Incidence of Knee Cartilage Pathology on Magnetic Resonance Imaging and Correlation to Clinical Symptoms and Orthopaedic History Among Players at the National Basketball Association Draft Combine

Abstract

Background:

High-level basketball athletes at the collegiate level and in the National Basketball Association (NBA) have a greater proportion of knee cartilage pathology than the nonathlete population. However, little is known as to whether identified pathology on knee magnetic resonance imaging (MRI) correlates with clinical symptoms or orthopaedic history in these players.

Purposes:

(1) To evaluate knee MRI scans in a cross-sectional population of NBA Draft Combine players to establish prevalence of knee pathology, including that of articular cartilage and meniscus in professional basketball players. (2) To identify independent variables including demographic characteristics, playing history, previous knee injury, and symptoms that correlate to these MRI findings.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

Players from the NBA Draft Combine over a 2-year period voluntarily participated by undergoing bilateral knee MRI scanning and completing clinical questionnaires. MRI scans were independently and blindly evaluated by 2 radiologists for cartilage assessment (using modified Noyes score) and meniscal pathology. Associations between imaging findings and pain/function scores and orthopaedic history were evaluated.

Results:

A total of 43 players (80 knees) were included. Intraclass correlation coefficients were a mean of 0.827 for agreement and 0.831 for consistency for the modified Noyes score. Cartilage pathology was identified in 48.3% of knees, with the most common locations being the patella and trochlea. Previous knee surgery was associated with lateral tibial plateau chondral pathology (odds ratio [OR], 6.58; P = .04). Reduced function scores were predictive of cartilage pathology on the lateral femoral condyle (OR, 0.55; P = .03). Increased pain scores were associated with a nonzero modified Noyes score (OR, 6.11; P < .01).

Conclusion:

The incidence of pathology identified on knee MRI scans in players at the NBA Draft Combine without clinical symptoms was high, in line with the hypothesis. Little correlation was found between the objective imaging findings and subjective pain, function, and orthopaedic injury history. Clinicians treating high-level athletes should focus on treating clinically significant findings and be cautious about treating pathology found on imaging that may not explain or correlate with symptoms. It remains critical to study the natural history of imaging findings in these athletes to better ascertain the ultimate effect of sport and physiologic load on disease progression.