5. Sports Medicine MCQs

A 16-year-old female presents with recurrent lateral patellar instability. She has failed a 6-month trial of physical therapy. Imaging reveals normal patellar height (Caton-Deschamps index 1.0), normal trochlear morphology, and a tibial tubercle-trochlear groove (TT-TG) distance of 23 mm on MRI. What is the most appropriate surgical intervention?

A 52-year-old previously active female experiences a sudden pop in the posterior aspect of her knee while descending into a deep squat. Over the next month, she develops significant medial joint line pain and an effusion. MRI demonstrates a medial meniscus posterior root tear. If left untreated, what is the primary biomechanical consequence of this injury?

A 6-month post-operative anterior cruciate ligament (ACL) reconstruction patient presents with an inability to achieve terminal extension. The patient describes an anterior knee 'clunk' when attempting to fully extend the knee passively. Sagittal MRI shows a nodular soft tissue mass located anterior to the ACL graft in the intercondylar notch. What is the most appropriate management of this condition?

During a physical examination of a football player who sustained a direct blow to the anteromedial aspect of the tibia, you perform the dial test. The patient exhibits 20 degrees of increased external rotation of the tibia compared to the uninjured leg at 30 degrees of knee flexion. However, at 90 degrees of knee flexion, the external rotation is symmetric to the uninjured side. This examination finding is most indicative of an isolated injury to which of the following structures?

A 22-year-old collegiate football player sustains a recurrent anterior shoulder dislocation. Imaging (Figure 15) shows a significant anteroinferior glenoid bone loss estimated at 27%. Which of the following is the most appropriate surgical management?

A 28-year-old female recreational skier injured her knee. MRI (Figure 8) demonstrates an acute anterior cruciate ligament (ACL) tear and an extrusion of the medial meniscus on the coronal sequence with a missing meniscal bow tie sign on the sagittal sequence. Which of the following is the most appropriate management for the meniscus during ACL reconstruction?

A 30-year-old man sustains a direct blow to the anteromedial aspect of his knee. Examination reveals a positive dial test with 15 degrees of increased external rotation at both 30 and 90 degrees of knee flexion compared to the contralateral side. He also has a positive posterior drawer test. What is the most likely combination of injured structures?

A 21-year-old collegiate baseball pitcher complains of medial elbow pain during the late cocking and early acceleration phases of throwing. He reports feeling a 'pop' during his last outing. The moving valgus stress test is positive. An MRI (Figure 10) confirms a high-grade tear of the anterior bundle of the ulnar collateral ligament (UCL) at its insertion on the sublime tubercle. Which of the following graft choices is most commonly used for UCL reconstruction in this scenario?

A 19-year-old female gymnast complains of bilateral shoulder pain and a feeling of her shoulders 'slipping out of place' during routines. Physical examination reveals a positive sulcus sign bilaterally that does not obliterate with external rotation, a positive Beighton score of 7/9, and symmetric voluntary posterior subluxation. What is the most appropriate initial management?

What is the primary advantage of utilizing a quadriceps tendon autograft over a bone-patellar tendon-bone (BTB) autograft in primary anterior cruciate ligament (ACL) reconstruction?

A 24-year-old overhead throwing athlete presents with shoulder pain during the late cocking phase of throwing. What is the primary biomechanical mechanism contributing to a type II SLAP tear in this specific patient population?

A 45-year-old patient undergoes an MRI for acute posterior knee pain after a deep squat. The MRI reveals a medial meniscus posterior root tear. Biomechanically, leaving this injury untreated is most equivalent to which of the following?

A 30-year-old sustains an acute knee injury. On physical examination, the dial test is positive with 15 degrees of increased external rotation at 30 degrees of knee flexion, but symmetric to the contralateral side at 90 degrees of flexion. Which structural injury does this exam finding indicate?

A 35-year-old recreational athlete sustains an acute Achilles tendon rupture. In discussing nonoperative versus operative management using modern functional rehabilitation protocols, which of the following statements is true?

A 19-year-old competitive swimmer presents with bilateral shoulder pain and a positive sulcus sign. She is diagnosed with multidirectional instability (MDI). What is the mainstay of initial treatment for her condition?

A 40-year-old water skier sustained a hyperflexion injury of the hip with an extended knee, resulting in an acute 3-tendon proximal hamstring avulsion. Retraction is measured at 4 cm. What is the most significant clinical risk of nonoperative management in this specific scenario?

A 25-year-old basketball player sustains a noncontact twisting knee injury. Radiographs reveal an avulsion fracture of the anterolateral proximal tibia (Segond fracture). This radiographic finding is considered pathognomonic for an injury to which primary structure?

A 17-year-old female soccer player undergoes an uncomplicated primary anterior cruciate ligament (ACL) reconstruction with a bone-patellar tendon-bone autograft. She successfully completes an accelerated rehabilitation program. What is her greatest risk factor for a future ACL injury upon returning to sport?