5. Sports Medicine MCQs

During a physical examination of a patient with a suspected anterior cruciate ligament (ACL) injury, a positive pivot shift test is elicited. This test primarily evaluates the competency of which functional bundle of the ACL?

When evaluating a patient with recurrent anterior shoulder instability, what specifically defines an "off-track" Hill-Sachs lesion?

During an anterior cruciate ligament (ACL) reconstruction using a bone-patellar tendon-bone autograft, a resident places the femoral tunnel too anteriorly. What classical clinical finding will be observed during intraoperative graft tensioning?

A 24-year-old overhead throwing athlete presents with posterior shoulder pain. Physical examination reveals a positive active compression test (O'Brien test) that elicits deep joint pain with the forearm pronated, which is relieved with the forearm in supination. What is the most likely associated finding on MR arthrography?

A 25-year-old athlete sustains a twisting knee injury. MRI reveals a full-thickness anterior cruciate ligament (ACL) tear and a displaced bucket-handle tear of the medial meniscus. What is the most appropriate management?

A 19-year-old female collegiate soccer player sustains an anterior cruciate ligament (ACL) tear. Which of the following anatomic factors is most strongly associated with an increased risk of non-contact ACL injuries in female athletes?

A 40-year-old male suffers a seizure and subsequently complains of severe right shoulder pain. Radiographs show a "lightbulb" sign on the AP view and an empty glenoid sign. What is the most common associated bony defect seen with this specific injury?

In the evaluation of anterior shoulder instability, an Anterior Labroligamentous Periosteal Sleeve Avulsion (ALPSA) lesion differs from a classic Bankart lesion in which of the following ways?

A 15-year-old white boy presents to your office with inability to elevate his right shoulder and flex his elbow. He sustained a fall from an all-terrain vehicle 8 weeks ago. He landed on the right shoulder and says his neck was twisted away at the time of fall. He was seen at the local emergency department; skull, chest, cervical and thoracic spine, and shoulder X-rays showed no damage. There was no loss of consciousness and he has no chest pain or breathing difficulties. He was observed in the hospital until stable and was referred to follow up in the hand clinic at 4 weeks and scheduled for an electromyogram. Clinical examination reveals weakness of deltoid, supraspinatus, infraspinatus, teres minor, biceps, brachialis, brachioradialis, and extensor carpi radialis longus. The remainder of his forearm musculature is preserved and he can grasp and release and pinch. Sensations are decreased along the distribution of the axillary nerve. There is 3 cm wasting of his arm and 2 cm of his forearm. Tinel sign is positive around the clavicle. Horner signs are absent and his arm lies against the body. The EMG report shows fibrillation potentials in the weak muscles. The parents are concerned and say they have not seen any improvement. The boy reports that he is now able to flex his elbow. When asked to demonstrate you notice that he flexes his wrist and pronates his forearm to swing his elbow into flexion. What is the least helpful test in further management of this patient?

A 15-year-old white boy presents to your office with inability to elevate his right shoulder and flex his elbow. He sustained a fall from an all-terrain vehicle 8 weeks ago. He landed on the right shoulder and says his neck was twisted away at the time of fall. He was seen at the local emergency department; skull, chest, cervical and thoracic spine, and shoulder X-rays showed no damage. There was no loss of consciousness and he has no chest pain or breathing difficulties. He was observed in the hospital until stable and was referred to follow up in the hand clinic at 4 weeks and scheduled for an electromyogram. Clinical examination reveals weakness of deltoid, supraspinatus, infraspinatus, teres minor, biceps, brachialis, brachioradialis, and extensor carpi radialis longus. The remainder of his forearm musculature is preserved and he can grasp and release and pinch. Sensations are decreased along the distribution of the axillary nerve. There is 3 cm wasting of his arm and 2 cm of his forearm. Tinel sign is positive around the clavicle. Horner signs are absent and his arm lies against the body. The EMG report shows fibrillation potentials in the weak muscles. The parents are concerned and say they have not seen any improvement. The boy reports that he is now able to flex his elbow. When asked to demonstrate you notice that he flexes his wrist and pronates his forearm to swing his elbow into flexion. The plan of management in this boy 5 months after injury with no clinical improvement should be:

Following an anterior cruciate ligament (ACL) reconstruction using a bone-patellar tendon-bone autograft, a patient develops a "cyclops lesion". Which of the following clinical findings is most characteristic of this complication?

A 45-year-old female experiences a sudden pop in her posterior knee while squatting. MRI reveals a complete radial tear of the posterior horn of the medial meniscus at its bony attachment. Biomechanically, this injury is most equivalent to:

When comparing bone-patellar tendon-bone (BPTB) autografts to hamstring autografts for anterior cruciate ligament (ACL) reconstruction, BPTB grafts are historically associated with a higher incidence of which of the following complications?

During an anterior cruciate ligament (ACL) reconstruction, if the femoral tunnel is inadvertently placed too far anteriorly (shallow), what is the most likely clinical consequence during knee range of motion?

A 24-year-old athlete undergoes an open Latarjet procedure for recurrent anterior shoulder instability with significant glenoid bone loss. Which nerve is most at direct risk during the coracoid transfer and inferior subscapularis split?

A 22-year-old soccer player undergoes anterior cruciate ligament (ACL) reconstruction utilizing a bone-patellar tendon-bone (BTB) autograft. What is the most commonly reported complication specifically associated with this graft choice compared to hamstring autograft?

A 25-year-old athlete undergoes an anterior cruciate ligament reconstruction using a bone-patellar tendon-bone autograft. Improper placement of the femoral tunnel too anteriorly will result in which of the following kinematic abnormalities?

During a physical examination of a patient with a suspected multiligament knee injury, the dial test is performed. The 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 of flexion. Which structure is most likely injured?

Failure following supramalleolar osteotomy for ankle arthritis is associated with:

A 22-year-old rugby player presents with recurrent anterior shoulder instability. Imaging reveals an anterior glenoid bone loss of 28% and an engaging Hill-Sachs lesion. Which of the following is the most appropriate definitive management?