5. Sports Medicine MCQs

A 50-year-old female experiences a 'pop' in the back of her knee while squatting. An MRI demonstrates a complete radial tear of the posterior horn of the medial meniscus exactly at its root attachment. Biomechanically, an un-repaired medial meniscus posterior root tear is equivalent to which of the following?

The microfracture technique for cartilage restoration works by penetrating the subchondral bone plate to release marrow elements. The resulting repair tissue is predominantly characterized by which of the following?

In a skeletally immature patient with an osteochondritis dissecans (OCD) lesion of the knee, which location is most common, and which MRI finding best indicates instability of the lesion that may require surgical fixation?

A 25-year-old male sustains a twisting knee injury. Examination reveals increased external tibial rotation at 30 degrees of knee flexion compared to the contralateral side. However, external rotation is symmetric at 90 degrees of knee flexion. Which structure is most likely injured?

A 30-year-old undergoes a microfracture procedure for a 1.5 cm2 full-thickness chondral defect on the medial femoral condyle. What is the primary histological composition of the repair tissue generated by this marrow stimulation technique?

A 9-year-old Tanner stage 1 patient requires surgical reconstruction for a completely torn anterior cruciate ligament (ACL). Which of the following graft choices is strictly contraindicated due to the highest risk of premature physeal closure and angular deformity?

A 14-year-old male presents with vague, activity-related knee pain. Radiographs demonstrate a classic osteochondritis dissecans (OCD) lesion. What is the most common anatomic location for an OCD lesion in the knee?

A 12-year-old boy presents with a 1.5 cm osteochondritis dissecans (OCD) lesion on the lateral aspect of the medial femoral condyle. His physes are wide open. After 6 months of non-operative management, MRI shows no healing but the lesion remains perfectly stable with intact overlying cartilage. What is the most appropriate next step?

The native anterior cruciate ligament (ACL) consists of two distinct functional bundles. Which of the following best describes the primary biomechanical function of the posterolateral (PL) bundle?

In reconstructing the posterolateral corner (PLC) of the knee, understanding native anatomy is critical to restoring stability. The popliteofibular ligament originates from the popliteus musculotendinous junction and inserts onto which specific anatomic landmark?

The medial patellofemoral ligament (MPFL) is a critical stabilizer of the extensor mechanism. At which degree of knee flexion does the MPFL provide the greatest percentage of restraint to lateral patellar translation?

A 25-year-old male sustains a high-velocity knee injury. Clinical examination demonstrates a deep transverse furrow ('dimple sign') over the medial joint line, and the knee is irreducible by closed means. Which structural interposition is most likely preventing reduction?

When harvesting the central third of the quadriceps tendon for an anterior cruciate ligament (ACL) reconstruction, violating the deepest layer of the extensor mechanism risks entry into the suprapatellar pouch. The quadriceps tendon is composed of multiple layers. Which muscle's aponeurosis contributes exclusively to the deepest layer of the quadriceps tendon?

During the physical examination of a patient with a multiple-ligament knee injury, the 'Dial test' is performed. The patient exhibits 15 degrees of increased external rotation of the tibia compared to the contralateral side at 30 degrees of knee flexion, and 15 degrees of increased external rotation at 90 degrees of flexion. Which structural injury pattern does this indicate?

A 28-year-old football player sustains a twisting injury to his knee. On physical examination, the dial test reveals +10 degrees of increased external rotation at 30 degrees of knee flexion compared to the contralateral side. At 90 degrees of knee flexion, the external rotation is symmetric bilaterally. What is the most likely injury pattern?

An 18-year-old male with closed physes presents with knee pain. MRI reveals a 2 x 2 cm osteochondritis dissecans (OCD) lesion on the lateral aspect of the medial femoral condyle. A distinct high-signal T2 line is present behind the osteochondral fragment. Diagnostic arthroscopy shows the overlying cartilage is completely intact and ballotable, but without breach. What is the most appropriate surgical treatment?

During posterior cruciate ligament (PCL) reconstruction, graft attenuation and ultimate failure can occur due to the sharp angle the graft must navigate as it exits the proximal posterior tibia and heads toward the medial femoral condyle. This phenomenon is termed the 'killer turn'. Which surgical technique is most strongly associated with this biomechanical disadvantage?

A 45-year-old female undergoes anatomic repair of a complete posterior medial meniscal root tear. By restoring the anatomical insertion of the root, which of the following biomechanical consequences of the tear is most directly mitigated?