5. Sports Medicine MCQs

During a medial patellofemoral ligament (MPFL) reconstruction for recurrent patellar instability, the surgeon inadvertently places the femoral tunnel proximal and anterior to the true anatomic insertion (Schottle's point). This malpositioning will cause the graft to be:

A 30-year-old man presents with chronic knee pain 10 years after sustaining an isolated, untreated Grade III PCL tear. Based on the altered kinematics of a PCL-deficient knee, which compartments are most likely to demonstrate advanced osteoarthritic changes?

A 24-year-old professional soccer player presents with a symptomatic, isolated 3.5 cm^2 full-thickness chondral defect on the weight-bearing surface of the medial femoral condyle.

Conservative management has failed. Which of the following is the most appropriate surgical intervention?

A 14-year-old boy with open physes presents with knee pain. MRI reveals a 1.5 cm osteochondritis dissecans (OCD) lesion on the lateral aspect of the medial femoral condyle. The overlying articular cartilage is intact and there is no subchondral fluid line. What is the best initial treatment?

A 20-year-old soccer player sustains a non-contact twisting knee injury. Radiographs show a small avulsion fracture of the anterolateral proximal tibia.

What is the most likely associated ligamentous injury, and what is its primary biomechanical function?

A 25-year-old professional baseball pitcher complains of posterior shoulder pain during the late cocking phase of throwing. Examination reveals a positive peel-back sign and increased external rotation with a deficit in internal rotation. What is the most likely diagnosis?

During an anterior cruciate ligament (ACL) reconstruction using an anteromedial portal technique, the surgeon aims to place the femoral tunnel in the anatomic footprint. Compared to the traditional transtibial technique, the anteromedial portal technique is associated with which of the following tunnel characteristics?

A 19-year-old collegiate hockey player presents with recurrent anterior shoulder instability. Preoperative evaluation determines an Instability Severity Index Score (ISIS) of 8. Which of the following surgical procedures is most appropriate to minimize his risk of recurrence?

A 24-year-old male sustains a traumatic knee injury. On physical examination, the dial test reveals 15 degrees of increased external rotation compared to the contralateral side at 30 degrees of knee flexion, but symmetrical external rotation at 90 degrees of knee flexion. What is the most likely diagnosis?

A 28-year-old professional baseball pitcher presents with posterior shoulder pain during the late cocking phase of throwing. Physical examination reveals a glenohumeral internal rotation deficit (GIRD) of 25 degrees. What is the primary pathophysiological mechanism contributing to this condition?

A 16-year-old female presents with recurrent lateral patellar dislocations. The decision is made to perform a medial patellofemoral ligament (MPFL) reconstruction. To prevent overloading the medial compartment and restricted knee flexion, the femoral attachment of the graft must be accurately placed. Where is the anatomic origin of the MPFL on the femur?

A 55-year-old male presents with shoulder pain and weakness after a fall. On examination, he has a positive "bear-hug" test and increased external rotation compared to the contralateral side. Which structure is most likely injured?

A 14-year-old male presents with vaguely localized knee pain and occasional catching. Radiographs reveal an osteochondritis dissecans (OCD) lesion. What is the most common anatomical location for this lesion in the knee?

A 40-year-old water skier sustains a complete proximal hamstring avulsion. He undergoes acute surgical repair. During the surgical approach to the ischial tuberosity, which of the following neurovascular structures is at the highest risk of iatrogenic injury, particularly with retraction?

A 25-year-old professional tennis player presents with shoulder pain and weakness in external rotation. An MRI demonstrates a massive, irreparable posterosuperior rotator cuff tear with severe fatty infiltration. The patient has preserved forward elevation but a positive external rotation lag sign. Which tendon transfer is most appropriate to restore active external rotation?

A 22-year-old athlete sustains an isolated Grade II posterior cruciate ligament (PCL) injury. Which of the following non-operative rehabilitation strategies is most effective for promoting intrinsic ligament healing and restoring knee stability?

A 25-year-old male sustains a direct blow to the proximal tibia with his knee flexed during a rugby match. On physical examination, he has a positive posterior drawer test. A dial test is performed, demonstrating greater than 10 degrees of increased external rotation compared to the contralateral knee at both 30 degrees and 90 degrees of flexion. What is the most likely diagnosis?

A 22-year-old collegiate baseball pitcher presents with vague posterior shoulder pain during the late cocking phase of throwing. Examination reveals a 25-degree loss of internal rotation (GIRD) compared to the non-throwing shoulder. Which of the following is the primary pathoanatomy responsible for this clinical presentation?

An 18-year-old female soccer player undergoes primary anterior cruciate ligament (ACL) reconstruction. When comparing bone-patellar tendon-bone (BPTB) autograft to hamstring autograft, which of the following is a recognized disadvantage specific to the BPTB autograft?

A 21-year-old rugby player presents with recurrent anterior shoulder instability. A CT scan of the shoulder reveals an engaging Hill-Sachs lesion and a 25% anterior glenoid bone defect.

What is the most appropriate definitive surgical management?