MCQs on ACL Injuries

 ### **MCQs on ACL Injuries** #### **1. Which of the following is the most common mechanism of ACL injury?** A) Direct blow to the lateral knee B) Hyperextension of the knee C) Sudden pivoting or cutting movement D) Repeated microtrauma **Answer:** C) Sudden pivoting or cutting movement --- #### **2. Which clinical test is considered the most sensitive for diagnosing an ACL tear?** A) Anterior Drawer Test B) Posterior Drawer Test C) Lachman Test D) Valgus Stress Test **Answer:** C) Lachman Test --- #### **3. Which of the following structures is most commonly injured along with the ACL in the "Unhappy Triad" of the knee?** A) Lateral Collateral Ligament & Lateral Meniscus B) Medial Collateral Ligament & Medial Meniscus C) Posterior Cruciate Ligament & Medial Meniscus D) Patellar Tendon & Fibular Collateral Ligament **Answer:** B) Medial Collateral Ligament & Medial Meniscus --- #### **4. A soccer player presents with a history of hearing a "pop" in his knee during a sudden change in direction. His knee is swollen and unstable. Which of the following is the best initial imaging test?** A) X-ray B) Ultrasound C) CT scan D) MRI **Answer:** D) MRI --- #### **5. Which of the following is a common long-term complication of an untreated ACL tear?** A) Avascular necrosis B) Osteoarthritis C) Osteosarcoma D) Patellar fracture **Answer:** B) Osteoarthritis --- #### **6. Which muscle group should be strengthened in ACL rehabilitation to provide dynamic stability to the knee?** A) Quadriceps B) Hamstrings C) Gastrocnemius D) Gluteus Maximus **Answer:** B) Hamstrings --- #### **7. An athlete with an ACL tear undergoes reconstruction surgery. Which of the following is a commonly used graft for ACL reconstruction?** A) Achilles tendon B) Tibialis anterior tendon C) Patellar tendon D) Peroneal tendon **Answer:** C) Patellar tendon --- #### **8. In an ACL injury, which of the following signs is most likely to be present during clinical examination?** A) Posterior sag sign B) Increased anterior tibial translation C) Positive McMurray’s test D) Decreased patellar reflex **Answer:** B) Increased anterior tibial translation --- ### **More MCQs on ACL Injuries** #### **9. Which of the following is NOT a risk factor for ACL injury?** A) Female gender B) Weak hamstrings C) High BMI D) Increased quadriceps-to-hamstring ratio **Answer:** C) High BMI ✔ **Explanation:** While obesity may increase stress on joints, it is not a primary risk factor for ACL injuries. Female athletes are at higher risk due to hormonal, biomechanical, and neuromuscular factors. --- #### **10. Which movement does the ACL primarily prevent?** A) Posterior translation of the tibia on the femur B) Anterior translation of the tibiaMCQs on ACL Injuries on the femur C) Medial rotation of the tibia D) Lateral rotation of the femur **Answer:** B) Anterior translation of the tibia on the femur ✔ **Explanation:** The ACL prevents excessive forward movement of the tibia and excessive internal rotation of the knee. --- #### **11. Which of the following knee injuries is commonly confused with an ACL tear due to similar symptoms?** A) Patellar dislocation B) Meniscus tear C) Quadriceps tendon rupture D) Posterior cruciate ligament (PCL) tear **Answer:** A) Patellar dislocation ✔ **Explanation:** Patellar dislocation also presents with a **"pop" sound, swelling, and instability**, making it a common misdiagnosis. --- #### **12. Which rehabilitation phase after ACL reconstruction focuses on regaining full range of motion?** A) Phase 1 (Acute Phase) B) Phase 2 (Strengthening Phase) C) Phase 3 (Return to Sport Phase) D) Phase 4 (Maintenance Phase) **Answer:** A) Phase 1 (Acute Phase) ✔ **Explanation:** The initial post-surgical phase emphasizes reducing swelling, restoring knee extension, and preventing stiffness. --- #### **13. A patient with a chronic ACL tear has difficulty walking down stairs. What is the most likely cause?** A) Weak quadriceps B) Weak hamstrings C) Lateral meniscus tear D) Medial collateral ligament injury **Answer:** A) Weak quadriceps ✔ **Explanation:** Chronic ACL deficiency leads to quadriceps weakness and instability, making stair descent challenging. --- #### **14. Which of the following factors makes ACL injuries more common in female athletes?** A) Higher testosterone levels B) Increased Q-angle C) Shorter tibia D) Larger ACL diameter **Answer:** B) Increased Q-angle ✔ **Explanation:** The **wider pelvis** in females leads to a greater **Q-angle**, increasing stress on the ACL. --- #### **15. What is the best initial management for a suspected ACL tear in an emergency setting?** A) Immediate surgery B) RICE therapy (Rest, Ice, Compression, Elevation) C) Full weight-bearing and activity as tolerated D) Knee immobilization with a cast **Answer:** B) RICE therapy (Rest, Ice, Compression, Elevation) ✔ **Explanation:** Initial management focuses on reducing **pain & swelling** before definitive treatment (MRI & possible surgery). --- #### **16. Which graft type for ACL reconstruction is associated with the least donor site morbidity?** A) Patellar tendon graft B) Hamstring tendon graft C) Quadriceps tendon graft D) Allograft **Answer:** D) Allograft ✔ **Explanation:** **Allografts (from cadaver tissue)** avoid donor site pain but have a higher failure rate in young athletes. --- #### **17. Which test helps differentiate ACL injury from PCL injury?** A) Pivot Shift Test B) Posterior Drawer Test C) Apley’s Test D) Thessaly Test **Answer:** B) Posterior Drawer Test ✔ **Explanation:** The **Posterior Drawer Test** checks for PCL injury, while the **Anterior Drawer & Lachman Tests** check for ACL injury. --- #### **18. A basketball player with an ACL tear wants to avoid surgery. Which of the following factors makes non-surgical treatment a reasonable option?** A) High activity level B) Age above 40 years C) Desire to return to competitive sports D) History of previous ACL reconstruction **Answer:** B) Age above 40 years ✔ **Explanation:** Older patients or **non-athletes** may manage an ACL tear with **bracing & physical therapy** instead of surgery. ---


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