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.
Keywords
collegiate American football - noncontact knee injuries - meniscal pathology - ultrasonography
- medical screening
