5. Sports Medicine MCQs

A 45-year-old 'weekend warrior' sustains a sudden 'pop' in his knee while forcefully decelerating during a basketball game. He is unable to perform a straight leg raise. In differentiating a quadriceps tendon rupture from a patellar tendon rupture on lateral knee radiographs, which of the following findings would strictly indicate a quadriceps tendon rupture?

A 28-year-old male sustains an isolated Posterior Cruciate Ligament (PCL) injury. After failing non-operative management, he undergoes a single-bundle PCL reconstruction. To optimally restore the primary restraint to posterior tibial translation, the graft should be placed in the anatomic footprint of the anterolateral (AL) bundle. At what knee flexion angle should the AL bundle graft be tensioned and fixated?

A 45-year-old active female presents with acute onset posteromedial knee pain after a deep squat. MRI reveals a complete radial tear at the posterior root of the medial meniscus with 4 mm of meniscal extrusion. Biomechanically, if left untreated, this injury most closely approximates the contact pressures of which of the following scenarios?

During an arthroscopic rotator cuff repair, the surgeon identifies a tear of the subscapularis tendon. Which of the following physical examination tests is most specific for evaluating a tear involving the upper border of the subscapularis tendon?

A 26-year-old overhead athlete is diagnosed with a Type II SLAP tear. The primary pathomechanical mechanism contributing to this injury in overhead throwers is known as the 'peel-back' mechanism. In which phase of the throwing motion does the peel-back mechanism exert the greatest torsional force on the biceps-labral anchor?

A 13-year-old male with open physes presents with knee pain. MRI reveals a 1.5 cm osteochondritis dissecans (OCD) lesion with an intact overlying articular cartilage on the lateral aspect of the medial femoral condyle. Initial non-operative management fails after 6 months. What is the most appropriate next step in management?

A 24-year-old female is 4 months status post ACL reconstruction with a bone-patellar tendon-bone autograft. She complains of an audible 'clunk' and an inability to achieve terminal extension. A localized nodule of fibrovascular tissue anterior to the graft is confirmed on MRI. Which of the following technical errors during the initial surgery most strongly predisposes to this specific complication?

A 24-year-old male presents with recurrent anterior shoulder instability. CT scan demonstrates a 15% anterior glenoid bone loss and an engaging Hill-Sachs lesion. The surgeon plans an arthroscopic Bankart repair with a Remplissage procedure. Which of the following structures is tenodesed into the Hill-Sachs defect during a Remplissage?

A 30-year-old male with chronic posterior knee instability undergoes a single-bundle Posterior Cruciate Ligament (PCL) reconstruction. To optimally restore primary restraint against posterior tibial translation, the graft should replicate which native bundle of the PCL, and at what knee flexion angle should it be conventionally tensioned?

A 25-year-old professional baseball pitcher presents with 'dead arm' syndrome and posterior shoulder pain during the late cocking phase of throwing. MRI arthrogram reveals a Type II Superior Labrum Anterior Posterior (SLAP) tear. During this specific phase of the throwing motion, what is the primary biomechanical force driving the 'peel-back' mechanism of the labrum?

A 26-year-old athlete sustains a traumatic knee injury. On examination, there is an increase of 15 degrees of external rotation of the tibia on the femur at 30 degrees of knee flexion compared to the uninjured side. However, at 90 degrees of knee flexion, the external rotation is symmetric between both knees. Which of the following structures is most likely injured?

A 14-year-old male presents with knee pain. MRI shows a 1.5 cm x 1.5 cm osteochondritis dissecans (OCD) lesion on the lateral aspect of the medial femoral condyle. The overlying articular cartilage is intact, but there is high T2 signal behind the lesion indicating lack of osseous integration. The patient's physes remain open. He has failed 4 months of strict non-weight bearing and rest. What is the most appropriate next step in surgical management?

A 32-year-old recreational athlete undergoes repair of an acute Achilles tendon rupture. The surgeon plans an early functional rehabilitation protocol instead of traditional prolonged cast immobilization. Based on current high-level evidence, which of the following is the most established benefit of early functional rehabilitation compared to standard cast immobilization?

A 23-year-old skier presents to the emergency department after a twisting knee injury. Plain radiographs reveal an elliptic avulsion fracture of the lateral tibial plateau, known as a Segond fracture. Which ligamentous structure is most intimately associated with this bony avulsion, and what major intra-articular injury is virtually pathognomonic with this finding?

A 22-year-old collegiate baseball pitcher presents with vague posterior shoulder pain during the late cocking phase of throwing. Arthroscopic evaluation reveals fraying of the posterosuperior labrum and a partial articular-sided tear of the supraspinatus. What is the primary pathophysiological mechanism for this specific constellation of findings?

A 45-year-old female presents with acute medial joint line pain after squatting. MRI reveals a complete radial tear of the medial meniscus at its posterior root attachment, accompanied by 4 mm of meniscal extrusion. If treated non-operatively, what is the most likely biomechanical consequence within the knee?

During a posterior cruciate ligament (PCL) reconstruction, the surgeon aims to accurately recreate the native biomechanics of the ligament. Which bundle of the PCL is the largest, and in what position of knee flexion is it under the most tension?

A 35-year-old male with a history of poorly controlled seizures presents with a locked posterior shoulder dislocation. CT imaging reveals an anteromedial humeral head impaction fracture (reverse Hill-Sachs lesion) involving 30% of the articular surface. What is the most appropriate surgical intervention?

A 28-year-old marathon runner presents with persistent medial knee pain. Imaging and subsequent arthroscopy confirm a 3.5 cm2 isolated, full-thickness chondral defect on the weight-bearing surface of the medial femoral condyle. The surrounding cartilage and meniscus are pristine. Which of the following is the most appropriate definitive surgical treatment?