Steadman Philippon Research Institute, Vail, Colorado, U.S.A.; The Steadman Clinic, Vail, Colorado, U.S.A..
Steadman Philippon Research Institute, Vail, Colorado, U.S.A.
Arthroscopy. 2018 Mar;34(3):671-677. doi: 10.1016/j.arthro.2017.08.300. Epub 2017 Dec 8.
To (1) describe the magnetic resonance imaging (MRI) characteristics of knee chondral injuries identified at the National Football League (NFL) Combine and (2) assess in-game performance of prospective NFL players with previously untreated knee chondral injuries and compare it with matched controls.
All players with knee chondral injuries identified at the NFL Combine (2009-2015) were retrospectively reviewed. Players with prior knee surgery were excluded. A knee MRI for each player was reviewed; location, modified International Cartilage Repair Society (ICRS) grade (I-IV), and associated compartment subchondral edema were documented. Position, respective NFL Draft pick selection number, games started, played, snap percentage, and position-specific performance metrics during the first 2 NFL seasons were recorded for the injury and injury-free control group composed of players with (1) no prior knee injury, (2) no significant missed time prior to the NFL (≤2 total missed games in college), (3) no history of knee surgery, and (4) drafted in the respective NFL Draft following the NFL Combine.
Of the 2,285 players reviewed, 101 (4.4%) had an injury without prior knee surgery. The patella (63.4%) and trochlea (34%) were most commonly affected. Defensive linemen were at highest risk for unrecognized injuries (odds ratio 1.8, P = .015). Players with previously untreated injuries, compared with controls, were picked later (mean pick: 125.8) and played (mean: 23) and started (mean: 10.4) fewer games during the initial 2 NFL seasons (P < .001 for all). Particularly, subchondral bone edema and full-thickness cartilage injuries were associated with fewer games played (P = .003).
The patellofemoral joint was most commonly affected in NFL Combine participants. Previously untreated knee articular injuries in players at the NFL Combine are associated with poorer early NFL performance in comparison to uninjured players. Subchondral bone edema and full-thickness cartilage injury on MRI were associated with fewer games played during the initial NFL career.
Level III, case-control study.
（1）描述国家橄榄球联盟（NFL）综合体能测试中膝关节软骨损伤的磁共振成像（MRI）特征，（2）评估有未经治疗的膝关节软骨损伤的有潜力的 NFL 球员的比赛表现，并与匹配的对照组进行比较。
回顾性审查在 NFL 综合体能测试中发现的所有膝关节软骨损伤的球员。排除有膝关节手术史的球员。对每位球员进行膝关节 MRI 检查；记录损伤位置、改良国际软骨修复协会（ICRS）分级（I-IV 级）和相关关节软骨下骨水肿。记录损伤组和无损伤对照组的位置、各自的 NFL 选秀顺位、开始的比赛、参加的比赛、抢断百分比以及前两个 NFL 赛季的特定位置表现指标。无损伤对照组由符合以下条件的球员组成：（1）无膝关节损伤史，（2）在进入 NFL 之前没有明显的错过比赛时间（大学期间总共错过的比赛不超过 2 场），（3）无膝关节手术史，以及（4）在 NFL 综合体能测试后参加了各自的 NFL 选秀。
在审查的 2285 名球员中，有 101 名（4.4%）球员存在未经手术治疗的膝关节损伤。髌骨（63.4%）和滑车（34%）最常受到影响。防守线卫的未被识别的损伤风险最高（优势比 1.8，P =.015）。与对照组相比，未经治疗的损伤球员的选秀顺位较晚（平均选秀顺位：125.8），在最初的两个 NFL 赛季中参加的比赛（平均：23 场）和首发比赛（平均：10.4 场）更少（所有 P 值均<.001）。特别是，软骨下骨水肿和全层软骨损伤与较少的比赛参加有关（P =.003）。
NFL 综合体能测试参与者中最常见的是髌股关节受累。与未受伤的球员相比，在 NFL 综合体能测试中患有未经治疗的膝关节关节损伤的球员在早期 NFL 表现较差。MRI 上的软骨下骨水肿和全层软骨损伤与最初的 NFL 生涯中较少的比赛参加有关。
III 级，病例对照研究。
