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

Abstract

Joshua J Cassinat,1 Matthew Aceto,1 Jonathan Schwartzman,1 Yasmine Ghattas,1 Zachary Gapinski,2 Benjamin C Service1,2 1Department of Medicine, University of Central Florida College of Medicine, Orlando, FL, USA; 2Department of Orthopedic Surgery, Orlando Health Jewett Orthopedic Institute, Orlando, FL, USACorrespondence: Joshua J Cassinat, Email [email protected]: 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.Plain Language Summary: It is known that ankle and knee injuries make up a significant proportion of injuries in professional athletes with some of these injuries requiring surgical intervention. The current literature is inconclusive on the impact of demographic and performance metrics on risk for surgical intervention in knee and ankle injuries. Through multivariate analysis, our findings indicate that demographic variables, such as weight and player position, along with player performance metrics like minutes per game and usage rate, play a significant role in increasing risk for surgery in NBA athletes. In addition to identifying risk factors, we also describe the rates of surgical intervention and the epidemiology of ankle and knee injuries in the National Basketball Association. Overall, identifying surgical rates and risk factors is crucial for developing preventive strategies, and optimizing performance in professional NBA athletes.Keywords: National Basketball Association, Knee, Ankle, Multivariate, Meniscus, Orthopaedic Surgery, Injury risk factors

Keywords

• national basketball association
• knee
• ankle
• multivariate
• meniscus
• orthopaedic surgery
• injury risk factors