Knee Injuries and Associated Risk Factors in National Basketball Association Athletes

Sports Injuries in Basketball, Handball, and Volleyball Players: Systematic Review

Sports injuries were prevalent across various sports and resulted in temporary or permanent limitations in an athlete's competitive performance. This research aimed to compile and analyze studies on sports injuries among basketball, handball, and volleyball players, with a particular focus on their frequency, nature, and variations based on gender and player position. A systematic search was conducted using digital databases, including PubMed, MEDLINE, ERIC, Google Scholar, and ScienceDirect, covering the period from 2015 to 2025. The search strategy involved relevant keywords and their combinations related to injuries and athletes, selecting studies that explored injury types, locations, and preventive measures. The findings indicated that lower limb injuries were the most prevalent in all three sports. Basketball players frequently experienced knee and ankle injuries, and handball players were prone to knee injuries, while volleyball players most commonly sustained knee and foot injuries. Additionally, specific risk factors contributing to these injuries were identified. Preventive interventions, such as neuromuscular training and plyometric exercises, were found to effectively reduce injury rates across these sports. The majority of studies suggested that female athletes had a higher injury incidence compared to their male counterparts. This may be attributed to several factors, including hormonal differences (such as the effect of estrogen on ligament laxity), anatomical factors (e.g., a larger Q-angle in women), and differences in training practices that could predispose female athletes to higher injury rates. Furthermore, regardless of the sport, injuries occurred more frequently during competition and tended to increase with the physical demands of the game.

Increased Musculoskeletal Injury Risk Without Impact on Statistical In-Game Performance Within 90 Days From Concussion Among Professional Basketball Athletes

Background

Concussions have previously been shown to have persistent neurological changes represented by altered reaction time and postural stability in high-level athletes. The effects of concussions on professional basketball players' performance and subsequent injuries during the 90 days after return to play (RTP) have not been investigated.

Purpose/Hypothesis

the purpose of this study was to evaluate player statistical performance and risk of musculoskeletal (MSK) injury within 90 days of RTP from a diagnosed concussion. It was hypothesized that within the 90 days after RTP from a concussion, players would be at a greater risk for MSK injury with an associated decrease in player statistical performance.

Study Design

Descriptive epidemiology study.

Methods

Concussions sustained by National Basketball Association (NBA) players between the 2015-2016 and 2021-2022 seasons, excluding the 2019-2020 season, were evaluated using a publicly available database. The database was queried to identify any MSK injury in the 90-day post-RTP period after a concussion, along with time loss after subsequent injury. Performance statistics were obtained from each player's preindex season and postindex season, as well as defined time points within the 90-day post-RTP period. Each concussed player was matched 1 to 1 with a nonconcussed control using position, win shares, player efficiency rating, and points per game. MSK injury incidence and player statistics in the concussion group were compared with controls using unpaired Student t tests.

Results

A total of 70 concussions were identified in 70 professional basketball players and included in this analysis. A total of 49 players sustained an MSK injury in the 90-day post-RTP period (70%). Compared with controls, the odds of sustaining an MSK injury in the concussed cohort were 11.3 times greater (95% CI, 5.04-25.2; P < .001). Games missed after subsequent MSK injury were similar between the concussed and control groups (P = .687). Comparisons over the 90-day post-RTP period did not reveal any significant changes in points per game, minutes per game, or true shooting percentage (P > .05). When compared with controls, no changes in performance statistics were significantly different (P > .05).

Conclusion

Our analysis demonstrates that basketball players who sustain concussions are at a significantly increased risk for subsequent MSK injury within the 90-day post-RTP period but not player performance. Knowledge of this increased risk of MSK injury in concussed athletes can help guide concussion management for proper RTP and targeted rehabilitation in professional basketball players.

PRP platelet-rich plasma injection combined with aquatic exercise therapy improves functional recovery of basketball players with knee joint injury

OBJECTIVE

To explore the effect of PRP platelet-rich plasma injection combined with aquatic exercise therapy on the functional recovery of basketball players with knee joint injury.

METHODS

This retrospective study included 60 basketball players who sustained knee joint injury between January 2021 to June 2023. Among them, 28 patients received PRP platelet-rich plasma injection (control group), while the other 32 patients received PRP platelet-rich plasma injection combined with aquatic exercise therapy (observation group). We compared the improvements in knee joint pain level, knee joint mobility, knee joint muscle strength and other indexes between the two groups before and after the interventions.

RESULTS

After 8 weeks of intervention, the visual analogue scale (VAS) score in the observation group was significantly lower than that before the intervention; Besides, the knee flexion range and Lysholm knee function score in the observation group were significantly improved (all P<0.05); and all these improvements were more substantial than those in the control group (all P<0.05). The KOOS scores of both groups increased significantly after 8 weeks of intervention as compared to pre-intervention, and the scores in the observation group were significantly higher than those in the control group (all P<0.05).

CONCLUSION

PRP injection combined with aquatic exercise therapy significantly improves knee mobility, muscle strength and function, and reduces pain severity, in basketball players with knee injuries.

The Primary Risk Factors for Season-Ending Injuries in Professional Basketball Are Minutes Played Per Game and Later Season Games

PURPOSE

To determine the incidence rates and associated risk factors of season-ending injuries (SEIs) in the National Basketball Association (NBA) from the 2015-20 seasons.

METHODS

Publicly available records of active NBA players between the 2015-16 and 2020-21 seasons were reviewed to identify players with an SEI. In this study, SEI was classified as any injury that resulted in failure to return at least 5 games before the end of the team's game schedule. Injury data from the 2019-20 NBA season, shortened because of the coronavirus disease 2019 pandemic, were omitted. The primary outcome was the incidence of SEIs reported per 1,000 game exposures (GEs). Player demographics, basketball statistics, injury characteristics, and timing of injury were recorded. Secondary analysis, including bivariate analysis and multivariate logistic regression, was performed to investigate factors associated with having an SEI.

RESULTS

In total, 196 players (15.6% of all players) sustained a combined 238 SEIs between the 2015-16 and 2020-21 seasons, indicating a rate of 1.74 SEIs per 1,000 GEs. When characterized by body part, knee injuries were found to be the most frequent SEI, at a rate of 0.47 injuries per 1,000 GEs. Accounting for potential confounders, having an SEI was significantly associated with more minutes per game played (odds ratio, 1.06, 95% confidence interval, 0.99-1.01, P < .001).

CONCLUSIONS

SEIs occurred in 15.6% of players in this study, with an overall rate of 1.74 SEIs per 1,000 GEs. The most significant risk factor associated with injury was minutes per game. SEI was more likely to occur in the third and fourth quartiles of the NBA season than in the first or second quartile.

LEVEL OF EVIDENCE

Level III, retrospective comparative prognostic investigation.

Multivariate Analysis of Risk Factors for Injury and Surgical Interventions in Ankle and Knee Injuries in NBA Athletes

Objective

Lower extremity ankle and knee injuries occur at a high rate in the National Basketball Association (NBA) often requiring surgical intervention. This study aimed to identify surgical rates and risk factors for surgical intervention using multivariate analysis in ankle and knee injuries in NBA player.

Methods

Player demographics, performance metrics, advanced statistics, and injury characteristics were recorded using publicly available data. To standardize injury events over multiple years, injury events per 1000 athlete exposure events (AE, one player participating in one game) were calculated. Descriptive analysis and multivariate logistic regression were completed to find associations with surgical intervention in ankle and knee injuries.

Results

A total of 1153 ankle and knee injuries were included in the analysis with 73 (6.33%) lower extremity injuries treated with surgery. Knee injuries had a higher incidence of surgical intervention (0.23 AE) than ankle injuries (0.04 AE). The most frequent surgical knee injury was meniscus tear treated with meniscus repair (0.05 AE) and the most frequent ankle surgery was surgical debridement (0.01 AE) Multivariate logistic regression indicated lower extremity injuries that required surgery were associated with more minutes per game played (odds ratio [OR] 1.13; p = 0.02), a greater usage rate (OR 1.02 p < 0.001), the center position (OR 1.64; 95% [CI] 1.2-2.24; p = 0.002) and lower player efficiency rating (OR 0.96; 95% p < 0.001).

Conclusion

Knee surgery was significantly more frequent than ankle surgery despite similar injury rates per 1000 exposures. The center position had the greatest risk for lower extremity injury followed by minutes played while a higher player efficiency rating was protective against surgical intervention. Developing strategies to address these factors will help in the management and prevention of lower extremity injuries requiring surgical intervention.

Characterization of Ankle Injuries and Associated Risk Factors in the National Basketball Association: Minutes Per Game and Usage Rate Associated With Time Loss

Background

Ankle injuries are more common in the National Basketball Association (NBA) compared with other professional sports.

Purpose/Hypothesis

The purpose of this study was to report the incidence and associated risk factors of ankle injuries in NBA athletes. It was hypothesized that factors associated with an increased physiologic burden, such as minutes per game (MPG), usage rate, and associated lower extremity injury, would be associated with increased ankle injury risk and time loss.

Study Design

Descriptive epidemiology study.

Methods

Ankle injury data from the 2015-2016 through 2020-2021 NBA seasons were evaluated. The truncated 2019-2020 season due to the COVID-19 pandemic was omitted. The primary outcome was the incidence of ankle injuries, reported per 1000 game-exposures (GEs). Secondary analysis was performed to identify risk factors for ankle injuries through bivariate analysis and multivariable logistic regression of player demographic characteristics, performance statistics, injury characteristics, and previous lower extremity injuries. Factors influencing the time loss after injury were assessed via a negative binomial regression analysis.

Results

A total of 554 ankle injuries (4.06 injuries per 1000 GEs) were sustained by NBA players over 5 NBA seasons, with sprain/strain the most common injury type (3.71 injuries per 1000 GEs). The majority of ankle injury events (55%) resulted in 2 to 10 game absences. The likelihood of sustaining an ankle injury was significantly associated with a greater number of games played (P = .029) and previous injury to the hip, hamstring, or quadriceps (P = .004). Increased length of absence due to ankle injury was associated with greater height (P = .019), MPG (P < .001), usage rate (P = .025), points per game (P = .011), and a prior history of foot (P = .003), ankle (P < .001), and knee injuries (P < .001).

Conclusion

The incidence of ankle injuries was 4.06 per 1000 GEs in professional basketball players. Games played and prior history of hip, hamstring, or quadriceps injuries were found to be risk factors for ankle injuries. Factors associated with physiologic burden such as MPG and usage rate were associated with an increased time loss after injury.