国家篮球协会选秀大会球员膝关节软骨病理的磁共振成像发生率及其与临床症状和骨科病史的关系

Sachin Allahabadi, Zeeshan A. Khan, Jorge Chahla, Peter Meisel, John P. DiFiori, Asheesh Bedi, Imran M. Omar, Joshua M. Polster, Hollis G. Potter, Brian J. Cole
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摘要

背景:高水平篮球运动员在大学水平和国家篮球协会(NBA)比非运动员人群有更大比例的膝关节软骨病理。然而,很少有人知道膝关节磁共振成像(MRI)的病理是否与这些运动员的临床症状或骨科病史相关。目的:(1)评估NBA选秀联盟球员的膝关节MRI扫描,以确定职业篮球运动员膝关节病理的患病率,包括关节软骨和半月板。(2)确定独立变量,包括人口统计学特征、运动史、既往膝关节损伤以及与这些MRI结果相关的症状。研究设计:横断面研究;证据水平,3。方法:来自NBA选秀联盟的球员自愿参加了两年的双侧膝盖MRI扫描和填写临床问卷。MRI扫描由2名放射科医生独立和盲目评估软骨评估(使用改进的Noyes评分)和半月板病理。评估影像学表现与疼痛/功能评分和骨科病史之间的关系。结果:共纳入43名运动员(80个膝关节)。修正Noyes评分的类内相关系数均值为一致性0.827,一致性0.831。48.3%的膝关节有软骨病变,最常见的部位是髌骨和滑车。既往膝关节手术与胫骨外侧平台软骨病理相关(优势比[OR], 6.58; P = 0.04)。功能评分降低可预测股骨外侧髁软骨病变(OR, 0.55; P = .03)。疼痛评分增加与修正Noyes评分非零相关(OR, 6.11; P < 0.01)。结论:在NBA选秀大会上,没有临床症状的球员在膝关节MRI扫描中发现的病理发生率很高,与假设相符。客观影像学表现与主观疼痛、功能和骨科损伤史之间的相关性很小。治疗高水平运动员的临床医生应侧重于治疗具有临床意义的发现,并谨慎对待可能无法解释或与症状相关的影像学病理。研究这些运动员影像学表现的自然历史,以更好地确定运动和生理负荷对疾病进展的最终影响仍然至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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
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.
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