5. Sports Medicine MCQs

A 28-year-old athlete undergoes an open repair of a completely ruptured pectoralis major tendon. The surgeon notes that the tendon consists of two primary heads with a unique insertion pattern. Which of the following accurately describes the anatomic insertion of the pectoralis major tendon onto the humerus?

A 19-year-old football player undergoes an anterior cruciate ligament (ACL) reconstruction. The surgeon wishes to replicate the native anatomy of the ACL bundles. Which statement correctly describes the femoral footprint of the ACL bundles with the knee in extension?

A 25-year-old male sustains a posterior shoulder dislocation resulting in isolated weakness in external rotation and a sensory deficit over the lateral deltoid. Which of the following defines the borders of the anatomic space through which the injured nerve passes?

Anterolateral and anteromedial portals are standard in anterior ankle arthroscopy. Establishing the anterolateral portal places which of the following nerves at highest risk of iatrogenic injury?

Anatomic ACL reconstruction relies on identifying the femoral footprint. The lateral intercondylar ridge (Resident's ridge) serves as a key surgical landmark.

Where is the native ACL femoral footprint located relative to this ridge when the knee is viewed at 90 degrees of flexion?

A 24-year-old athlete undergoes an isolated Posterior Cruciate Ligament (PCL) reconstruction using a double-bundle technique.

To accurately recreate the biomechanics of the native PCL, at what degree of knee flexion should the anterolateral (AL) and posteromedial (PM) bundles be tensioned and fixed, respectively?

During a Latarjet procedure for recurrent anterior shoulder instability with significant glenoid bone loss, the coracoid process is transferred to the anterior glenoid.

Which nerve is at greatest risk of iatrogenic injury during the medial retraction of the conjoined tendon and subsequent screw fixation?

A 22-year-old hockey player presents with anterior groin pain exacerbated by hip flexion and internal rotation. Imaging reveals Cam-type femoroacetabular impingement (FAI).

During hip arthroscopy, which of the following intra-articular pathologic findings is most commonly associated with isolated Cam impingement?

During a Medial Patellofemoral Ligament (MPFL) reconstruction for recurrent patellar instability, the surgeon inadvertently places the femoral tunnel proximal to the anatomic insertion site.

What is the expected biomechanical consequence during knee range of motion?

A 30-year-old runner has an isolated, full-thickness 3.5 cm^2 chondral defect on the medial femoral condyle. The surgeon considers Matrix-induced Autologous Chondrocyte Implantation (MACI).

Which of the following represents an absolute or strong relative contraindication to MACI for this patient?

A 35-year-old overhead athlete presents with posterior shoulder pain and profound weakness in external rotation. An MRI reveals a paralabral cyst in the spinoglenoid notch.

Which physical exam finding and associated intra-articular pathology is most likely present?

A 28-year-old football player sustains a multiligamentous knee injury. Physical exam reveals a positive posterior drawer test and increased external tibial rotation at 30 degrees of knee flexion compared to the contralateral side. However, at 90 degrees of knee flexion, the external tibial rotation is symmetric bilaterally. What is the most likely injury pattern?

A 14-year-old female gymnast complains of lateral elbow pain, clicking, and a loss of 15 degrees of extension. Radiographs and MRI demonstrate a 12mm osteochondral defect of the capitellum with subchondral fluid and a loose cartilaginous flap.

What is the most appropriate surgical intervention?

A 22-year-old female with an isolated ACL deficiency and genu varum is scheduled for an ACL reconstruction and an opening-wedge high tibial osteotomy (HTO). What is the potential biomechanical consequence of a standard medial opening-wedge HTO on the sagittal plane of the knee, and how does it affect the ACL graft?

In overhead throwing athletes, a Type II SLAP tear is often attributed to the 'peel-back' mechanism.

During which phase of the throwing motion does the maximal peel-back force occur on the superior labrum?

A 9-year-old Tanner stage 1 male sustains a complete, mid-substance ACL tear.

A physeal-sparing extra-articular reconstruction is planned. Which structure is traditionally utilized and routed over the 'over-the-top' position to reconstruct the ACL without violating the open physes?

A 65-year-old manual laborer presents with a massive, irreparable posterosuperior rotator cuff tear (supraspinatus and infraspinatus) with an intact subscapularis and functional deltoid. He lacks active external rotation (positive hornblower's sign). Which tendon transfer is most biomechanically appropriate to restore external rotation in this patient?

A 23-year-old professional soccer player presents with anterior knee pain and swelling. MRI reveals a 4.5 cm² full-thickness osteochondral defect with a 6 mm deep subchondral bone cyst on the weight-bearing surface of the medial femoral condyle. He has previously undergone a failed microfracture procedure. What is the most appropriate definitive surgical treatment?

During the evaluation of a patient with a multiligamentous knee injury, the examiner performs the Dial test. The test demonstrates 15 degrees of increased external rotation of the tibia relative to the femur at 30 degrees of knee flexion compared to the contralateral side. At 90 degrees of knee flexion, the external rotation is symmetric bilaterally. This clinical finding most likely indicates an isolated injury to which of the following?