5. Sports Medicine MCQs

An 18-year-old athlete undergoes an isolated arthroscopic all-inside repair of a vertical longitudinal tear located in the red-white zone of the medial meniscus. To maximize the biological healing potential of this isolated meniscal repair, which of the following intraoperative adjuncts is most strongly supported by current literature?

A 35-year-old male weightlifter presents with chronic anterior shoulder pain that radiates down his arm. He reports pain primarily during the bench press and cross-body adduction. Physical examination reveals point tenderness over the coracoid process, and a positive O'Brien test that is relieved by external rotation. MRI of the shoulder reveals a coracohumeral distance of 4 mm and subscapularis tendinosis without a rotator cuff tear. After failing 6 months of physical therapy and corticosteroid injections, what is the most appropriate surgical management?

A 22-year-old collegiate football player presents with a recurrent anterior cruciate ligament (ACL) tear after sustaining a contact injury. His primary ACL reconstruction was performed 3 years ago utilizing a bone-patellar tendon-bone (BTB) autograft. Preoperative computed tomography (CT) demonstrates a femoral tunnel diameter of 16 mm and a tibial tunnel diameter of 15 mm. What is the most appropriate next step in surgical management?

A 28-year-old offensive lineman complains of recurrent posterior shoulder instability that has failed extensive nonoperative management. Imaging shows a reverse Hill-Sachs lesion involving 25% of the anterior humeral articular surface and an associated posterior labral tear. To prevent engagement and provide the best clinical outcome, what is the most appropriate surgical management?

A 25-year-old hockey player is undergoing hip arthroscopy for symptomatic femoroacetabular impingement (FAI) characterized by a prominent cam lesion and an alpha angle of 70 degrees. During the osteochondroplasty, excessive bony resection of the cam lesion at the femoral head-neck junction most significantly increases the risk of which of the following complications?

A 30-year-old male is evaluated in the clinic following a severe twisting injury to his left knee. Physical examination reveals a positive dial test with 15 degrees of increased external rotation at 30 degrees of flexion compared to the contralateral side. However, at 90 degrees of knee flexion, the external rotation is symmetric bilaterally. Which structure or combination of structures is most likely injured?

A 62-year-old highly active male presents with chronic pseudoparalysis of his right shoulder. Imaging reveals a massive, retracted, and irreparable supraspinatus and infraspinatus tear. He elects to undergo an arthroscopic superior capsular reconstruction (SCR).

To optimize the biomechanical success of the SCR and effectively centralize the humeral head, the allograft must be securely attached to the superior glenoid and which other structures?

A 14-year-old male presents with vague knee pain and intermittent mechanical catching. Radiographs reveal a 2 x 2 cm osteochondritis dissecans (OCD) lesion on the lateral aspect of the medial femoral condyle. MRI reveals a high T2 signal rim completely surrounding the osteochondral fragment. His physes remain open.

What is the most appropriate management?

A 25-year-old professional football player sustains a contact injury to his right knee. On physical examination, the dial test reveals 20 degrees of increased external rotation at 30 degrees of knee flexion compared to the contralateral knee. However, at 90 degrees of knee flexion, the external rotation is symmetric bilaterally. Based on these examination findings, which of the following structures is most likely injured?

A 22-year-old hockey player presents with chronic groin pain exacerbated by hip flexion and internal rotation. Examination demonstrates a positive anterior impingement test. An anteroposterior pelvis radiograph is obtained.

The radiograph demonstrates a prominent "crossover sign." Measurement of the alpha angle on a Dunn lateral view is 45 degrees. Which of the following is the most likely diagnosis?

A 50-year-old female presents with sudden onset medial-sided knee pain and a "pop" while squatting in her garden. She has no mechanical locking but exhibits an antalgic gait. MRI reveals a 4 mm medial meniscal extrusion and a radial defect directly at the posterior root attachment of the medial meniscus. If left untreated, the biomechanical consequence of this specific injury is most equivalent to which of the following?

A 45-year-old manual laborer presents with chronic, anterior shoulder pain that has failed 6 months of physical therapy and NSAID management. He describes deep, aching pain and catching when lifting objects away from his body. O'Brien's active compression test is positive. MRI reveals an isolated Type II SLAP (Superior Labrum Anterior to Posterior) tear. Given his age and occupational demands, which of the following is the most appropriate surgical management?

A 40-year-old water skier sustains a hyperflexion injury to the hip with her knee fully extended. She presents with significant ecchymosis over the posterior thigh, an antalgic gait, and an inability to run. MRI confirms a complete, 3-tendon avulsion of the proximal hamstring complex with 4 cm of retraction. Open surgical repair is planned. Which of the following neurovascular structures is located immediately lateral to the ischial tuberosity and is at highest risk during surgical retrieval and repair?

A 21-year-old male rugby player presents with recurrent anterior shoulder instability. He has had 5 dislocations in the past year. CT scan reveals 25% anterior glenoid bone loss. He undergoes an open Latarjet procedure. Which of the following describes the "sling effect" provided by the Latarjet procedure?

A 55-year-old man presents with anterior shoulder pain and weakness following a fall onto an outstretched hand. On physical examination, he demonstrates a positive bear-hug test and increased passive external rotation compared to the contralateral side. MRI confirms an isolated, full-thickness tear of the subscapularis tendon. During arthroscopic repair, which of the following structures must be carefully evaluated and is most commonly associated with this injury pattern?

A 24-year-old male hockey player presents with groin pain exacerbated by hip flexion and internal rotation. Radiographs demonstrate an alpha angle of 70 degrees on the Dunn lateral view and a lateral center edge angle of 35 degrees. He is diagnosed with femoroacetabular impingement (FAI). If left untreated, the pathomechanics of his specific impingement type typically result in which of the following patterns of chondral injury?

A 28-year-old male suffers a high-energy knee injury resulting in a combined posterior cruciate ligament (PCL) and posterolateral corner (PLC) tear. He undergoes a staged reconstruction. During reconstruction of the posterolateral corner, an anatomic fibular-based technique is planned. Which three primary static stabilizing structures of the PLC are reconstructed in this technique?