Free Orthopedic Sports Medicine Practice Questions

Question 1

A 24-year-old soccer player who installs flooring has recurrent instability from an anterior cruciate ligament tear. He has regained full motion and elected autograft reconstruction. Prolonged kneeling is essential to his work. When comparing hamstring with bone-patellar tendon-bone autograft, which trade-off belongs in the consent discussion?

Accepted Answer

Hamstring may reduce kneeling pain, whereas bone-patellar tendon-bone may reduce graft-failure risk.

Answer

Bone-patellar tendon-bone may reduce kneeling pain, whereas hamstring may reduce graft-failure risk.

Answer

Bone-patellar tendon-bone is favored over hamstring for reducing both kneeling pain and graft-failure risk.

Answer

Hamstring is favored over bone-patellar tendon-bone for reducing both graft-failure risk and kneeling pain.

Question 2

During an assessment of persistent groin pain, a 26-year-old midfielder points to the proximal adductor region. Palpation there and resisted adduction reproduce his usual pain. Hip flexion-adduction-internal rotation and resisted hip flexion are painless; the inguinal canal is not tender. An outside MRI describes cam morphology and a small anterosuperior labral tear. Which diagnosis is best supported by the concordant clinical findings?

Accepted Answer

Adductor-related groin pain

Answer

Iliopsoas-related groin pain

Answer

Inguinal-related groin pain

Answer

Femoroacetabular impingement syndrome

Question 3

Preoperative imaging for recurrent anterior shoulder instability shows an estimated intact glenoid diameter of 30 mm and an anterior glenoid defect of 4 mm. The Hill-Sachs defect is 15 mm wide, with an 8-mm bone bridge between its lateral margin and the rotator cuff insertion. Using glenoid track = (0.83 × intact glenoid diameter) − anterior defect, which assessment correctly integrates the humeral and glenoid measurements?

Accepted Answer

Track 20.9 mm; Hill-Sachs interval 23 mm: off-track, raising concern about Bankart repair alone.

Answer

Track 20.9 mm; Hill-Sachs interval 15 mm: on-track, with the defect contained within the track.

Answer

Track 24.9 mm; Hill-Sachs interval 23 mm: on-track, with the defect contained within the track.

Answer

Track 21.6 mm; Hill-Sachs interval 23 mm: off-track, raising concern about isolated soft-tissue stabilization.

Question 4

Wrist arthroscopy for persistent ulnar-sided pain after a racquet injury reveals an unstable flap confined to the central triangular fibrocartilage disc. Immobilization and rehabilitation have failed. The foveal attachment is intact, the distal radioulnar joint is stable throughout forearm rotation, and there is no ulnar impaction. The operative finding calls for which treatment?

Accepted Answer

Selective arthroscopic debridement of the unstable central flap

Answer

Foveal reattachment of the triangular fibrocartilage complex

Answer

Ulnar-shortening osteotomy to unload the ulnocarpal articulation

Answer

Tendon-graft reconstruction of the distal radioulnar ligaments

Question 5

A 41-year-old trail runner starts heel-drop exercises for insertional Achilles tendinopathy. Pain worsens when her heel descends below the step, although level-ground walking and calf raises from the floor remain comfortable. Ultrasound shows insertional degeneration without a tear. How should the loading program be modified?

Accepted Answer

Progress calf raises without lowering the heel below neutral.

Answer

Continue below-step heel drops with less resistance.

Answer

Replace calf strengthening with prolonged end-range dorsiflexion stretching.

Answer

Suspend calf loading and prescribe four weeks in a walking boot.

Question 6

A collegiate pitcher has lost velocity and reports medial elbow pain during late cocking, followed by posteromedial pain at terminal extension. A supervised rehabilitation program and attempted interval throwing have failed. Examination demonstrates symptomatic valgus laxity; imaging shows a chronically attenuated ulnar collateral ligament and a posteromedial olecranon osteophyte. There are no ulnar nerve symptoms. Which operative strategy addresses both the instability and the impingement?

Accepted Answer

Ulnar collateral ligament reconstruction with treatment of the symptomatic osteophyte

Answer

Isolated posteromedial osteophyte excision followed by a progressive interval-throwing program

Answer

Primary repair of the attenuated native ligament with posteromedial osteophyte excision

Answer

Ulnar nerve transposition combined with excision of the posteromedial osteophyte

Question 7

MRI obtained for a 56-year-old recreational runner's gradually developing medial knee pain shows a horizontal degenerative tear of the medial meniscal body, with intact roots and no displaced fragment. Radiographs show mild joint-space narrowing. She reports occasional clicking but has full extension and has never experienced a truly locked knee. She has not tried an exercise-based treatment program. What should treatment begin with?

Accepted Answer

Progressive exercise therapy with symptom-guided modification of running

Answer

Arthroscopic partial meniscectomy before starting a strengthening program

Answer

Six weeks of non-weight-bearing to allow the degenerative tear to heal

Answer

Arthroscopic repair of the degenerative tear before permitting loaded exercise

Question 8

Three days after a diagnosed concussion, a 17-year-old basketball player has a mild, improving headache, a normal neurologic examination, and no red-flag symptoms. Ten minutes of easy stationary cycling does not worsen symptoms. His parent asks whether all exercise must wait until the headache has completely disappeared. The appropriate advice is to:

Accepted Answer

Continue symptom-limited light aerobic activity while avoiding contact and fall-risk activities.

Answer

Maintain complete physical and cognitive rest until several symptom-free days have elapsed.

Answer

Obtain brain MRI before permitting further aerobic exercise during the symptomatic period.

Answer

Progress directly to full-intensity noncontact basketball drills because cycling was tolerated.

Question 9

A rugby player's plantar-flexed foot was trapped beneath another player. He has persistent midfoot pain, plantar ecchymosis, and tenderness at the first and second tarsometatarsal joints, but initial non-weight-bearing radiographs were normal. He can now safely stand for imaging. To determine whether the midfoot maintains alignment under physiologic loading, which study is most informative?

Accepted Answer

Bilateral weight-bearing AP, oblique, and lateral foot radiographs

Answer

Non-weight-bearing CT with multiplanar reconstructions

Answer

Non-weight-bearing MRI focused on the Lisfranc ligaments

Answer

Repeat non-weight-bearing radiographs with dedicated magnified oblique views

Question 10

In a patient with a chronic full-thickness rotator cuff tear, sagittal MRI demonstrates substantially more fat than muscle within the supraspinatus muscle belly. Tendon retraction has been documented separately. Which Goutallier grade and implication for repair are appropriate?

Accepted Answer

Grade 4 fatty infiltration; a potentially adverse factor for healing after repair.

Answer

Grade 2 fatty infiltration; a potentially adverse factor for healing after repair.

Answer

Grade 3 fatty infiltration; a potentially adverse factor for healing after repair.

Answer

Grade 4 fatty infiltration; sufficient evidence by itself that the tendon is irreparable.

Free Orthopedic Sports Medicine Practice Questions

Domain 1: Lower Extremity: Hip (10-14%)

Question 1

Domain 2: Lower Extremity: Knee (15-21%)

Question 2

Question 3

Domain 3: Lower Extremity: Foot and Ankle (11-17%)

Question 4

Question 5

Domain 4: Upper Extremity: Shoulder (12-18%)

Question 6

Question 7

Domain 5: Upper Extremity: Elbow (10-16%)

Question 8

Domain 6: Upper Extremity: Wrist and Hand (12-14%)

Question 9

Domain 7: Non-Operative (11-17%)

Question 10

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