5. Sports Medicine MCQs

A 50-year-old female experiences a sudden pop in her posterior knee while squatting. MRI demonstrates a radial tear at the posterior root of the medial meniscus.

Biomechanically, leaving this medial meniscus posterior root tear untreated is most comparable to which of the following?

A 28-year-old male undergoes hip arthroscopy for femoroacetabular impingement (FAI) with a symptomatic CAM lesion. During the osteochondroplasty of the anterolateral femoral head-neck junction, the surgeon must be cautious to avoid injury to the primary blood supply of the femoral head. Which vessel is at greatest risk if the resection is carried too far posterosuperiorly?

A 25-year-old professional rugby player sustains a contact injury to his right knee. Physical examination reveals a positive dial test with 20 degrees of increased external rotation compared to the contralateral side at both 30 degrees and 90 degrees of knee flexion. Varus stress testing demonstrates grade III laxity at both 0 degrees and 30 degrees of flexion. Which combination of ligamentous structures is most likely injured?

A 22-year-old collegiate baseball pitcher complains of posterior shoulder pain that is most severe during the late cocking phase of throwing. He has a loss of 25 degrees of internal rotation compared to his non-throwing shoulder. Which of the following describes the primary pathophysiologic mechanism for his pain?

A 28-year-old male undergoes right hip arthroscopy for femoroacetabular impingement. Postoperatively in the recovery room, he complains of profound numbness in the perineum and scrotum, and difficulty achieving an erection over the next several days. Which mechanism is the primary cause of this complication?

A 16-year-old female experiences a first-time lateral patellar dislocation while playing soccer. The patella spontaneously reduces. Initial radiographs reveal no acute fractures. Which of the following is an absolute indication for surgical intervention following this primary dislocation event?

A 45-year-old man falls onto his outstretched arm while skiing and sustains an acute, traumatic isolated full-thickness tear of the subscapularis tendon. Which of the following physical examination findings is most specific for this injury?

A 24-year-old athlete presents with a failed anterior cruciate ligament (ACL) reconstruction.

Computed tomography evaluation demonstrates significant femoral and tibial tunnel widening, with both tunnels measuring >16 mm in diameter. What is the most appropriate next step in management?

A 13-year-old skeletally immature male gymnast complains of ongoing knee pain.

MRI reveals a 1.5 cm x 1.5 cm osteochondritis dissecans (OCD) lesion on the lateral aspect of the medial femoral condyle. The overlying cartilage is intact, and there is no fluid behind the lesion. Non-operative management, including restricted weight-bearing and activity modification, has failed after 6 months. What is the most appropriate surgical treatment?

A 24-year-old female athlete undergoes an anterior cruciate ligament (ACL) reconstruction using a bone-patellar tendon-bone autograft. Postoperatively, she demonstrates a severe loss of terminal knee flexion. During physical examination under anesthesia, the reconstructed graft is noted to be excessively tight in flexion, but relatively lax in extension. What is the most likely technical error that occurred during the reconstruction?

A 28-year-old soccer player sustains a direct blow to the anteromedial aspect of the proximal tibia while the knee is flexed. On physical examination, the dial test reveals 25 degrees of external rotation of the tibia compared to 10 degrees on the contralateral side at 30 degrees of knee flexion. However, at 90 degrees of knee flexion, the external rotation is symmetric bilaterally. Which of the following structures is most likely injured?

A 22-year-old collegiate baseball pitcher complains of vague anterior shoulder pain and a 'dead arm' sensation that exclusively occurs during the late cocking phase of throwing. An MRI arthrogram confirms an isolated Type II SLAP (Superior Labrum Anterior and Posterior) tear. What is the primary biomechanical mechanism responsible for generating this specific pathology in an overhead athlete?

A 50-year-old active female feels a sharp 'pop' in her posterior knee while rising from a deep squat. MRI reveals a complete radial tear immediately adjacent to the posterior horn medial meniscus attachment, with 4 mm of meniscal extrusion seen on coronal sequences. Biomechanically, in terms of tibiofemoral contact pressures, this injury is most equivalent to which of the following?

During a medial patellofemoral ligament (MPFL) reconstruction for recurrent patellar instability, the surgeon utilizes intraoperative fluoroscopy to identify the anatomic femoral attachment site (Schöttle's point). Which of the following accurately describes the correct radiographic landmarks for this location on a strict lateral radiograph?

A 28-year-old marathon runner presents with persistent anterior knee pain. MRI and subsequent diagnostic arthroscopy reveal a symptomatic, 4.5 cm² full-thickness unipolar chondral defect on the weight-bearing surface of the medial femoral condyle. He has failed exhaustive nonoperative management. His mechanical alignment is neutral, and both menisci are intact. According to current treatment algorithms, what is the most appropriate primary cartilage restoration procedure?

A 24-year-old professional soccer player presents with recurrent knee instability 2 years after an arthroscopic anterior cruciate ligament (ACL) reconstruction using a bone-patellar tendon-bone autograft. He reports a 'giving way' episode without a new traumatic event. A sagittal MRI from his recent evaluation is shown in Figure 1.

What is the most common etiology for early clinical failure of this reconstructed ligament?

A 24-year-old male hockey player presents with chronic, deep groin pain exacerbated by hip flexion and internal rotation. Radiographs demonstrate a pistol-grip deformity. A coronal T2-weighted MRI of his right hip is shown in Figure 11.

During arthroscopic intervention for this condition, where is the most common location of concomitant articular cartilage damage expected to be found?

A 32-year-old weightlifter presents with right shoulder pain and weakness after feeling a clunk during a heavy bench press exercise. He reports difficulty externally rotating the arm. A modified axillary radiograph is provided in Figure 5.

Imaging reveals a reverse Hill-Sachs lesion that involves approximately 25% of the articular surface. What is the most appropriate surgical management?

A 26-year-old rugby player sustained a direct blow to the anteromedial aspect of his knee while it was fully extended. On physical examination, he demonstrates 15 degrees of increased external tibial rotation at 30 degrees of knee flexion compared to the contralateral side. At 90 degrees of flexion, the external rotation side-to-side difference is only 3 degrees. Which of the following structures is most likely injured?

A 17-year-old gymnast undergoes a medial patellofemoral ligament (MPFL) reconstruction using a semitendinosus autograft for recurrent patellar dislocations. The surgeon uses fluoroscopy to identify Schöttle's point for the femoral anchor placement. Which of the following best describes the radiographic landmarks for the anatomic femoral attachment of the MPFL on a true lateral radiograph?