Knee Sports MCQs

During a surgical reconstruction of the posterolateral corner (PLC) of the knee, anatomic femoral tunnel placement is critical for restoring normal kinematics. In relation to the popliteus tendon attachment on the lateral femoral epicondyle, where is the anatomical origin of the fibular collateral ligament (FCL)?

A 19-year-old female presents with recurrent lateral patellar instability. Imaging demonstrates an Insall-Salvati ratio of 1.4, a Caton-Deschamps index of 1.3, and a Tibial Tubercle-Trochlear Groove (TT-TG) distance of 22 mm. Which of the following surgical strategies is most appropriate?

A 30-year-old male sustains a posterior knee injury. Physical examination reveals a positive posterior drawer test. The Dial test demonstrates 15 degrees of increased external rotation at 30 degrees of knee flexion compared to the contralateral side, but symmetric external rotation at 90 degrees. Which structure is most likely injured?

A 25-year-old athlete presents with lateral knee pain and instability after a hyperextension injury. Physical examination reveals increased external rotation on the dial test of 15 degrees compared to the contralateral knee at 30 degrees of flexion, but symmetric rotation at 90 degrees of flexion. Which of the following structures is most likely injured?

A 19-year-old female undergoes medial patellofemoral ligament (MPFL) reconstruction for recurrent patellar instability. Postoperatively, she complains of severe medial knee pain and restricted flexion. What is the most likely technical error made during femoral tunnel placement?

A 28-year-old football player undergoes posterior cruciate ligament (PCL) reconstruction. The surgeon decides to use a single-bundle technique to reconstruct the anterolateral (AL) bundle. At what knee flexion angle does the AL bundle normally experience maximum tension?

A 24-year-old skier sustains an acute ACL tear. MRI suggests a posterior horn tear of the medial meniscus at the meniscocapsular junction. Arthroscopic evaluation via a posteromedial portal confirms a ramp lesion. Which of the following biomechanical effects is most exacerbated if this lesion is left untreated?

A 14-year-old male presents with persistent right knee pain and catching. Radiographs and MRI reveal a 2 cm osteochondritis dissecans (OCD) lesion on the lateral aspect of the medial femoral condyle. The physes are open, and the cartilage is intact with no subchondral fluid. What is the most appropriate initial management?

A 24-year-old professional football player sustains a posterolateral corner (PLC) injury of the knee. Which of the following structures is the primary restraint to varus instability at both 0 and 30 degrees of knee flexion?

A 26-year-old male is evaluated following a knee hyperextension injury. Physical examination reveals 15 degrees of increased external rotation at 30 degrees of knee flexion compared to the contralateral knee. However, at 90 degrees of flexion, the external rotation is symmetric. What injury pattern does this indicate?

A 20-year-old female runner has recurrent lateral patellar instability. CT imaging demonstrates a tibial tubercle-trochlear groove (TT-TG) distance of 24 mm with normal patellar height. Alongside MPFL reconstruction, which additional procedure is most indicated?

Which bundle of the posterior cruciate ligament (PCL) is considered the primary restraint to posterior tibial translation at 90 degrees of knee flexion?

During an acute anterior cruciate ligament (ACL) reconstruction in a 25-year-old athlete, a peripheral tear of the posterior horn of the medial meniscus at the meniscocapsular junction (Ramp lesion) is identified. What is the primary biomechanical consequence of leaving this lesion unrepaired?

A resident is performing a single-bundle anterior cruciate ligament (ACL) reconstruction. If the femoral tunnel is erroneously placed too far anteriorly (shallow) within the intercondylar notch, what abnormal graft tensioning pattern will result?

A 45-year-old male sustains a complete avulsion of the posterior root of the medial meniscus. Biomechanical studies indicate that the resulting contact pressures in the medial compartment of the knee are most functionally equivalent to which of the following conditions?

A 28-year-old male sustains a multi-ligamentous knee injury. Physical examination includes a dial test, which reveals 15 degrees of asymmetric increased external rotation of the tibia at 30 degrees of knee flexion compared to the uninjured side. However, external rotation is symmetric at 90 degrees of flexion. This pattern isolates injury to which structure(s)?