5. Sports Medicine MCQs

A 55-year-old man presents with chronic shoulder weakness. MRI demonstrates a massive, retracted tear of the supraspinatus and infraspinatus tendons. Fatty infiltration is Goutallier grade 3. Electromyography reveals denervation of the infraspinatus. What is the most likely anatomic cause of this neurologic finding?

A 28-year-old man sustains a direct blow to the anteromedial aspect of his proximal tibia while his knee is flexed. Physical examination demonstrates a positive posterior drawer test. 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. What is the most likely diagnosis?

A 22-year-old collegiate soccer player undergoes anterior cruciate ligament reconstruction using a bone-patellar tendon-bone autograft. Compared to a quadrupled hamstring autograft, which of the following is a recognized biomechanical advantage or characteristic of this graft choice?

A 24-year-old professional baseball pitcher complains of vague posterior shoulder pain and a decrease in pitching velocity. On physical examination, he has 15 degrees of internal rotation and 125 degrees of external rotation at 90 degrees of abduction. Which of the following is the most appropriate initial management?

A 16-year-old female experiences recurrent patellar dislocations. Imaging reveals a tibial tubercle-trochlear groove (TT-TG) distance of 14 mm, a normal Caton-Deschamps index, and a shallow trochlea. What is the primary soft-tissue restraint to lateral patellar translation at 20 degrees of knee flexion that should be reconstructed in this patient?

A 23-year-old rugby player presents with recurrent anterior shoulder instability. CT scan with 3D reconstruction reveals 28% glenoid bone loss. He is planned for a Latarjet procedure. Which of the following best describes the "sling effect" contributing to anterior stability in this procedure?

A 35-year-old recreational athlete sustains an acute closed midsubstance Achilles tendon rupture. He opts for nonoperative management. Which of the following rehabilitation protocols has been shown to result in re-rupture rates comparable to operative management?

A 14-year-old boy presents with vague anterior knee pain. Radiographs reveal a 1.5 cm osteochondritis dissecans (OCD) lesion on the lateral aspect of the medial femoral condyle. His physes are open. MRI shows no fluid behind the lesion. What is the most appropriate initial management?

A 21-year-old collegiate baseball pitcher has persistent deep shoulder pain during the late cocking phase of throwing despite 3 months of conservative management. MR arthrogram reveals a Type II SLAP tear. During arthroscopy, a Type II SLAP lesion is confirmed. What is the most appropriate surgical management for this overhead athlete?

A 25-year-old hockey player presents with chronic anterior groin pain exacerbated by hip flexion and internal rotation. Radiographs demonstrate an alpha angle of 65 degrees on the Dunn lateral view and normal acetabular version. This condition is most strongly associated with the development of which intra-articular pathology?

On an AP pelvis radiograph of a 30-year-old woman with hip pain, the anterior wall of the acetabulum is seen crossing over the posterior wall before reaching the lateral edge of the sourcil. This radiographic finding is indicative of:

A 42-year-old tennis player undergoes shoulder arthroscopy for impingement symptoms. Diagnostic arthroscopy reveals a partial articular-sided supraspinatus tendon avulsion (PASTA) involving 60% of the tendon thickness. What is the most widely accepted surgical management for this lesion?

A 21-year-old collegiate soccer player undergoes anterior cruciate ligament (ACL) reconstruction using a bone-patellar tendon-bone autograft. Which of the following is a recognized biomechanical or biological advantage of this graft choice compared to a quadrupled hamstring autograft at the time of initial healing?

A 35-year-old recreational baseball pitcher has a symptomatic Type II SLAP tear that has failed conservative management. He opts for an arthroscopic SLAP repair. What is the most common post-operative complication of this procedure?

A 16-year-old female presents with recurrent lateral patellar instability. Imaging shows a tibial tubercle-trochlear groove (TT-TG) distance of 22 mm, a normal TT-PCL distance, and normal trochlear depth. Which of the following is the most appropriate surgical intervention?

A 45-year-old male undergoes arthroscopic rotator cuff repair for a massive, retracted, U-shaped tear. Margin convergence is performed prior to securing the tendon to the greater tuberosity. What is the primary biomechanical advantage of margin convergence?

A 22-year-old female collegiate soccer player undergoes anterior cruciate ligament (ACL) reconstruction with a bone-patellar tendon-bone autograft. What is the most common technical error leading to late graft failure?

During a single-bundle posterior cruciate ligament (PCL) reconstruction using an Achilles tendon allograft, what is the optimal knee position and applied force during graft tensioning to best restore native knee kinematics?

A 24-year-old rugby player presents with recurrent anterior shoulder instability. 3D CT and MRI indicate 22% anterior glenoid bone loss and an engaging, off-track Hill-Sachs lesion. Which of the following surgical interventions is most appropriate to prevent recurrent instability?