A high prevalence of abnormal knee MRI findings in basketball players

Doctors at Stanford University published a study (1) on the physical damage caused to knees by playing Division 1 college basketball. What was interesting about this study was that the participating players reported NO knee pain. The study examined 12 male and 12 female players. Every player had both knees examined.

  • Every knee imaged had at least 1 structural abnormality both preseason and postseason.
  • A high preseason and postseason prevalence of knee fat pad edema (75% and 81%),
  • Patellar tendinopathy (83% and 90%),
  • and quadriceps tendinopathy (75% and 90%) was seen.
  • Intrameniscal signal change (meniscus injury) was observed in 50% preseason knees and 62% of postseason knees, but no discrete tears were found.
  • Bone marrow edema was seen in 75% and 86% of knees in the preseason and postseason, respectively.
  • Cartilage findings were observed in 71% and 81% of knees in the preseason and postseason, respectively.

The study concluded

  • A high prevalence of abnormal knee MRI findings was observed in a population of asymptomatic young elite athletes. These preliminary data suggest that high-intensity basketball may have potentially deleterious effects on articular cartilage.

This extensive asymptomatic damage may be a contributing reason why professional players (or any athlete) do not do as well following arthroscopic surgery in their desire to return-to-play.

In a research study (2) doctors measured results in  return-to-play (RTP) rates and performance-based outcomes after different orthopaedic procedures in National Basketball Association (NBA) players and to determine which surgeries are associated with the worst postoperative change in performance.

Here are the surgeries:

  • anterior cruciate ligament reconstruction,
  • Achilles tendon repair,
  • lumbar discectomy,
  • microfracture,
  • meniscus surgery,
  • hand/wrist or foot fracture fixation,
  • and shoulder stabilization

The RTP rate, games played per season, and player efficiency rating (PER) were determined before and after surgery. Statistical analysis was used to compare the change between pre- and postsurgical performance among the different injuries.

RESULTS: A total of 348 players were included. The RTP rates were highest in patients with hand/wrist fractures and lowest for those with Achilles tears.  Players undergoing Achilles tendon repair and arthroscopic knee surgery had a significantly greater decline in postoperative performance outcomes at the 1- and 3-year time points and had shorter career lengths compared with the other procedures.

Here again, they had the surgery, played less and not as well.

1 Pappas GP, Vogelsong MA, Staroswiecki E, Gold GE, Safran MR. Magnetic resonance imaging of asymptomatic knees in collegiate basketball players: the effect of one season of play. Clinical journal of sport medicine: official journal of the Canadian Academy of Sport Medicine. 2016 Nov;26(6):483.
2 Minhas SV, Kester BS, Larkin KE, Hsu WK. The effect of an orthopaedic surgical procedure in the National Basketball Association. The American Journal of Sports Medicine. 2016 Apr;44(4):1056-61.

 

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