated posterolateral corner injury. If increased external rotation is present at both 30 and 90 degrees, it suggests a combined PCL and PLC injury. The primary stabilizers of the PLC are the fibular collateral ligament, popliteus tendon, and popliteofibular ligament.

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