5. Sports Medicine MCQs

During an anatomic reconstruction of the posterolateral corner (PLC) of the knee, accurate placement of the fibular collateral ligament (FCL) femoral tunnel is crucial. Relative to the lateral epicondyle, where is the native femoral footprint of the FCL located?

A 17-year-old female gymnast complains of bilateral shoulder pain and a sensation of the shoulders 'sliding out' of joint. Exam reveals a positive sulcus sign, anterior apprehension, and generalized ligamentous laxity (Beighton score 7/9). What is the most appropriate initial treatment?

The arthroscopic Remplissage procedure is utilized as an adjunct to a Bankart repair in cases of significant, engaging Hill-Sachs lesions without critical glenoid bone loss. Which anatomical structure is tenodesed into the humeral defect during this procedure?

During the first 6 weeks following an ACL reconstruction utilizing a quadrupled hamstring autograft, what represents the weakest biomechanical link in the reconstructed knee?

During the harvest of a hamstring autograft for ACL reconstruction, the surgeon utilizes an oblique incision over the pes anserinus. The patient later reports an area of numbness over the anterolateral aspect of the proximal leg. Which nerve was most likely injured during the harvest?

A 24-year-old athlete presents with progressive loss of knee flexion and anterior knee pain 6 months after an anterior cruciate ligament (ACL) reconstruction using a bone-patellar tendon-bone autograft. Radiographs demonstrate that the femoral tunnel was placed anterior to the anatomic footprint (high and anterior in the notch). What is the primary biomechanical consequence of this tunnel malposition?

A 35-year-old man presents to the emergency department after a first-time seizure. His arm is locked in internal rotation and adduction. Radiographs reveal a posterior shoulder dislocation. A subsequent CT scan shows an anteromedial humeral head defect involving 30% of the articular surface. Following closed reduction, the shoulder remains unstable in internal rotation. What is the most appropriate surgical management?

A 22-year-old collegiate soccer player sustains a twisting injury to his knee. On examination, he has a normal Lachman test and normal posterior drawer test. The dial test shows 15 degrees of increased external rotation of the tibia at 30 degrees of knee flexion compared to the contralateral side, but symmetric external rotation at 90 degrees of flexion. Which structure is most likely injured?

A 20-year-old rugby player evaluates for recurrent anterior shoulder instability. A 3D CT scan reveals 25% anterior glenoid bone loss. MRI shows an engaging Hill-Sachs lesion. Based on the glenoid track concept, which of the following procedures is most appropriate to minimize the risk of recurrent instability?

A 23-year-old professional baseball pitcher complains of vague posterior shoulder pain during the late cocking phase of throwing. Physical examination reveals a 25-degree glenohumeral internal rotation deficit (GIRD) compared to the contralateral side, and a positive peel-back sign on arthroscopic simulation. What is the recommended initial management?

A 20-year-old collegiate rugby player presents with recurrent anterior shoulder instability. A 3D CT scan reveals 25% anterior glenoid bone loss. What is the most appropriate surgical management?

A 32-year-old recreational volleyball player is diagnosed with a Type II SLAP tear. What differentiates a Type II from a Type I SLAP tear?

A 28-year-old male volleyball player presents with painless weakness in external rotation of his right shoulder. MRI reveals a paralabral cyst in the spinoglenoid notch. Which muscle is predominantly affected?

Compared to operative repair, functional bracing and early weight-bearing (non-operative management) of acute Achilles tendon ruptures in recreational athletes has been shown to result in:

What is the most common location for an osteochondritis dissecans (OCD) lesion in the knee?

A 24-year-old passenger sustains a dashboard injury in a motor vehicle collision.

Examination reveals a positive posterior drawer test. At what angle of knee flexion is the posterior cruciate ligament (PCL) the primary restraint to posterior tibial translation?

During a routine arthroscopic rotator cuff repair, a patient is noted to have an isolated, complete rupture of the subscapularis tendon. Which physical examination test would have been most definitively positive preoperatively?

A 22-year-old collegiate baseball pitcher reports deep shoulder pain during the late-cocking phase of throwing. He demonstrates a positive O'Brien test and a positive pronated load test. What is the most likely pathophysiologic mechanism of this injury?