5. Sports Medicine MCQs

An 18-year-old male is evaluated for multidirectional instability (MDI) of the shoulder. He has generalized ligamentous laxity and positive sulcus signs bilaterally. Non-operative management with targeted physical therapy has failed after 9 months. If surgery is performed, what is the most critical intraoperative step to ensure success?

A patient undergoes a superior capsular reconstruction (SCR) using a dermal allograft for an irreparable supraspinatus tear. For the graft to effectively depress the humeral head and restore the superior restraint, to which two structures must the graft be securely fixated medially and laterally?

Six weeks following non-operative treatment of a nondisplaced Colles fracture, a 60-year-old female presents with a sudden inability to actively extend her thumb interphalangeal joint. What is the most appropriate management?

A 25-year-old professional soccer player undergoes an anterior cruciate ligament (ACL) reconstruction. Preoperative MRI revealed a suspicious fluid signal posterior to the medial meniscus. Intraoperatively, the surgeon suspects a 'ramp lesion'. Which of the following arthroscopic approaches provides the most optimal visualization for accurate diagnosis and repair of this specific lesion?

A 22-year-old rugby player presents with recurrent anterior shoulder instability. A 3D CT scan reveals 25% anterior glenoid bone loss. The surgeon plans to perform a Latarjet procedure. Which of the following biomechanical mechanisms is considered the primary stabilizer provided by this procedure when the shoulder is in the abducted and externally rotated position?

During a double-bundle posterior cruciate ligament (PCL) reconstruction, understanding the reciprocal tension pattern of the native PCL bundles is critical. Which of the following accurately describes the biomechanical behavior of the native PCL bundles during knee motion?

A 19-year-old female presents with a history of recurrent lateral patellar dislocations. Non-operative management has failed. Advanced imaging demonstrates an intact patellofemoral cartilage profile but reveals an elevated tibial tubercle-trochlear groove (TT-TG) distance. Above what specific TT-TG threshold is a medializing tibial tubercle osteotomy generally indicated?

A 28-year-old male volleyball player presents with insidious onset of vague posterior shoulder pain and isolated weakness in external rotation. An MRI reveals a paralabral cyst extending posteriorly. Compression of the involved neural structure at which of the following anatomic locations is the most likely cause of his specific physical exam findings?

A 30-year-old weightlifter feels a sudden 'pop' and tearing sensation in his anterior axillary fold while performing a heavy bench press. He is diagnosed with a pectoralis major tendon rupture. Which of the following accurately describes the anatomic relationship of the pectoralis major tendon at its insertion site?

A 55-year-old female reports a sudden, sharp pain in the back of her knee while descending stairs. MRI of the knee demonstrates a classic 'ghost sign'. This specific radiographic sign is most indicative of which of the following pathologies?

A 23-year-old collegiate hockey player complains of insidious anterior groin pain that worsens with deep flexion. Physical examination reveals limited internal rotation in flexion, and a positive anterior impingement test. Radiographs show an alpha angle of 68 degrees. In Cam-type femoroacetabular impingement (FAI), the offending osseous deformity is most frequently located at which aspect of the proximal femur?

A 30-year-old male presents to the clinic after a hyperextension knee injury. During physical examination, the Dial test reveals 15 degrees of increased external rotation at 30 degrees of knee flexion compared to the contralateral side. However, at 90 degrees of knee flexion, the external rotation is symmetric bilaterally. This clinical finding isolated to 30 degrees of flexion primarily implicates injury to which of the following structures?

A 35-year-old competitive water skier sustains an acute, complete, three-tendon proximal hamstring avulsion with 4 cm of retraction. Surgical repair is indicated. Which of the following peripheral nerves is anatomically situated closest to the ischial tuberosity footprint and is at the highest risk of iatrogenic injury during deep surgical dissection?

A 25-year-old professional baseball pitcher presents with posterior shoulder pain. Workup reveals 'internal impingement'. This pathologic process involves the articular surface of the rotator cuff becoming pinched between the greater tuberosity and the posterosuperior glenoid. During which specific phase of the throwing motion does this impingement primarily occur?

A 60-year-old male manual laborer presents with chronic shoulder weakness and pseudoparalysis of forward elevation. MRI demonstrates a massive, retracted, and irreparable posterosuperior rotator cuff tear (supraspinatus and infraspinatus) with advanced fatty infiltration (Goutallier stage 4), but the subscapularis is fully intact. There is no evidence of glenohumeral osteoarthritis. Which of the following is the most appropriate tendon transfer to restore active external rotation and elevation?

A 13-year-old male athlete presents with vague anterior knee pain and catching. Radiographs and subsequent MRI confirm the presence of Osteochondritis Dissecans (OCD) with intact overlying articular cartilage. Statistically, what is the most common anatomic location for an OCD lesion in the knee?

A 20-year-old elite track athlete sustains an acute fracture at the metaphyseal-diaphyseal junction of the 5th metatarsal (Jones fracture) during a sprint. Given her status as a high-level competitive athlete, what is the gold standard treatment to minimize the risk of nonunion and expedite return to play?

A 9-year-old boy (Tanner Stage 1) sustains a complete anterior cruciate ligament (ACL) rupture while skiing. He has wide-open physes and significant remaining growth potential. The parents opt for surgical intervention due to severe recurrent instability. Which surgical technique is most strongly recommended to minimize the risk of iatrogenic leg length discrepancy or angular deformity?

A 25-year-old football player sustains a knee hyperextension injury. On physical examination, the dial test reveals a 15-degree increase in external rotation at 30 degrees of knee flexion compared to the contralateral side. However, at 90 degrees of knee flexion, external rotation is symmetric bilaterally. What is the most likely diagnosis?