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A 37-year-old male presents with continued knee pain and instability 6 months status-post combined ACL and PCL reconstruction after a traumatic knee injury. On physical exam his ACL and PCL are intact, however he is noted clinically to have Grade 3 posterolateral corner laxity and varus malalignment of his knee. What is next most appropriate step in management?
Obtain long leg alignment films for pre-op planning
Fibular based posterolateral corner reconstruction
Combined tibial-fibular based posterolateral corner reconstruction
Physical therapy with closed chained quadriceps exercises, and avoidance of active hamstring exercises
Dynamic functional knee bracing
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A 24-year-old male is involved in a motorcycle accident and sustains a right knee injury. Physical examination manuever performed at 30 degrees of knee flexion is shown in Figure A. Which of the following correctly describes the normal anatomic orientation of the region injured in this patient?
Popliteus inserts proximal to the LCL on the femur
Posterior oblique ligament originates from the adductor tubercle, just posterior and proximal to the medial collateral ligament
Biceps femoris inserts posterior to the LCL on the fibular head
Popliteofibular ligament inserts lateral to the LCL on the fibular head
Deep medial collateral ligament has both meniscofemoral and meniscotibial ligaments
A 25-year-old male injured his left knee in a motor cycle accident. During examination he is noted to have a positive reverse pivot shift test and a negative posterior drawer. What other examination finding is this patient expected to have?
Positive anterior drawer test
Increased opening to valgus stress at 30 degrees of knee flexion
Positive apprehension sign with lateral patellar translation
A 10 degree increased external tibial rotation at 30 degrees of knee flexion
A 10 degree increased external tibial rotation at 90 degrees of knee flexion
Which of the following best describes the anatomic relationships of the lateral collateral ligament in the posterolateral corner?
inserts directly anterior to popliteofibular ligament on the fibula and courses deep to popliteus
inserts anterolaterally to popliteofibular ligament on the fibula and courses superfical to popliteus
inserts posteromedially to popliteofibular ligament on the fibula and courses deep to popliteus
inserts directly posterior to popliteofibular ligament on the fibula and courses superficial to popliteus
inserts posterior and distal to biceps femoris tendon on the fibula and courses superficial to popliteus
A soccer player sustains a knee injury. He is noted to have a significant increase in tibial passive external rotation both at 30 and 90 degrees. Which of the following structures is least likely to be injured?
Fibular collateral ligament tear
Popliteus tendon tear
Posterior cruciate ligament tear
Arcuate ligament tear
Posterior oblique ligament tear
The pathologic motion of the lateral tibial plateau moving posteriorly to the femoral condyle on a rotational stress examination is best described by which of the following terms?
Anteromedial rotatory instability
Anterolateral rotatory instability
Posteromedial rotatory instability
Posterolateral rotatory instability
A 34-year-old male presents with right knee pain, swelling, and symptoms of buckling 3 months after being involved in a motorcyle accident. He has a moderate effusion, positive Lachman, positive pivot shift, negative quadriceps active test, and medial sided knee pain with a positive Mcmurray test. Figure A demonstrates his leg external rotation at 30 degrees of flexion, however this deformity corrects with placing the knee at 90 degrees of flexion. Figure B shows a standing extremity alignment radiograph. Figure C shows a sagittal MRI image of the right knee. Appropriate surgical treatment includes each of the following EXCEPT:
High tibial osteotomy (HTO)
Arthroscopic medial partial menisectomy or repair
Posterolateral corner reconstruction
A 20 year-old male football player sustains a knee injury after being hit below the knee while blocking. You suspect a posterolateral corner (PLC) injury, but are also concerned about a posterior cruciate ligament (PCL) tear. Which of the following positive exam findings is indicative of a combined PLC and PCL injury?
Positive Dial test at 30 degrees of flexion
Valgus stress test opening at 0 and 30 degrees of flexion
Positive Posterior drawer test
Positive Pivot shift test
Positive Dial test at 30 and 90 degrees of flexion
Which of the following injury patterns is most appropriately managed with an immediate postoperative physical therapy regimen that includes no active flexion but does allow active extension from 90 to 0 degrees?
Patellar tendon repair
Anterior cruciate ligament reconstruction
Anterior cruciate ligament reconstruction with medial collateral ligament repair
Anterior cruciate ligament reconstruction with posterolateral corner repair
Posterior cruciate ligament reconstruction with posterolateral corner repair