5. Sports Medicine MCQs

A 19-year-old female gymnast complains of bilateral shoulder pain and a sensation of her shoulders "slipping." Examination demonstrates a positive sulcus sign and a positive apprehension test bilaterally, without a discrete history of trauma. Initial management should primarily consist of:

Six months after an uncomplicated anterior cruciate ligament (ACL) reconstruction with a bone-patellar tendon-bone autograft, a 22-year-old athlete complains of an inability to achieve full terminal extension. MRI reveals a nodular mass anterior to the ACL graft in the intercondylar notch. What is the most likely etiology?

A 24-year-old rugby player undergoes arthroscopic Bankart repair for recurrent anterior shoulder instability. Intraoperatively, an engaging Hill-Sachs lesion is identified with a glenoid bone loss of 10%. Which of the following adjunct procedures is most appropriate?

An obese 12-year-old boy presents with right groin pain and an obligate external rotation of the hip during passive flexion. He is diagnosed with a stable slipped capital femoral epiphysis (SCFE). Which complication is most closely associated with the natural history of the altered anatomy if left untreated?

A 19-year-old female swimmer presents with bilateral shoulder pain and a sensation of her shoulders slipping out of place. Examination reveals a positive sulcus sign bilaterally, apprehension and relocation tests, and generalized ligamentous laxity. What is the most appropriate initial management?

A 45-year-old recreational athlete sustains an acute Achilles tendon rupture and elects for non-operative management. Compared to operative repair, which of the following outcomes is most statistically associated with non-operative management?

A 25-year-old male undergoes an anterior cruciate ligament (ACL) reconstruction using a bone-patellar tendon-bone autograft. Postoperatively, he lacks full knee flexion but easily achieves full extension. The surgeon suspects malpositioning of the femoral tunnel. Where was the femoral tunnel most likely placed?

A 24-year-old male ultimate frisbee player presents with a reinjury of his previously reconstructed left knee. He explains that 4 years ago he ruptured his ACL playing basketball and had an allograft repair followed by an uneventful recovery. He returned to sports 8 months after surgery. Radiographs are shown below.

Which factor is most strongly associated with his graft failure?

A 24-year-old male ultimate frisbee player requires a revision ACL reconstruction. In choosing between a single-stage ACL revision and a two-step, staged ACL revision (removal of hardware with bone grafting, followed by later revision ACL reconstruction), which finding most strongly favors a staged revision?

During a revision ACL reconstruction, the graft impinges in the notch as the knee is extended, making terminal extension 5 degrees short of straight. Which factor is most likely responsible for this limitation in range of motion?

A 27-year-old soccer player sustains a PCL injury after falling onto a flexed knee. On examination, there is a slight sag and posterior translation of the tibia less than one centimeter. The initial management of this isolated PCL injury should primarily emphasize:

During a preparticipation physical examination for a 12-year-old girl interested in soccer, which of the following historical findings would be considered LEAST worrisome for sports participation?

A 16-year-old male athlete collapses during a basketball game and is diagnosed with sudden cardiac death. What is the most common underlying cause of sudden cardiac death in young athletes?

A patient undergoes a Zone II flexor tendon repair. Six weeks postoperatively, during a hand therapy session, the patient attempts to make a fist. The repaired middle finger achieves full flexion, but the adjacent ring and small fingers are unable to achieve full flexion, appearing to be 'blocked' by the middle finger. What is the most likely cause of this phenomenon?

A 28-year-old male presents with persistent loss of terminal extension six months after an anterior cruciate ligament (ACL) reconstruction. Lateral radiographs reveal that the entire tibial tunnel is positioned entirely anterior to Blumensaat's line when the knee is in full extension. Which of the following complications is most likely causing his loss of motion?

A patient complains of severe knee stiffness and an inability to flex the knee past 80 degrees following an ACL reconstruction. Intraoperative notes and postoperative imaging confirm that the femoral tunnel was drilled significantly anterior (high) to the anatomic footprint. What is the kinematic consequence of this technical error?

The posterior cruciate ligament (PCL) is the primary restraint to posterior tibial translation and is composed of two distinct functional bundles. Which of the following best describes their biomechanical behavior during knee motion?

A 25-year-old athlete sustains a twisting injury to the knee. On physical examination, the dial test demonstrates a 15-degree increase in external rotation compared to the uninjured contralateral knee at 30 degrees of flexion. At 90 degrees of flexion, the external rotation is symmetric bilaterally. What is the most likely injury pattern?

Which bundle of the posterior cruciate ligament (PCL) is tightest in deep knee flexion?

A patient presents with a knee injury. The dial test shows 15 degrees of increased external rotation at 30 degrees of knee flexion compared to the contralateral side, but symmetric rotation at 90 degrees. What is the most likely diagnosis?