AAOS 2026 Sports Medicine Self-Assessment Examination

AAOS 2026 Sports
Medicine
Self-Assessment Examination

,AAOS 2026 Sports medicine




Figure 1a Figure 1b




Figure 2a Figure 2b




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,AAOS 2026 Sports medicine


CLINICAL SITUATION FOR QUESTIONS 1 THROUGH 2
A 16-year-old boy fell while playing soccer. He said it felt like his knee buckled when he
planted his leg to kick a ball. He noticed an obvious deformity of his knee, which
spontaneously resolved with a “clunk.” He could not finish the game, but was able to bear
weight with a limp. He had 2 similar past episodes, but has never sought medical attention. An
initial examination demonstrated an effusion, tenderness at the proximal medial collateral
region and medial patellofemoral retinaculum, decreased range of motion, and patella
apprehension. A lateral patellar glide performed at 30 degrees of flexion was 3+. He was
otherwise ligamentously stable, and there were no other noteworthy findings.


Question 1 of 100
What do Figures 1a and 1b reveal?
1- Medial femoral condyle physeal widening
2- An ossseous or osteochondral loose fragment
3- Osgood-Schlatter disease
4- A patella nondisplaced fracture



PREFERRED RESPONSE: 2- An ossseous or osteochondral loose fragment


Question 2 of 100
Figures 2a and 2b are this patient’s proton density fat-saturated MR images. His tibial
tubercle-trochlear groove (TT-TG) distance is 12 mm, and he has normal limb-alignment film
findings. Treatment at this stage should include
1- hinged knee bracing, protected weight bearing, and physical therapy.
2- anteromedialization of the tibial tubercle.
3- internal fixation and medial patellofemoral ligament (MPFL) reconstruction.
4- arthroscopic lateral retinacular release.



PREFERRED RESPONSE: 3- internal fixation and medial patellofemoral ligament
(MPFL) reconstruction.




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, AAOS 2026 Sports medicine

DISCUSSION
This patient’s examination and history indicate recurrent patellar dislocations.
Radiographs show an osseous or osteochondral loose fragment. There is no evidence of an
obvious nondisplaced fracture or physeal changes. In the setting of suspected patella
dislocation or subluxation with loose fragment seen on radiograph, an MRI is indicated.
Lateral release alone is seldom indicated in a knee that is normal before injury. The
examination and MRI do not indicate a need for medial collateral ligament repair. Treatment
should consist of arthroscopy or arthrotomy and attempted internal fixation of this fragment.
If fixation is not possible, the loose body can be removed. Normal TT-TG values, an increased
lateral patellar glide, and a history of recurrent patellar dislocations after trauma suggest MPFL
incompetence and the need for reconstruction.


Question 3 of 100
Heat transfer from the skin to the environment when the ambient temperature exceeds
35°C primarily is attributable to
1- evaporation.
2- conduction.
3- convection.
4- radiation.



PREFERRED RESPONSE: 1- evaporation.


DISCUSSION
Heat transfer from the skin to the environment occurs through conduction, convection,
evaporation, and radiation. Evaporation of sweat is the primary mechanism by which core
body temperature is regulated when the ambient temperature exceeds 35°C. High humidity
can inhibit the evaporation of sweat, placing athletes at increased risk for heat-related illness,
which is defined as a core temperature above 40°C. Symptoms include dizziness, confusion,
irritability, hyperventilation, nausea, vomiting, fatigue, and collapse. Initial treatment involves
rapid cooling through immersion in cold or ice water to prevent end-stage organ failure.


Question 4 of 100
Which factor increases the success rate associated with all-inside lateral meniscal repair?
1- Concomitant anterior cruciate ligament (ACL) reconstruction
2- Concomitant medial meniscus repair


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