5. Sports Medicine MCQs

A 26-year-old overhead pitcher presents with vague, deep shoulder pain and decreased velocity. Physical examination reveals a positive O'Brien test and pain with resisted supination. An MR arthrogram demonstrates a Type II SLAP tear. If nonoperative management fails, what is the most appropriate surgical intervention?

A 21-year-old rugby player has recurrent anterior shoulder instability. CT scan

reveals 25% anterior glenoid bone loss. Which of the following is the most appropriate definitive management?

A 30-year-old man sustains a severe varus and hyperextension injury to his knee. Examination shows a positive dial test at 30 degrees of flexion but normal rotation at 90 degrees. What is the primary injured structure?

A 55-year-old man presents with an inability to actively internally rotate his arm. Physical examination reveals a positive belly-press test and increased external rotation compared to the contralateral side. MRI confirms a full-thickness tear of the subscapularis. During repair, which anatomic landmark reliably helps locate the retracted tendon?

A 16-year-old girl experiences recurrent lateral patellar dislocations. Imaging shows a normal Tibial Tubercle-Trochlear Groove (TT-TG) distance and normal patellar height. She is scheduled for medial patellofemoral ligament (MPFL) reconstruction. The anatomic femoral attachment of the MPFL is located:

A 65-year-old laborer has a massive, irreparable posterosuperior rotator cuff tear with an intact subscapularis, severe pseudoparalysis, and Hamada Grade 2 changes. Superior capsular reconstruction (SCR) is considered. Which structure provides the biomechanical basis for this procedure by keeping the humeral head reduced?

A 19-year-old female swimmer complains of bilateral shoulder pain and sensations of instability. Physical examination demonstrates generalized ligamentous laxity, positive sulcus sign, and apprehension in multiple planes. After 6 months of dedicated physical therapy, her symptoms persist. What is the surgical procedure of choice?

A 23-year-old minor league baseball pitcher presents with posterior shoulder pain during the late cocking phase of throwing. MRI demonstrates a partial articular-sided supraspinatus tendon avulsion (PASTA) and posterosuperior labral fraying. This pathology is primarily driven by:

A 14-year-old boy presents with vague right knee pain and catching. Radiographs

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

A 22-year-old rugby player presents with recurrent anterior shoulder instability. Advanced imaging reveals 30% anterior glenoid bone loss.

The most appropriate definitive surgical management is:

An 18-year-old female soccer player sustains a non-contact valgus and twisting injury to her knee, resulting in an ACL tear. During anatomic single-bundle ACL reconstruction, the surgeon specifically evaluates the femoral footprint. The posterolateral (PL) bundle of the anterior cruciate ligament is under its greatest tension in which of the following positions?

A 45-year-old recreational overhead athlete is diagnosed with an isolated Type II SLAP tear that has failed conservative management. When comparing arthroscopic SLAP repair to primary biceps tenodesis in this age demographic, evidence shows that SLAP repair is associated with:

A 25-year-old football player sustains a direct blow to the anteromedial aspect of his proximal tibia. Physical examination reveals increased external tibial rotation at 30 degrees of knee flexion, but symmetrical external rotation at 90 degrees compared to the contralateral knee. This isolated physical examination finding strongly indicates injury to the:

A 28-year-old professional baseball pitcher presents with a loss of throwing velocity and vague late-cocking phase shoulder pain. Examination reveals a 25-degree loss of internal rotation (GIRD) compared to the non-throwing shoulder. The primary pathophysiologic cause of this glenohumeral internal rotation deficit is:

A 55-year-old woman experiences a sudden popping sensation in the back of her knee while squatting to garden. An MRI reveals a medial meniscus posterior root tear. Biomechanically, this isolated injury is equivalent to which of the following?

A 22-year-old athlete undergoes an anterior cruciate ligament (ACL) reconstruction. At his 3-month postoperative visit, he lacks 15 degrees of full extension. A lateral radiograph demonstrates that the tibial tunnel is placed anterior to the intersection of Blumensaat's line and the tibial plateau. What is the most likely biomechanical consequence of this tunnel malposition?

A 19-year-old female gymnast presents with bilateral shoulder pain and a sensation of the shoulders 'slipping' during routines. Physical exam reveals a positive sulcus sign, positive apprehension tests with spontaneous relocation, and generalized ligamentous laxity. First-line management should focus on a rehabilitation program emphasizing strengthening of which of the following muscle groups?

A 45-year-old manual laborer presents with persistent shoulder pain and mechanical catching. Nonoperative management has failed, and arthroscopy reveals an isolated Type II SLAP tear. The surgeon elects to perform a primary biceps tenodesis rather than a SLAP repair. What is the primary advantage of biceps tenodesis over SLAP repair in this specific demographic?

A 26-year-old soccer player sustains a twisting injury to his knee. Physical examination reveals a positive posterior sag sign. A Dial test is performed, demonstrating a 15-degree increase in external rotation of the tibia compared to the contralateral leg at 30 degrees of knee flexion, but symmetrical external rotation at 90 degrees of knee flexion. These findings indicate an isolated injury to which structure?

A 16-year-old female experiences an acute lateral patellar dislocation while dancing. She is evaluated in the emergency department and reduced. Which of the following describes the most common anatomic location of injury to the medial patellofemoral ligament (MPFL) in this setting?