Mechanism of Knee Injuries in the National Basketball Association: A Video-Based Analysis

Abstract

Background. To characterize the mechanism of knee injuries among NBA players during the 2010–2020 seasons using video-based analysis. Methods. An injury database of NBA players was queried for knee injuries from the 2006-07 to 2020-21 seasons and cross-referenced with NBA injury reports. Youtube.com was searched to identify available injury footage. The mechanism of knee injury during play was analyzed by three independent reviewers. Non-mechanistic data related to the injury was gathered from news reports and official NBA websites. Results. A total of 2,868 knee injuries occurred in NBA players from 2010 to 2020 seasons; 121 had high quality videos for analysis. The most common mechanism of injury was knee flexion in valgus with internal rotation (27.3%, p<0.001), which was associated with injury to the ACL (55.2%, p=0.0001). Injuries occurred most often with control of the ball (62.8%, p=0.0064), while on offense (73.6%, p=0.0001), and without contact (71.1%, p=0.0001). A 28.1% incidence of re-injury was observed in the first 3-year period, and 43.8% of knee injuries required surgery. The average number of games missed due to injury requiring surgery was 55.1 games compared to 8.5 games in those treated nonoperatively p<0.0001. Conclusion. Understanding mechanisms of knee injury may guide preventative strategies and injury management programs in NBA players. Video-based analysis reveals the situational characteristics and mechanisms of knee injuries, but further studies are needed to develop injury prevention programs, efficacy of prevention strategies, and rehabilitation to minimize games missed from these injuries.