5. Sports Medicine MCQs

A 24-year-old professional soccer player has a symptomatic 1.5 cm² focal grade IV osteochondral defect on the weight-bearing surface of the medial femoral condyle. He wishes to return to high-level play as rapidly as possible. Which of the following surgical interventions provides the highest rate of rapid return to sport for this specific lesion size and patient profile?

A 30-year-old male sustains a direct blow to the anteromedial aspect of his proximal tibia while his knee is fully extended. He presents with posterolateral knee pain and a varus thrust during gait. Physical examination reveals a positive Dial test, demonstrating 15 degrees of increased external rotation of the tibia at 30 degrees of knee flexion compared to the contralateral side, but symmetric rotation at 90 degrees of flexion. Which of the following structures is most likely injured?

A 45-year-old competitive water skier sustains a forced hyperflexion injury of the hip with the knee fully extended. She experiences a loud pop and profound weakness in knee flexion and hip extension. MRI confirms a complete 3-tendon avulsion of the proximal hamstring origin with 4 cm of distal retraction. During surgical repair, what anatomic landmark relationship is most critical for locating and protecting the sciatic nerve?

A 24-year-old female soccer player undergoes an ACL reconstruction with a quadrupled hamstring autograft. During the rehabilitation phase, she struggles with deep knee flexion strength. Which of the following best describes the expected persistent muscle strength deficit following this specific graft choice compared to patellar tendon autograft?

A 21-year-old collegiate rugby player sustains recurrent anterior shoulder dislocations. An en face 3D CT reconstruction of the glenoid demonstrates 22% anterior glenoid bone loss. Which of the following surgical procedures is most appropriate to restore stability?

A 32-year-old male bodybuilder feels a pop in his anterior chest while bench pressing. Examination reveals loss of the anterior axillary fold and weakness in internal rotation. Surgery is planned for a pectoralis major tendon rupture. To restore the native footprint anatomy, the sternal head of the pectoralis major should be reattached in which anatomical position relative to the clavicular head on the humerus?

A 40-year-old recreational basketball player sustains an acute Achilles tendon rupture. He opts for functional rehabilitation (nonoperative management) with an early weight-bearing protocol. Compared to surgical repair, which of the following outcomes is most likely expected?

A 28-year-old male undergoes hip arthroscopy for cam-type femoroacetabular impingement. Postoperatively, he complains of numbness over the dorsal aspect of his foot and weakness in ankle dorsiflexion and great toe extension. Which of the following intraoperative factors most likely contributed to this complication?

A 22-year-old collegiate baseball pitcher presents with vague posterior shoulder pain and a decline in pitching velocity. Physical exam reveals a positive O'Brien test and positive posterior impingement sign. A peel-back mechanism of the superior labrum is visualized on MRI arthrogram. Which of the following physical exam findings is most commonly associated with this pathology?

An 18-year-old football player sustains a contact injury to his knee resulting in a posterolateral corner (PLC) injury. During anatomical reconstruction of the PLC, the surgeon aims to reconstruct the three major static stabilizing structures. Which of the following structures must be reconstructed to restore normal biomechanics?

A 45-year-old recreational runner feels a "pop" in the posterior aspect of her knee while performing a deep squat. An MRI confirms a complete radial tear of the posterior horn of the medial meniscus at its root attachment. If left untreated, which of the following biomechanical alterations is most likely to occur in the affected knee compartment?

A 21-year-old collegiate rugby player presents with recurrent anterior shoulder instability. A 3D CT scan reveals 25% anterior glenoid bone loss and an engaging Hill-Sachs lesion. The surgeon plans an open Latarjet procedure. During the transfer of the coracoid process through the split in the subscapularis tendon, which of the following neurologic structures is at greatest risk of iatrogenic injury?

A 9-year-old male (Tanner stage 1) sustains a complete midsubstance ACL rupture. The surgeon elects to perform a transphyseal ACL reconstruction using soft tissue autograft.

If the tibial tunnel is inadvertently placed too anteriorly, violating the tibial apophysis, which of the following growth disturbances is most likely to manifest?

A 25-year-old professional hockey player undergoes hip arthroscopy for femoroacetabular impingement (FAI). Preoperative imaging demonstrated a prominent cam lesion with an alpha angle of 72 degrees. The surgeon performs an arthroscopic osteochondroplasty of the femoral head-neck junction. Resection of more than what percentage of the femoral neck diameter substantially increases the risk of a postoperative femoral neck fracture?

A 16-year-old female presents with recurrent lateral patellar instability. MRI demonstrates a torn medial patellofemoral ligament (MPFL). She has failed nonoperative management and is scheduled for an MPFL reconstruction.

To achieve isometric graft function, the femoral origin of the MPFL graft should be placed anatomically. Relative to the osseous landmarks on the medial distal femur, the anatomic origin of the MPFL is located:

A 28-year-old elite male volleyball player presents with painless weakness of his dominant shoulder, noting a marked decrease in spiking power. Physical examination reveals normal forward elevation and abduction strength, but isolated profound weakness in external rotation. MRI reveals cystic fluid at the spinoglenoid notch. Which of the following muscles is expected to show denervation atrophy on electromyography (EMG)?

A 19-year-old male soccer player is evaluated for chronic medial knee pain and swelling. MRI and subsequent diagnostic arthroscopy reveal a symptomatic, isolated 3.5 cm squared full-thickness chondral defect on the weight-bearing surface of the medial femoral condyle. He has no malalignment or ligamentous instability. Which of the following surgical interventions is most likely to provide hyaline-like cartilage repair and is specifically indicated for a defect of this size?

A 26-year-old male presents with lateral knee pain and instability after being tackled directly on the anteromedial aspect of his tibia. Physical examination reveals increased external rotation of the tibia compared to the contralateral side at 30 degrees of knee flexion, but this asymmetry resolves at 90 degrees of knee flexion. Which of the following structures constitute the primary static stabilizers of the anatomically defined "posterolateral corner" (PLC) that is injured in this scenario?

A 19-year-old female collegiate soccer player sustains a noncontact twisting injury to her left knee. MRI demonstrates a complete anterior cruciate ligament (ACL) rupture and a displaced bucket-handle tear of the medial meniscus. During arthroscopy, the medial meniscus is repaired using an all-inside technique. Which of the following factors most significantly increases the healing rate of the repaired medial meniscus?

A 24-year-old professional rugby player presents with a history of recurrent anterior shoulder instability, having sustained 4 dislocations in the past year. Radiographic and CT imaging reveals a 25% anterior glenoid bone loss and an engaging Hill-Sachs lesion. What is the most appropriate surgical management to minimize his risk of recurrence?