Menu

5. Sports Medicine MCQs

Practice Set 28 of 360

This practice set contains high-yield board review questions covering key concepts in 5. Sports Medicine. Each clinical scenario is designed to test your diagnostic and management skills relevant to this subspecialty.

Question 541

Topic: Shoulder & Hip Sports

A 65-year-old man presents with a chronic, massive, irreparable posterosuperior rotator cuff tear. He has severe external rotation weakness but an intact subscapularis. Which of the following tendon transfers is most appropriate to restore active external rotation?

. Pectoralis major transfer
. Latissimus dorsi transfer
. Lower trapezius transfer
. Pronator teres transfer
. Biceps rerouting

Correct Answer & Explanation

. Latissimus dorsi transfer

Explanation

The latissimus dorsi tendon transfer is indicated for younger, active patients with irreparable posterosuperior rotator cuff tears and an intact subscapularis. It helps restore active external rotation and forward elevation.

Question 542

Topic: 5. Sports Medicine

When comparing a bone-patellar tendon-bone (BPTB) autograft to a quadrupled hamstring autograft for anterior cruciate ligament reconstruction, which of the following is a recognized characteristic of the BPTB graft?

. It has a lower ultimate tensile load than a quadrupled hamstring graft
. It exhibits greater viscoelastic creep over time
. It allows for faster biological incorporation due to bone-to-bone healing
. It is associated with a higher rate of postoperative saphenous neuritis
. It has higher stiffness than the native ACL but lower stiffness than hamstring grafts

Correct Answer & Explanation

. It allows for faster biological incorporation due to bone-to-bone healing

Explanation

The BPTB autograft benefits from bone-to-bone healing in the osseous tunnels, typically completing incorporation by 6 weeks. Soft-tissue grafts like the quadrupled hamstring rely on slower Sharpey's fiber integration.

Question 543

Topic: 5. Sports Medicine

A 22-year-old collegiate football player undergoes anterior cruciate ligament (ACL) reconstruction using a bone-patellar tendon-bone (BPTB) autograft. Compared to hamstring autografts, which of the following is an expected advantage or characteristic of the BPTB graft?

. Higher incidence of hamstring weakness
. Decreased risk of anterior knee pain
. Faster graft incorporation via bone-to-bone healing
. Lower incidence of contralateral ACL tear
. Increased knee flexion deficit

Correct Answer & Explanation

. Faster graft incorporation via bone-to-bone healing

Explanation

Bone-patellar tendon-bone (BPTB) autografts benefit from reliable bone-to-bone healing at the aperture sites, leading to faster graft incorporation. However, they carry a higher risk of anterior knee pain and patellar fracture compared to hamstring grafts.

Question 544

Topic: 5. Sports Medicine

A 22-year-old female soccer player undergoes primary anterior cruciate ligament (ACL) reconstruction using a bone-patellar tendon-bone (BTB) autograft. Which of the following is the most frequently reported complication specific to this graft choice compared to hamstring autograft?

. Increased rates of graft rerupture
. Deep vein thrombosis
. Anterior knee pain
. Postoperative knee instability
. Incisional neuroma of the saphenous nerve

Correct Answer & Explanation

. Anterior knee pain

Explanation

Anterior knee pain, especially with kneeling, is the most common specific morbidity associated with bone-patellar tendon-bone (BTB) harvest. Rerupture rates are historically slightly lower or equivalent to hamstring grafts, but donor site morbidity is higher.

Question 545

Topic: Knee Sports

During an endoscopic anterior cruciate ligament (ACL) reconstruction, the surgeon places the femoral tunnel too anteriorly. What is the expected clinical consequence of this technical error?

. The graft will be tight in flexion and loose in extension
. The graft will be loose in flexion and tight in extension
. The graft will be tight throughout the entire arc of motion
. The graft will be loose throughout the entire arc of motion
. The graft will impinge in the intercondylar notch during extension

Correct Answer & Explanation

. The graft will be tight in flexion and loose in extension

Explanation

Placing the femoral tunnel too anteriorly (high in the notch) results in an ACL graft that is excessively tight in flexion and loose in extension. This can lead to a loss of full knee flexion and residual laxity in extension.

Question 546

Topic: 5. Sports Medicine

Which of the following is the most common complication associated with the use of a bone-patellar tendon-bone (BPTB) autograft for anterior cruciate ligament reconstruction?

. Saphenous nerve injury
. Anterior knee pain
. Patellar tendon rupture
. Arthrofibrosis
. Deep vein thrombosis

Correct Answer & Explanation

. Anterior knee pain

Explanation

Anterior knee pain, especially pain associated with kneeling, is the most frequently reported complication following BPTB autograft harvest. Patellar fracture or tendon rupture are much more severe but rare.

Question 547

Topic: Shoulder & Hip Sports
A 24-year-old baseball pitcher presents with a painful clunk in his shoulder during the late cocking phase of throwing. An MRI arthrogram reveals a superior labral tear extending into the long head of the biceps tendon anchor, causing instability of the biceps-labral complex. This represents which type of SLAP lesion?
. Type I
. Type II
. Type III
. Type IV
. Type V

Correct Answer & Explanation

. Type II

Explanation

A Type II SLAP lesion involves detachment of the superior labrum and the origin of the long head of the biceps tendon from the supraglenoid tubercle. This leads to distinct instability of the biceps-labral complex.

Question 548

Topic: Shoulder & Hip Sports

A 40-year-old male sustains a traumatic anterior shoulder dislocation. After closed reduction, an MRI shows an avulsion of the anterior labrum along with the anterior band of the inferior glenohumeral ligament (IGHL). What is the specific name of this lesion?

. ALPSA lesion
. Bankart lesion
. HAGL lesion
. SLAP lesion
. Perthes lesion

Correct Answer & Explanation

. Bankart lesion

Explanation

A classic Bankart lesion is defined as an avulsion of the anterior-inferior labrum and the attached inferior glenohumeral ligament complex from the anterior glenoid rim. It is the primary essential lesion in anterior shoulder instability.

Question 549

Topic: 5. Sports Medicine

A 24-year-old athlete feels a "pop" in his knee while pivoting. MRI confirms an isolated anterior cruciate ligament (ACL) rupture. He opts for a bone-patellar tendon-bone (BPTB) autograft reconstruction. Which of the following is the most common complication specific to this graft choice?

. Hamstring weakness
. Patellar fracture
. Anterior knee pain
. Graft rupture
. Deep vein thrombosis

Correct Answer & Explanation

. Anterior knee pain

Explanation

Anterior knee pain (patellofemoral pain) is the most common complication following ACL reconstruction using a BPTB autograft. While patellar fracture or tendon rupture can occur, they are much less common.

Question 550

Topic: 5. Sports Medicine

A 22-year-old female soccer player undergoes anterior cruciate ligament (ACL) reconstruction using a bone-patellar tendon-bone (BTB) autograft. Six months postoperatively, she reports anterior knee pain with kneeling. Compared to hamstring autograft, BTB autograft has a higher risk of which of the following?

. Higher graft failure rate
. Greater residual knee laxity
. Increased risk of contralateral ACL tear
. Increased incidence of anterior knee pain
. Decreased return to sport rate

Correct Answer & Explanation

. Increased incidence of anterior knee pain

Explanation

BTB autografts are associated with a higher incidence of donor site morbidity, specifically anterior knee pain and pain with kneeling, compared to hamstring autografts. Rates of graft failure and return to sport are generally comparable.

Question 551

Topic: Shoulder & Hip Sports

A 24-year-old overhead athlete undergoes an arthroscopic Bankart repair for recurrent anterior shoulder instability. Which of the following structural lesions must be addressed to minimize the risk of recurrent instability postoperatively?

. SLAP lesion
. Engaging Hill-Sachs lesion
. Subacromial impingement
. Type II acromion
. Buford complex

Correct Answer & Explanation

. Engaging Hill-Sachs lesion

Explanation

An engaging Hill-Sachs lesion can lever the humeral head out of the glenoid when the shoulder is in abduction and external rotation. If not addressed (e.g., via a remplissage procedure or bone block), it significantly increases the risk of recurrent instability.

Question 552

Topic: Knee Sports

A 21-year-old female collegiate soccer player sustains a twisting knee injury, feeling a pop followed by immediate hemarthrosis. An MRI reveals a complete tear of the anterior cruciate ligament (ACL) and a peripheral longitudinal tear of the medial meniscus. Which of the following statements is true regarding meniscal repair performed concurrently with ACL reconstruction?

. Concurrent ACL reconstruction significantly decreases the biological healing rate of the meniscal repair.
. The meniscal repair has a higher healing rate compared to a repair performed in an isolated, ACL-intact knee.
. Only the avascular white-white zone tears should be surgically repaired during ACL reconstruction.
. Partial meniscectomy yields better long-term functional outcomes and less osteoarthritis than meniscal repair in this setting.
. Rehabilitation should strictly prohibit all weight-bearing for 12 weeks to protect the meniscal repair.

Correct Answer & Explanation

. The meniscal repair has a higher healing rate compared to a repair performed in an isolated, ACL-intact knee.

Explanation

Meniscal repairs performed concurrently with ACL reconstruction demonstrate significantly higher healing rates than isolated repairs. The intra-articular bleeding and pluripotent marrow elements released during the bony tunnel reaming enhance the biological healing environment.

Question 553

Topic: 5. Sports Medicine

A surgeon utilizes a processed freeze-dried cortical allograft strut for structural support in a revision hip arthroplasty. Which of the following biological properties does this graft inherently possess?

. Osteogenesis only
. Osteoinduction only
. Osteoconduction only
. Osteogenesis and osteoinduction
. Osteoconduction, osteoinduction, and osteogenesis

Correct Answer & Explanation

. Osteoconduction only

Explanation

Freeze-dried cortical allografts provide a structural scaffold for host cells to populate, meaning they are osteoconductive. The processing kills viable cells (loss of osteogenesis) and denatures most proteins like BMPs (severe loss of osteoinduction).

Question 554

Topic: 5. Sports Medicine

During an anterior cruciate ligament (ACL) reconstruction, inadvertently placing the femoral tunnel too anteriorly will result in which of the following postoperative complications?

. Loss of terminal extension
. Loss of flexion
. Persistent pivot shift
. Graft laxity in deep flexion
. Patellar tendon rupture

Correct Answer & Explanation

. Loss of flexion

Explanation

An anteriorly placed femoral tunnel causes the ACL graft to tighten excessively as the knee moves into flexion. This results in a mechanical block and significant loss of postoperative flexion.

Question 555

Topic: 5. Sports Medicine

Following an anterior cruciate ligament (ACL) reconstruction using a bone-patellar tendon-bone autograft, at what postoperative time frame is the graft biomechanically at its weakest?

. 1 to 2 weeks
. 6 to 8 weeks
. 3 to 4 months
. 6 to 8 months
. 9 to 12 months

Correct Answer & Explanation

. 6 to 8 weeks

Explanation

The graft is at its weakest during the remodeling phase, typically around 6 to 8 weeks postoperatively. This corresponds to the period where revascularization and cellular repopulation actively degrade the initial graft tissue before new collagen synthesis predominates.

Question 556

Topic: Knee Sports

A 24-year-old athlete sustains a severe knee twist. Physical examination reveals an isolated increase in external tibial rotation of 15 degrees compared to the contralateral knee at 30 degrees of flexion, but symmetrical rotation at 90 degrees of flexion. Injury to which of the following structures is most likely responsible?

. Posterior cruciate ligament (PCL)
. Anterior cruciate ligament (ACL)
. Popliteofibular ligament
. Medial collateral ligament (MCL)
. Posteromedial corner

Correct Answer & Explanation

. Popliteofibular ligament

Explanation

A positive dial test showing increased external rotation at 30 degrees of flexion that reduces at 90 degrees indicates an isolated injury to the posterolateral corner (PLC). The popliteofibular ligament is one of the three primary static stabilizers of the PLC.

Question 557

Topic: Shoulder & Hip Sports

Which of the following muscles is first affected in facioscapulohumeral dystrophy:

. Orbicularis oris
. Serratus anterior
. Deltoid
. Supraspinatus
. Infraspinatus

Correct Answer & Explanation

. Orbicularis oris

Explanation

In facioscapulohumeral dystrophy, the facial muscles are affected first, commonly presenting with an inability to whistle. The serratus muscles and scapular stabilizers are affected next. The deltoid, supraspinatus, and infraspinatus are typically not affected in this disease.

Question 558

Topic: 5. Sports Medicine

Which of the following measures has not been shown to decrease rates of injury in healthy children participating in recreational sports:

. Knee braces during basketball and football
. Ankle braces in basketball
. Helmets for bicyclists
. Mouth guards for basketball
. Break-away bases for baseball

Correct Answer & Explanation

. Knee braces during basketball and football

Explanation

Knee braces have been shown not to reduce injury rates for children for children with sound knees. All other measures have been shown to reduce injury rates.

Question 559

Topic: 5. Sports Medicine

Which recreational activity causes the most musculoskeletal injuries in children ages 5 to 14 in the United States:

. Bicycles
. Football
. Soccer
. Trampolines
. Gymnastics

Correct Answer & Explanation

. Bicycles

Explanation

Bicycles are the leading cause of musculoskeletal injury in American children, with 415,000 injuries per year, followed by basketball, football, and roller sports.

Question 560

Topic: 5. Sports Medicine

Which of the following is the most common cause of low back pain in young athletes:

. Thoracolumbar Scheuermann apophysitis
. Herniated nucleus pulposus
. Slipped vertebral apophysis
. Spondylolysis
. Avulsion of the spinous apophysis

Correct Answer & Explanation

. Spondylolysis

Explanation

Spondylolysis is the most common cause of back pain in young athletes, accounting for approximately 50% of cases. The other causes are significantly less common.

Test Yourself

Switch to an interactive, timed exam simulation to truly master this topic.

On this Page