Practice Set 85 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.
A 45-year-old female sustains a posterior medial meniscus root tear. Biomechanically, this injury is most equivalent to which of the following?
. Total meniscectomy
In bone-patellar tendon-bone (BTB) ACL reconstruction, which phase of graft healing is characterized by peak fibroblast proliferation and the beginning of collagen remodeling, but marks the weakest point of the graft?
. Revascularization phase
A 28-year-old male sustains a dashboard injury in a motor vehicle collision. Examination reveals a positive posterior drawer test. The dial test shows a 15-degree increase in external rotation at both 30 degrees and 90 degrees of flexion compared to the contralateral normal knee. Which of the following structures are most likely injured?
. Posterior cruciate ligament and posterolateral corner
When designing a posterior-stabilized (PS) total knee arthroplasty implant, the interaction between the femoral cam and the tibial post is engineered to replicate the function of which native structure?
. Posterior cruciate ligament
During an anterior cruciate ligament (ACL) reconstruction, the surgeon drills the femoral tunnel too vertically (high and anterior in the intercondylar notch). Which of the following clinical findings is most likely to result from this non-anatomic tunnel placement?
. Residual rotational instability demonstrated by a positive pivot shift test
A patient presents with a knee dislocation and a suspected posterolateral corner (PLC) injury. The dial test is performed. Which of the following findings is diagnostic of an isolated PLC injury without an associated PCL tear?
. Increased external rotation at 30 degrees but normal at 90 degrees of flexion
During an anterior cruciate ligament (ACL) reconstruction using a bone-patellar tendon-bone autograft, the surgeon places the femoral tunnel too far anteriorly. What is the most likely biomechanical consequence of this tunnel malposition?
. The graft will be tight in flexion and loose in extension
In a posterior-stabilized (PS) total knee arthroplasty design, what is the primary biomechanical function of the cam-and-post mechanism?
. To induce femoral rollback during knee flexion
What is the primary function of the "screw-home" mechanism in the normal human knee during terminal extension?
. External rotation of the tibia on the femur to lock the knee in stable extension
A 22-year-old athlete sustains a non-contact knee injury with a reported 'pop'. Initial radiographs reveal a small avulsion fracture of the lateral aspect of the proximal tibial plateau. This radiographic finding (Segond fracture) is virtually pathognomonic for an injury to which of the following structures?
. Anterior cruciate ligament
During anterior cruciate ligament (ACL) reconstruction, understanding the functional bundles is key to restoring normal knee kinematics. Which statement correctly describes the tension patterns of the native ACL bundles?
. The anteromedial bundle is tight in extension and the posterolateral bundle is tight in flexion.
The posterior cruciate ligament (PCL) is the primary restraint to posterior tibial translation. Which of the following accurately describes its functional bundle anatomy and biomechanics?
. The anterolateral bundle is tight in flexion; the posteromedial bundle is tight in extension.
. Distal to the adductor tubercle and proximal to the medial epicondyle
The popliteofibular ligament is a primary stabilizer against external rotation of the tibia. It originates from the popliteus tendon and attaches to which anatomical structure?
. Gerdy's tubercle
During a posterolateral approach to the knee for ligamentous reconstruction, the surgeon identifies the structures of the posterolateral corner. What is the correct anatomical relationship of the popliteus tendon footprint on the lateral femoral condyle relative to the lateral collateral ligament (LCL) origin?
. Proximal and anterior
A 48-year-old woman had an 8-month history of spontaneous onset of left medial knee pain. She was otherwise healthy with an unremarkable past medical history. Prior to the onset of knee pain, she jogged,played tennis, and golfed regularly. She wished to remain active. Examination showed a fit woman witha BMI of 26, a stable left knee with full range of motion, and some mild medial joint line tenderness.Radiograph results were normal. An MRI scan showed diffuse grade 3 and a focal area of grade 4 chondromalacia on the medial femoral condyle. The medial meniscus had a degenerative signal but no tear. The remainder of the knee showed no additional pathology. What is the most appropriate initial treatment?
. Lateral heal wedge
The anterior cruciate ligament (ACL) consists of two bundles: the anteromedial (AM) and posterolateral (PL). When the knee is extended, which statement best describes the tension of these bundles?
. Both bundles are equally tense.
. Between the adductor tubercle proximally and medial epicondyle distally, and posterior to both
A 45-year-old female presents with acute posterior knee pain and a 'pop' while squatting. MRI reveals a medial meniscus posterior root tear. Which of the following biomechanical consequences is most likely if left untreated?
. Decreased contact pressure in the medial compartment
A patient undergoes reconstruction of the posterolateral corner (PLC) of the knee. The reconstruction includes the fibular collateral ligament (FCL), popliteus tendon (PT), and popliteofibular ligament (PFL). What is the primary restraint to varus opening at 30 degrees of knee flexion?
. Popliteus tendon