5. Sports Medicine MCQs

A 35-year-old recreational basketball player sustains an acute Achilles tendon rupture. He is evaluating operative versus non-operative treatment. Based on recent high-level randomized controlled trials (RCTs), what is true regarding early functional rehabilitation protocols (non-operative) compared to surgical repair?

A 21-year-old ballerina presents with an audible and palpable 'clunk' deep in her anterior groin. This consistently occurs when she extends her hip from a flexed, abducted, and externally rotated position. She denies any history of trauma. What is the most likely anatomic cause of this specific snapping?

A 20-year-old collegiate rugby player sustains a closed, midshaft clavicle fracture. He is treated non-operatively in a sling. At his 6-week follow-up, he is pain-free with full shoulder range of motion. Radiographs demonstrate bridging callus on 2 of 4 cortices. What is the standard recommendation for return to contact/collision sports?

A 42-year-old recreational tennis player presents with vague, deep shoulder pain. He has a positive O'Brien's active compression test. MRI arthrogram reveals a Type II Superior Labrum Anterior Posterior (SLAP) tear. What is the most evidence-based surgical management for this patient if conservative therapy fails?

A 12-year-old male soccer player presents with vague, intermittent medial knee pain. Radiographs demonstrate a radiolucent lesion with a sclerotic margin on the lateral aspect of the medial femoral condyle. An MRI shows a 14 mm Osteochondritis Dissecans (OCD) lesion with no subchondral fluid or cysts. His distal femoral physis is wide open. What is the most appropriate initial management?

A 28-year-old professional soccer player is diagnosed with a core muscle injury (athletic pubalgia) after complaining of chronic, insidious-onset lower abdominal and proximal adductor pain. The underlying pathophysiology most commonly involves a biomechanical imbalance between which two opposing muscular attachments on the pubis?

A 29-year-old competitive weightlifter feels a sharp 'tearing' sensation in his anterior axilla while performing a heavy bench press. Examination reveals extensive ecchymosis, a loss of the anterior axillary fold contour, and weakness in internal rotation and adduction. MRI confirms a complete avulsion of the sternoclavicular head from the humerus. Which of the following is true regarding surgical repair of this injury?

A 26-year-old male presents with persistent medial knee pain following a localized trauma 2 years ago. He has failed nonoperative management. MRI reveals an isolated, well-contained 4.0 cm^2 full-thickness chondral defect on the weight-bearing surface of the medial femoral condyle. The subchondral bone is intact. What is the most appropriate cartilage restoration procedure for a defect of this size?

A 52-year-old man trips on a stair and experiences a sudden inability to actively extend his right knee. Examination reveals a palpable defect proximal to the patella. Radiographs demonstrate patella baja. He undergoes a primary quadriceps tendon repair using transosseous tunnels. To optimize patellofemoral tracking and minimize abnormal tilt, where should the transosseous tunnels be positioned within the patella?

A 22-year-old soccer player sustains a twisting injury to his left knee. Physical examination reveals a positive Dial test, demonstrating 15 degrees of increased external rotation compared to the contralateral knee at 30 degrees of flexion, but symmetric external rotation at 90 degrees of flexion. Which structure is unequivocally injured?

A 27-year-old professional volleyball attacker complains of insidious posterior shoulder aching and weakness when attempting to spike the ball. Physical exam reveals notable atrophy of the infraspinatus fossa, but the supraspinatus fossa appears normal. External rotation strength is 3/5, while abduction strength in the scapular plane is 5/5. Where is the most likely anatomic location of nerve compression?

A 17-year-old female presents with recurrent lateral patellar dislocations. Nonoperative management has failed. MRI evaluation of her knee demonstrates a normal trochlear depth but reveals a tibial tubercle-trochlear groove (TT-TG) distance of 22 mm. What is the most appropriate surgical intervention to correct this specific anatomic risk factor?

A 25-year-old professional baseball pitcher presents with chronic, posterior shoulder pain during the late cocking and early acceleration phases of throwing. Physical examination reveals a glenohumeral internal rotation deficit (GIRD) of 25 degrees. What is the classic pathophysiologic mechanism of "internal impingement" in this athlete?

A 24-year-old competitive rugby player presents with recurrent anterior shoulder instability. A 3D CT scan reveals a 24% anterior glenoid bone defect. He has failed an extensive course of non-operative management. What is the most appropriate surgical intervention?

A 28-year-old professional volleyball player complains of vague posterior shoulder pain and selective weakness in external rotation. Exam reveals isolated atrophy of the infraspinatus fossa. MRI is most likely to show a paralabral cyst causing nerve entrapment in which of the following locations?

During the repair of an acute pectoralis major tendon rupture, the surgeon isolates the distinct heads of the tendon. Which of the following accurately describes the anatomic insertion of the sternal head of the pectoralis major onto the humerus relative to the clavicular head?

A 40-year-old male presents to the ED after a seizure. He holds his left arm in internal rotation. Radiographs confirm a posterior shoulder dislocation. CT scan reveals an anteromedial humeral head impaction fracture (reverse Hill-Sachs lesion) involving 30% of the articular surface. Which of the following is the most appropriate surgical intervention?

Glenohumeral Internal Rotation Deficit (GIRD) in the overhead throwing athlete is biomechanically linked to the development of a Type II SLAP tear. Which capsular abnormality is considered the primary driver of this internal rotation deficit and the resultant peel-back mechanism?

During a Latarjet procedure, retractors are often placed deep to the conjoint tendon. To avoid neuropraxia or permanent injury to the musculocutaneous nerve, retractor placement must be carefully monitored. What is the generally accepted 'safe zone' for retractor placement in relation to the coracoid process?