4.3 of 99 Ratings
Figure A is the sagittal MRI of a 32-year-old male who was evaluated by the orthopedic trauma resident following an MVC in which he hit a tree. While no fractures were identified, the patient was found to have a tense effusion and bruising on the anterior aspect of his knee. Which of the following is true of the injured structure shown in Figure A?
Inserts superior to the articular margin of the tibia
Deficiency leads to patellofemoral and lateral compartment arthritis
Anterolateral bundle is tight in flexion, posteromedial bundle is tight in extension
Anterolateral bundle is tight in extension, posteromedial bundle is tight in flexion
Anteromedial bundle tight in flexion, posterolateral bundle is tight in extension
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Which of the following should be avoided in early rehabilitation following posterior cruciate ligament (PCL) reconstruction?
Quadriceps muscle activation
Closed chain active terminal extension exercises
Prone passive flexion with active terminal extension
Prone hamstring curls
Active maximal ankle dosiflexion
A 23-year-old collegiate soccer player sustained a right knee injury 6 months ago. He has been treated with rest and rehabilitation but is unable to play at his previous level due to his knee "giving way." Physical exam reveals 10° varus alignment when standing and a varus thrust with walking. Strength is full compared to the other side. Ligamentous exam reveals a stable ACL and MCL, but opens to a varus stress and a 3+ posterior drawer and positive dial test at both 30° and 90° degrees of flexion. What is the best treatment option to allow this patient to return to competitive athletic activity?
Reconstruction of the PCL
Reconstruction of the ACL and PCL
High tibial osteotomy to decrease tibial slope and correct varus malalignment; reconstruction of the PCL & PLC
High tibial osteotomy to increase tibial slope and correct varus malalignment; reconstruction of the PCL & PLC
Which of the following rehabilitation principles is true regarding non-operative treatment of a grade II PCL tear?
Quadriceps strengthening and prone range of motion should begin as tolerated
Hamstring strengthening and supine range of motion should begin as tolerated
Resisted quadriceps and hamstring strengthening, no early range of motion
No strengthening for 6 weeks
No range of motion for 6 weeks
At what angle of knee flexion should the graft be tensioned at during posterior cruciate ligament (PCL) reconstruction with a single bundle graft?
5 degrees hyperextension
0 degrees flexion
15 degrees flexion
30 degrees flexion
90 degrees flexion
Figure A is an arthroscopic image of a left knee as viewed from an anterolateral viewing portal demonstrating the attachment footprint of a damaged structure. Strengthening of what muscle group most effectively counteracts the deficit that results from the damaged structure?
A 35-year-old construction worker presents with medial-sided knee pain. He has no instability complaints but at age 18, he sustained a Grade 1 PCL injury that was treated non-operatively. A radiograph is shown in Figure A. What surgical treatment is the best option given his age and occupation?
Unicompartmental knee replacement
Total knee replacement
Lateral closing wedge osteotomy of the proximal tibia
Medial opening wedge osteotomy of the proximal tibia
A football player sustains an isolated posterior cruciate ligament (PCL) tear. Which of the following mechanisms is most likely to have caused this injury?
Fall on the flexed knee with the foot in plantarflexion
Fall on the flexed knee with the foot in dorsiflexion
Non-contact twist causing knee external rotation and valgus
Non-contact twist causing knee internal rotation and varus
Direct contact blow to the posterior knee
A 35-year-old male sustained an isolated PCL injury over 5 years ago which was treated non-operatively. If his follow-up radiographs show degenerative changes related to his PCL-deficiency, the changes are likely to be present in which of the following knee compartments?
medial and patellofemoral
lateral and patellofemoral