Knee Ultrasonography to Determine Risk for Noncontact Injuries in Collegiate American Football Players

Abstract

Knee ultrasonography has been used effectively as a screening tool for determining risk for knee injuries in athletes. Ultrasonography may be a valuable screening tool for relative risk of noncontact knee injuries that occur over a typical playing career in collegiate American football players. In this prospective longitudinal study, we evaluated American football players (n = 48) in an academic institution affiliated with the National Collegiate Athletic Association Division I athletic program. Players underwent comprehensive ultrasonography of both knees prior to beginning their collegiate careers. Anatomic structures were evaluated for presence and severity of abnormalities. Noncontact lower extremity injuries sustained over the collegiate career of the subjects were documented. Data were analyzed for correlations, differences in proportions, and odds ratio (OR). Seventy-nine percent of the athletes had at least one ultrasonographic abnormality, with quadriceps tendon (47.9%) and patellar tendon (39.6%) abnormalities predominating. Seventy-nine percent of players had at least one noncontact lower extremity injury (23.5% involving the knee) during their careers with an average of 2.8 injuries per career. The majority of injuries occurred in the second and third playing years. There was a significantly higher likelihood of patellar tendon injury based on the presence of patellar tendon ultrasonographic pathology (p = 0.024; OR = 11x). There was a significantly higher likelihood of quadriceps muscle–tendon injury based on the presence of quadriceps tendon ultrasonography pathology (p = 0.0012; OR = 140x). All athletes sustaining meniscal injuries had preexisting joint effusion but no preexisting ultrasonographic meniscal pathology. Knee ultrasonography along with patient history and complete physical examination may help reduce injury risk through education, prevention, and training programs.

On-site Ultrasound Screens out Asymptomatic Knee Lesions in Elite Adolescent Male Basketball Players

“…Additional analysis of our data was done among player groups, which showed no difference of IKDC-SKF score between ultrasonographic effusion positive and negative knees of players (77.82 vs 76.56, P=0.77, unpaired t-test). Also, in a longitudinal follow-up study of collegiate American football players by Lewis et al, there was no higher likelihood for developing knee injury in a 5-year career duration with effusion noted on pre-career ultrasonography screening [19].…”

“…Our investigation also showed similar result. In previous study of Cook et al, in teenager basketball player aged 14-18 years, if asymptomatic patellar tendinosis is noticed in ultrasonography, there is 30% chance that symptoms will develop in the future, which is significantly higher compared with those who have normal ultrasonographic appearance (9%) [27] and Lewis et al also revealed that there was a significantly higher likelihood of patellar tendon injury based on the presence of patellar tendon ultrasonographic pathology and the odds ratio was 11 [19]. These findings made screening of asymptomatic patellar tendinopathy clinically relevant due to the impact on basketball player when it becomes symptomatic.…”

“…Although recent study demonstrated excellent precision of ultrasonography as compared to MRI in the diagnosis of ACL and PCL tears and serve as immediate diagnosis in patients with acute knee trauma [18], we did not include ACL/PCL screening in our protocol since these injury is less likely to be "unknown" because of the injury almost always occur in an acute scenario. The results of previous study showed that, as part of a precareer screening tool, ultrasonography can provide valuable information for determining relative risk of noncontact injuries diagnosed during a 5-year playing career in collegiate American football players in the setting of a prospective longitudinal study [19]. A cross sectional comprehensive ultrasonography scanning can not only act a screening for potential injury, but also establish baseline for follow-up study.…”

An exploration of UK student physiotherapists' goal setting practices within anterior cruciate ligament rehabilitation

“…Anterior cruciate ligament (ACL) injuries are one of the most common and debilitating injuries of the knee (Montalvo et al, 2019). It accounts for one‐third of all knee injuries, requiring extensive rehabilitation, whether managed conservatively or following reconstructive surgery (Lewis et al, 2019). Not only are ACL injuries clearly associated with the young and active population, injury rates are gaining momentum within the adolescence group (Cruz, Pandya, Ganley, & Kocher, 2019).…”

Public Online Interest in Injuries Sustained by National Football League Quarterbacks

“… 4 , 5 , 6 , 7 Similarly, numerous studies regarding the prevention and rehabilitation of musculoskeletal injuries in football have also been undertaken. 8 , 9 , 10 Interest in injuries sustained during the play of football is not concerning only to the academic community; indeed, football and the dangers that the game presents have become a prevalent concern among players, parents, and spectators alike.…”