5. Sports Medicine MCQs

A 28-year-old male is evaluated for knee pain and instability after a motorcycle accident. Examination reveals a normal posterior drawer test but increased varus laxity at 30 degrees of flexion. The dial test shows 15 degrees of increased external rotation at 30 degrees of knee flexion compared to the contralateral side, but symmetric external rotation at 90 degrees. Which of the following structures is most likely injured?

A 21-year-old male hockey player presents with deep anterior groin pain that worsens with prolonged sitting and deep flexion activities. Physical exam is remarkable for a positive flexion, adduction, internal rotation (FADIR) test. Radiographs reveal an alpha angle of 65 degrees and a positive crossover sign. What is the most accurate description of his pathology?

A 16-year-old female dancer experiences her third lateral patellar dislocation. Conservative management and physical therapy have failed. Radiographs show a Caton-Deschamps index of 1.1 and a sulcus angle of 135 degrees. A CT scan reveals a tibial tubercle-trochlear groove (TT-TG) distance of 22 mm. Which of the following surgical interventions is most appropriate to restore stability?

A 10-year-old skeletally immature male sustains a mid-substance complete ACL tear. He has wide-open physes with an estimated 5 years of growth remaining. Nonoperative management is attempted, but he experiences recurrent instability episodes, prompting surgical intervention. Which of the following surgical techniques poses the highest risk for iatrogenic angular limb deformity or growth arrest in this patient?

A 15-year-old female high school soccer player sustains an anterior cruciate ligament (ACL) tear. Examination reveals a grade 3 Lachman test, a positive pivot shift, and generalized ligamentous laxity (Beighton score 6/9). Radiographs show closed physes. She wishes to return to competitive soccer. Which of the following graft choices is most strongly associated with the lowest risk of revision surgery in this patient profile?

A 25-year-old male undergoes a Latarjet procedure for recurrent anterior shoulder instability with 25% glenoid bone loss. Postoperatively, he presents with profound weakness in elbow flexion and decreased sensation over the lateral aspect of his forearm. Which of the following intraoperative maneuvers most likely caused this neurologic injury?

A 26-year-old male ice hockey player presents with insidious onset right groin pain, worsened by deep flexion and internal rotation. Examination demonstrates a positive FADIR test. Radiographs reveal a prominent bony bump at the anterolateral femoral head-neck junction with an alpha angle of 65 degrees. He undergoes arthroscopic osteochondroplasty for a cam deformity. During the resection of the femoral neck deformity, over-resection of the head-neck junction poses the greatest risk for which of the following complications?

A 10-year-old boy complains of a clunking sensation and pain in his lateral right knee. He has no history of trauma. MRI confirms the diagnosis of a symptomatic complete discoid lateral meniscus. There is no meniscal tear. What is the most appropriate surgical treatment?

A 6-year-old boy presents with a 6-month history of a painless snapping sound in his right knee. Examination reveals a palpable clunk at 20 degrees of flexion during extension of the knee. MRI confirms a complete discoid lateral meniscus with no evidence of a meniscal tear. What is the most appropriate management?

A 14-year-old boy presents with chronic anteromedial knee pain. An MRI is obtained which demonstrates a 2.5 x 2.5 cm osteochondritis dissecans (OCD) lesion on the lateral aspect of the medial femoral condyle. T2-weighted sequences show high signal intensity fluid completely encircling the bony lesion.

Diagnostic arthroscopy reveals a ballottable but macroscopically intact articular cartilage surface. What is the most appropriate surgical treatment?

A 12-year-old boy presents with vague, poorly localized knee pain and occasional catching. Radiographs demonstrate an osteochondritis dissecans (OCD) lesion.

In which of the following anatomic locations is an OCD lesion of the knee most classically found?

A 24-year-old hockey player presents with persistent anterior groin pain exacerbated by hip flexion.

An AP pelvis radiograph reveals a prominent 'crossover sign'. What is the primary pathomorphology associated with this radiographic finding?

A 22-year-old elite hockey player presents with chronic, activity-limiting groin pain. An AP pelvis radiograph demonstrates a "crossover sign" and projection of the ischial spine into the pelvic basin. These radiographic findings are most indicative of which pathology?

A 22-year-old woman presents with recurrent lateral patellar dislocations after failing 6 months of targeted physical therapy.

Advanced imaging demonstrates a tibial tubercle-trochlear groove (TT-TG) distance of 23 mm and a Caton-Deschamps index of 1.35. Which of the following is the most appropriate surgical treatment?

A 24-year-old male athlete presents with deep anterior groin pain exacerbated by hip flexion and internal rotation. An AP pelvis radiograph demonstrates a crossover sign and a prominent ischial spine sign. The alpha angle on the lateral view is 45 degrees. These radiographic findings are most consistent with which of the following pathomorphologies?

A 28-year-old professional hockey player reports deep anterior groin pain that is exacerbated by hip flexion and internal rotation. An anteroposterior radiograph of the pelvis demonstrates a 'crossover sign'.

What is the primary pathophysiologic mechanism responsible for this patient's condition?

A 24-year-old collegiate hockey player presents with chronic anterior groin pain exacerbated by hip flexion and internal rotation. Anteroposterior pelvis radiographs reveal a prominent crossover sign and an ischial spine sign. Which of the following best describes the pathomorphology contributing to this patient's impingement?

A 28-year-old male sustains a direct blow to the anteromedial aspect of his proximal tibia while his knee is flexed. Physical examination reveals increased external rotation of the tibia compared to the contralateral side when tested at 30 degrees of knee flexion, but symmetric external rotation when tested at 90 degrees of knee flexion. Which of the following structures is most likely injured?

In a posterior-stabilized (PS) total knee arthroplasty, the cam-post mechanism is designed to mechanically substitute for the resected posterior cruciate ligament (PCL). What is the primary kinematic function of this mechanism during deep knee flexion?