5. Sports Medicine MCQs

Which of the following best describes an Anterior Labroligamentous Periosteal Sleeve Avulsion (ALPSA) lesion?

A 19-year-old male sustains a first-time traumatic anterior shoulder dislocation during a football game. He is neurologically intact and the shoulder is closed reduced. What is his approximate risk of recurrent instability if managed non-operatively?

A 24-year-old male undergoes arthroscopic stabilization for recurrent anterior shoulder instability. Intraoperatively, he is found to have a 20% glenoid bone loss and an engaging Hill-Sachs lesion. Which of the following procedures involves tenodesis of the infraspinatus into the humeral defect?

A 16-year-old female gymnast presents with bilateral shoulder pain and a feeling of looseness. She has a positive sulcus sign bilaterally and apprehension with load and shift testing in multiple directions. What is the most appropriate initial management?

During a Latarjet procedure for anterior shoulder instability with significant glenoid bone loss, the coracoid process is osteotomized and transferred to the anterior glenoid. Which nerve is most at risk during the coracoid osteotomy and mobilization of the conjoint tendon?

A 45-year-old male is brought to the emergency department after suffering a generalized seizure. He holds his arm adducted and internally rotated. Radiographs reveal a posterior shoulder dislocation. Which of the following osseous lesions is most commonly associated with this injury?

A 28-year-old male with recurrent anterior shoulder dislocations is undergoing preoperative evaluation. A 3D CT scan is obtained. At what percentage of anterior glenoid bone loss is an arthroscopic soft tissue Bankart repair generally considered to have an unacceptably high failure rate, thus indicating a bony augmentation procedure?

A 48-year-old patient presents with a chronic, symptomatic Rockwood Type V acromioclavicular joint separation sustained 8 months prior. He has failed conservative management. The surgeon plans an anatomic coracoclavicular ligament reconstruction. Which of the following statements accurately reflects the principles of chronic AC joint reconstruction as outlined in the case?

A 68-year-old osteopenic female sustains a fall onto her shoulder, resulting in a displaced greater tuberosity fracture with significant superior retraction. During surgical planning, the surgeon considers the primary muscle responsible for this displacement. Which rotator cuff tendon primarily inserts on the superior facet of the greater tuberosity and is the main driver of superior displacement?

A 40-year-old male sustains a fall and presents with a suspected displaced greater tuberosity fracture. Initial radiographs (AP, scapular Y, axillary views) show a possible fracture, but the exact degree of displacement and comminution is unclear. Which of the following imaging modalities is considered essential for detailed pre-operative planning of a displaced greater tuberosity fracture?

A 55-year-old female dislocates her shoulder anteriorly after a fall. Post-reduction radiographs demonstrate an associated, minimally displaced greater tuberosity fracture. What is the relationship between this fracture and the risk of a concomitant rotator cuff tear?

In the classical Weaver-Dunn procedure for chronic acromioclavicular joint instability, the coracoacromial (CA) ligament is transferred to the distal clavicle. What is a primary limitation of using the isolated CA ligament for this reconstruction?

During open reduction and internal fixation of a proximal humerus fracture extending into the greater tuberosity, you use heavy non-absorbable sutures to secure the tuberosity fragment. Which muscle's tendon insertion are you primarily capturing to counteract the superior deforming force on the greater tuberosity?

A 25-year-old overhead athlete sustains a closed, isolated greater tuberosity fracture after a fall. To optimize return to play and avoid mechanical subacromial impingement, surgical fixation is highly recommended if superior displacement exceeds which of the following thresholds?

A 45-year-old skier sustains an anterior shoulder dislocation with an associated isolated greater tuberosity fracture.

The dislocation is successfully reduced in the emergency department. Post-reduction radiographs demonstrate the greater tuberosity fragment remains displaced 7 mm superiorly. What is the most appropriate definitive management?

A 35-year-old collegiate football player sustains a knee injury during a game, characterized by a direct blow to the proximal tibia with the knee flexed, resulting in a posterior knee dislocation (Schenck KD II). After successful reduction, the knee demonstrates significant posterior sag and a positive posterior drawer test. Additionally, a varus stress test at 30 degrees of flexion reveals significant laxity, and a positive dial test at 30 and 90 degrees of flexion is noted. Based on this clinical presentation, which of the following structures is MOST likely to be involved in addition to the PCL?

During a multi-ligament knee reconstruction for a chronic posterior knee dislocation, the surgeon is performing a PCL reconstruction using an allograft. To ensure proper graft tensioning and prevent posterior sag, at what knee position and with what maneuver should the PCL graft be tensioned?

A 38-year-old recreational athlete is undergoing rehabilitation after a multi-ligament knee reconstruction, including a PCL reconstruction. During the initial maximum protection phase (weeks 0-6), which of the following exercises or activities should be MOST strictly avoided to protect the PCL graft?

A 29-year-old male is undergoing arthroscopic-assisted ACL reconstruction following a knee dislocation. The surgeon is preparing to pass the graft through the femoral and tibial tunnels. The image below depicts a common technique for graft fixation during this procedure. Based on the image and the case description, what is the primary purpose of the structure being fixed in the femoral tunnel?

A 33-year-old active duty military personnel sustains a multi-ligamentous knee injury (ACL, PCL, and MCL tears) during a training exercise. After successful reduction and confirmation of vascular integrity, the orthopedic surgeon discusses the timing of definitive ligament reconstruction. According to current literature and guidelines, what is the most common approach regarding the timing of multi-ligament knee reconstruction?