Assessing prevalence of knee injuries among athletes

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Assessing prevalence of knee injuries among athletes

https://doi.org/10.21203/rs.3.rs-3132300/v1

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Background

The knee joint is the largest joint in the body. It contributes to a large part of the skeletal function of supporting movement, bearing body weight and performing basic movements with muscular and neural control. Complex injuries of the knee joint are common and result from accidents or sports injuries in various fields. This study aims to direct interest in sports medicine towards this type of injury, which is considered an important matter in reducing the burden of injuries on the sports community, as the target group represents athletes of ages ranging between 15 and 40 years.

Methods

This cross-sectional study was conducted in April 2022 using a sample-appropriate sampling pattern. A self-administered, self-filled questionnaire in Arabic was distributed to the participants, after obtaining ethical approval from the Institutional Review Board (IRB), College of Medicine. Syrian Private University.

Results

Out of 903 participants, 58% were male and 42% were female. Their mean age was 27.23 years (± 9.1). The prevalence of one-time knee injuries was 25% among the participants. More than half of them exercise between 2 and 5 hours a week. Participants who participated more in sports, especially competitive ones, were associated with a higher rate of knee injuries. Knee pain was the most common complaint. Of those who sought medical attention, most were treated conservatively with analgesia, physiotherapy, and knee braces.

Conclusions

Knee injuries are common in our community. Football was the dominant sport associated with knee injuries, and most of these injuries were treated conservatively. Stretching and warming up did not help reduce the incidence of injuries. We need to increase awareness and knowledge about these injuries. A comprehensive research must be conducted on prevention methods and factors and studied in order to know and apply effective measures in reducing the rate of these injuries and their complications. In addition, more research is needed to estimate the prevalence of these injuries among females in our population and whether they have different patterns of injuries compared to males.

Orthopedics

Sports Medicine and Kinesiology

Knee injuries

athletes

sports medicine

youth sports injuries are a public health problem due to the negative consequences on young athletes' health and wellbeing (1). Due to the rise in persons who engage in physical activity on a regular basis, both professionally and recreationally, joint injuries, particularly to the knee, have dramatically increased. Additionally, young children have begun participating in sports at an earlier age, with requests for instruction and rising levels of competition, perhaps without the proper technical supervision (2). Sports-associated injuries that affect the musculoskeletal system account for 80% of all injuries sustained during competition (3). According to reports, young athletes most frequently suffer knee injuries (4).

Mainly to the overhead forces placed on the lower limbs during sports involving running and jumping, where the force on the knees can reach up to 10 times the body weight, the lower limbs are most frequently affected. Other significant factors include a change in direction, as in football, and physical contact between competitors. Sports-related injuries to the hip, thigh, knee, leg, ankle, and foot account for 90% of all injuries (5).

Previous research on knee injuries in US athletes noted high rates, high proportions of knee injuries compared to other injuries, increased risk of recurrence and high numbers of knee injuries necessitating surgical treatment. However, these studies were geographically restricted, described injury patterns in general but not in detail, or failed to note injury patterns across a wide range of sports (6). Numerous criteria can be used to identify a sports injury, including the need for medical attention, the need to discontinue practice or a competition, and decreased activity levels (7). The National Athletic Injury Reporting System (NAIRS) of the United States of America categorizes lesions into the following groups: Non-reportable, meaning the athlete does not stop training; minor; moderate; major; missing more than 21 days; catastrophic injury, leaving athlete permanently disabled (8, 9). Additional elements could affect how serious the injury is, its type, how long it takes to treat, whether or not the student misses’ school, and the associated expenditures (9).

The highest prevalence of early osteoarthritis development has been seen in the knee joint, making adolescent knee injuries even more concerning. The early onset of osteoarthritis, which requires long-term care, is a serious consequence after a number of knee injuries (10). Thus, the identification of knee problems in order to conduct early interventions is highly needed.

An accurate estimate of the prevalence of knee injuries in our population is lacking, particularly given the vast range of sporting facilities available today for youth to participate in all sports, which will raise the risk of sport-related injuries. The purpose of this study is to determine the frequency of knee injuries among Saudi males as well as their degree of knowledge regarding these injuries and early treatment. In our population, women participate less in sporting events, and access to female college students is less practical than it is for men.

Study design and participants:

This cross-sectional study was conducted in April 2022 using convenience sampling pattern. Students were asked to participate voluntarily, and written informed consent was obtained from all participants. They were informed that all their responses were recorded anonymously, that it was not mandatory to respond to all questions, and that they were allowed to opt out of the survey at any time. The inclusion criteria included participants who practice different sports from age groups between 14 and 60 years. The objectives of the study were explained to the students in a written form attached to the questionnaire.

Questioner:

A self-administered questionnaire in Arabic was used and distributed to students of the Syrian Private University and Damascus University and others from sports groups or individuals within the study setting, and it was not limited to current sports practitioners but also included people who had previously practiced it, who had suffered a knee injury or not. Reliability was evaluated by Cronbach's alpha test at 0.761.

The questionnaire includes two parts:

1- Demographic information 9 questions included questions about: age, sex, height, weight, economic status, work, habits (smoking, alcohol), and a question about evaluating food between bad, good, moderate, and excellent.

2–4 questions about practicing sports, about the type of sport, the duration of the exercise, whether the sports practitioner considers himself an amateur or a professional, and a precedent of knee injury.

3–10 questions about the injury, specifying the sport during which the knee injury occurred, the mechanism of exposure to the injury, the type of injury to which it was exposed, the symptoms that appeared after exposure to the injury, the type of ground on which the injury occurred, the mechanism of injury diagnosis, the period of discontinuance from performance after the injury, The mechanism of treating the injury, inquiring about whether a surgical operation was performed, the return of the knee to its normal performance after recovery.

4 − 3 questions included a question about exposure to other bone or joint injuries, a question about the development of degeneration with age, and a question about the presence of chronic bone or joint diseases.

Patients who answered yes when asked about a history of knee joint injury filled out the entire questionnaire, while those who answered no filled out only the first and last sections.

Statistical Analysis:

The data were analyzed using the SPSS Statistical Package for Social Sciences version 25.0, showing numbers and percentages (for categorical variables), or averages and standard deviations, SD (for continuous variables). The Chi-Square test was used to study whether there is a relationship between two descriptive variables. A p-value < 0.05 was adopted as statistical significance.

Sample characteristics:

The sample for our study included 903 patients, with an average age of 27.23 years and a standard deviation of 9.10 years. Male patients made up the majority of the sample, numbering 521 patients (58%), while female patients made up 382 (42%). Patients with heights between 160 and 170 cm made up the majority of the sample, numbering 320 patients (35%). Patients with weights between 60 and 100 kg made up the majority of the sample. When asked about their employment status, 421 of these patients were students at a rate of 42%, 213 were workers at a rate of 24%, 103 were employed in the medical sector at a rate of 11%, and only 34 were unemployed, at a rate of 4%. 51 patients smoked between two and two packets per day at a rate of 6%, 146 patients smoked between half and one packet per day at a rate of 16%, and 136 patients smoked less than half a packet per day at a rate of 15%. With a rate of 62%, the greatest number of these patients—a total of 564 patients—were nonsmokers. When asked whether they drank alcohol, 157 patients responded "yes," with a response rate of 17%, whereas the remaining 746 patients "no," with a response rate of 83%. The nutritional status was moderate in 454 patients (50%), good in 319 patients (35%), while in 81 patients the nutritional status was poor (9%), and excellent in 49 patients (5%) only.

Characteristics of sports practices:

The majority of patients—381 patients, or 42%—practiced bodybuilding, making it the sport that was most frequently reported. With 344 patients, or 38%, of its practitioners, football came in second position. Basketball players came in third, with 337 patients and a rate of 37%. Table tennis players came in second with 119 patients and a rate of 13%. Swimmers came in third with 308 patients and a rate of 34%. The remainder of the sample was split among other sports, with rates ranging from 2–8% for tennis, volleyball, martial arts, horseback riding, walking, and rugby. 228 patients practiced sports for less than two hours per week, by 25%, and the largest number of them exercised between 2–5 hours per week, by 32%. As for the patients who exercised for 5–8 hours per week, their number was 198 patients, by 22%. 106 of the patients who were exercising for 8–11 hours were 12%, while the rest of the patients were exercising for 11–14 hours and more than 14 hours per week, where their number was 48, 37 patients, 5%, and 4%, respectively. When asked if they regarded themselves amateurs or professionals in sports, 204 patients responded that they were amateurs at a rate of 23%, while the remaining 699 patients responded that they were amateurs at a rate of 77%.

knee injury characteristics:

226 patients (25%) 0, indicated that they had only ever experienced a knee injury while exercising, whereas 156 patients (17%) indicated that they had done so more than once. The remaining 521 individuals (58%), never experienced a knee-level injury. Football was the most common sport in which patients suffered knee injuries, with a number of 174 patients, or 45%. Bodybuilding and basketball came in second place, with the same number of patients who sustained a knee injury while practicing these sports, reaching 100 patients, with a rate of 26% for each. Tennis came in the third place among the sports that led to knee injury among the 5 athletes, with a rate of 1%. Volleyball came last, as the knee was injured in 3 athletes, at a rate of 1%.

Regarding injury mechanism, 96 patients responded that it was brought on by years of chronic stress at a rate of 25%; 81 patients said it was due to a collision with another player or field equipment at a rate of 21%; 54 patients said it was due to a sprain and a fall at a rate of 14% each; and 97 patients said it was brought on by knee rotation while they were bearing weight at a rate of 25%.

Regarding type of injury, ligamentous injury was the most common, as it was suffered by 121 patients with a rate of 32%, the muscle tendon injury came in the second place in 58 patients with a rate of 15%, while the cartilaginous injury was in the third place, as it suffered from 42 patients with a rate of 37%, and bone injury and joint degeneration came in the third place At 33, 28 patients, with a rate of 9% and 7%, respectively.

Regarding symptoms, Pain is the most common symptom, as it was found in 303 patients with a rate of 80%, and early and late edema was found in 110, and 46 patients with a rate of 29%, and 12%, respectively. And 13%, respectively. Difficulty in bending the knee came in the rank in terms of the prevalence of symptoms indicated by 182 patients after suffering a knee injury, at a rate of 48%. In the third place, joint tenderness was the symptom suffered by 123 patients, at a rate of 32%. The ability to walk was a symptom experienced by 62 and 101 patients, 16% and 27%, respectively.

Regrading diagnosis methods, 15 patients were diagnosed with CT scan by 4%, while 91 patients were diagnosed with MRI by 24%, and 94 patients were diagnosed with simple X-ray by 25%, while 48% did not make a radiological diagnosis of their injury.

Which ground types were as follows, solid floor (42%), wooden floor (15%), rubber floor (14%), and finally sandy floor (3%). Patients who sustained knee injuries ceased exercising for a week or less on average (13% of patients), between one and three weeks on average (19% of patients), between three weeks and two months on average (15% of patients), and between two and four months on average (59 individuals). There were 42 patients who had entirely ceased exercising, at a rate of 11%, and 45 patients who had stopped exercising for more than 4 months, at a rate of 12%. In contrast, 51 (13%) of the patients never quit exercising.

Regarding management, Conservative treatment was the most common treatment for patients, as it was followed in 161 patients by 42%, and rest came as one of the treatments for 151 patients by 40%. On the other hand, 45 patients required surgery by 12%, and a splint for 25 patients by 7%. Regarding type of surgical procedure applied, the anterior cruciate ligament reconstruction was the most common surgical procedure, as it was applied in 21 patients with a rate of 48%.

Endoscopy to remove a cartilage tear came in second place in 14 patients, with a rate of 30%, and 5 patients had undergone lateral ligament restoration by 11%. The rest of the patients underwent posterior cruciate ligament surgery and fracture fixation with a rate of 7% and 5%, respectively.

With a standard of 5 degrees and a range of 1 to 5, the patients were asked if their knee had recovered to its usual position following the injury. The average of their responses was 3.66 with a standard deviation of 1.17. With a rate of 28%, only 253 patients had experienced a bone or joint injury other than a knee injury, while 186 patients had done so more than once. The majority of patients, 464 patients (51%), had not been subjected to any joint or bone damage.

When examining the relationship between knee injury exposure and patient characteristics, we discovered a statistically significant correlation between age and knee injury exposure, with the average ages of patients who had experienced this injury once or more being 28.21 years and 27.36 years, respectively. There is a substantial link between these two variables, as shown by the P value of 0.0264.

Additionally, when examining the association between the patient's gender and the degree of his exposure to knee injury, we discovered a significant link between each of the male sexes and the rise in the percentage of injuries, with the percentage of males who had knee injuries for one or more times reaching 62%, 69%, compared to 38%, 31% for females. The P value was 0.0005, indicating that there is a statistical relationship between these two variables.

The knee is the largest joint in the body with a very complex structure, and is the joint most often injured by young sports participants. On the other hand, the vast majority of knee injuries can be treated conservatively with rest, ice, reduced movement, and physical therapy. However, others may require surgical intervention (11, 12).

Knee injuries can be either acute or chronic. Acute knee injuries are defined by most definitions as "diagnosed within the first 30 to 42 days of injury or the onset of symptoms."

Knee injuries range from ligament injuries to cartilage, tendons, and bones. A detailed clinical history with physical examination and appropriate investigations is crucial to making the correct diagnosis. Most knee injuries occur in a non-contact fashion mainly involving the anterior cruciate ligament (ACL) which is the main stabilizer of the joint and often accompanied by other structural injury (13–17). Other ligaments can be involved, including the posterior cruciate ligament (PCL), lateral collateral ligament (LCL), and medial collateral ligament (MCL). Moreover, the cartilaginous structures in injury to the medial and lateral meniscus—which act as shock absorbers with a secondary role in stabilizing the joint—can be ruptured or partially involved (18).

The main complication that follows most knee injuries is the early development of joint degeneration which is expected to require long-term management (19, 20).

In this study, we explored different aspects of knee injuries including their prevalence and associated factors. The prevalence of one-time knee injuries was 25% among the participants. This is higher than what was reported by 13.5% in a similar study of college students in Delhi, India (21). On the other hand, this percentage was close in our study to a study conducted in Saudi Arabia, where the prevalence of knee injury was 23% (22).

However, the prevalence we found still falls within the range of a global prevalence among adolescents of 10 to 25% based on a systematic review by Louw et al. Which included 19 studies, with more recent studies reporting higher rates (23), where at the University of Central Lancashire, Preston, UK, estimated the prevalence of knee injuries to be 31.8% among their students with knee pain as a prevalent symptom (24).

This percentage was close in our study when calculating people who were injured more than once, as the percentage of knee injury reached about 42%.

Although the average age of our sample was 27.23 years, more than half of them were found to exercise between 2 and 5 hours per week. This reflects the sedentary life prevalent in this part of the world. Compared to the physical activity guidelines for Americans from the US Department of Health and Human Services, this age group should be more active. "Adults should do at least 150 to 300 minutes per week of moderate intensity, or 75 to 150 minutes per week of vigorous-intensity aerobic physical activity," they said. Therefore, for someone to be considered physically active and derive significant health benefits, they must do at least 2 1/2 hours of moderate intensity level or 1 hour and 15 minutes of vigorous intensity level aerobic exercise each week (25).

Participants who participated more in sports, especially competitive ones, were associated with a higher rate of knee injuries. Our result is similar to that of previous studies from the USA and the UK, which showed an increased incidence of these injuries with increasing level of competition (26, 27). The most common mechanism that led to these injuries was due to a non-contact mechanism (78%); This is consistent with what was observed by John et al (64.4%) of their sample (28). Moreover, the American Journal of Sports Medicine was reported by Arndt and Dick that the non-contact mechanism was the cause of most ACL injuries among USA basketball and soccer players (29). The percentage of this mechanism causing knee damage in our study converged with the Saudi study, which indicated that the non-contact mechanism causing knee damage amounted to 68.7% of the total mechanisms of knee damage in their sample (22). We found an association between increasing the height and weight of the patient and the prevalence of knee injuries, and this result is consistent with previous studies that showed an increased risk of sports injuries in general and knee injuries in particular with an increase in body mass index, and this could be attributed to an increase in mechanical load on the knee joints during exercise or any other physical activity (30, 31).

Knee pain was the most common complaint, followed by difficulty in bending the knee and hearing a popping sound. These results were consistent with the results of the Saudi study, which indicated that pain and then hearing a popping sound were the most common symptoms reported by patients as a result of their knee injury (22).

In comparison with previous studies, sprain was the most common diagnosis of knee injury among college football players in the USA (32–34), but their classification was different, and all types of ligament injuries were included under knee sprain. For example, both the ACL and MCL are classified under a sprain, so the comparison here is imprecise.

Of those who sought medical attention, most were treated conservatively with analgesia, physiotherapy, and knee braces. Only 12% of the participants underwent surgery. Similarly, studies by Nielsen et al. and Swenson et al. Conservative treatment is the cornerstone of management, but the percentage of surgical intervention was higher (20–21%) (35, 36). However, when comparing our results with the results of the study conducted in Saudi Arabia, the percentages were similar, as the percentage of surgical work for knee damage was only 10% (22).

Regarding knee splints and their impact, in a review paper by Chew KT and colleagues (37), they described the different types and aspects of these splints. Several studies have investigated the effect of patellofemoral knee splints, which are performed to maintain the natural alignment of the patella and relieve anterior knee pain. However, the results of these studies are inconsistent, with some reporting significant improvement in knee pain and function (38, 39), while others reported no significant improvement (40, 41). In the review Chew et al., they report that there are different causes of knee pain from which some patients may benefit, while others may not, and they mention the need for more studies to investigate the effect of these braces on specific knee problems.

As for a functional orthosis designed to support the knee after a ligament injury, Swirtun et al. A prospective, randomized study to evaluate the effect of a functional orthosis on patients with anterior cruciate ligament tear who were treated non-surgically. Patients reported significant improvement in the rehabilitation and stability of their knee. However, these benefits were not evident on objective measures including the Knee Osteoarthritis Outcome Score (KOOS), and are only subjective outcomes (42). Also, Wojtys et al. A biomechanical study on the use of a functional orthosis on a knee with ACL deficiency showed a significant reduction in tibialis anterior motion (43).

In addition, a study was conducted on the effectiveness of knee braces as a preventive measure, where Hewson et al. In studying a college football team at the University of Arizona in a prospective case-control study, they found that the number of knee injuries was similar in both the groups that wore splints and those that didn't use splints (44). On the other hand, other studies have reported a higher incidence of knee injuries after the use of prophylactic knee braces (45).

Various types of activities have been associated with knee injuries including strengthening exercises, volleyball, running and various other sports but the majority of knee injuries were during football, which is consistent with a previous study by Kujala et al. (46), but we cannot determine if they have the highest risk of knee injuries without comparing the hours of exposure for each sport, and then we can find out the injury rate and risk for each. Therefore, this can either be attributed to the popularity of the sport in our culture, so the percentage would be clearly higher or to the functional demand on the knee structures and movements required in the sport.

In the current study, 19% of the participants needed between 1 and 3 weeks to recover after knee injuries and were unable to return to their pre-injury activity level, and others needed less time to recover. Compared to other studies that reported a decrease in the ability of some patients to perform at their previous level of physical activity even after being managed by healthcare providers (47, 48).

Knee injury is a known risk factor for developing early knee osteoarthritis (49, 50). It also increases the risk of another new knee injury in the following year (51). This is why it should be a matter of concern for healthcare providers and researchers to study and implement factors that can reduce the rate of these injuries, to prevent long-term physical and economic consequences.

Study's limitations:

This is cross- sectional survey study, thus recall bias is common. In addition, unable to determine casualty. Furthermore, subjective assessments may not be accurate as objective.

Knee injuries are common in our society. Football was the dominant sport associated with knee injuries, and most of these injuries were treated conservatively. Stretching and warming up did not help reduce the incidence of injuries. We need to increase awareness and knowledge about these injuries. A comprehensive research must be conducted on prevention methods and factors and studied in order to know and apply effective measures in reducing the rate of these injuries and their complications. In addition, more research is needed to estimate the prevalence of these injuries among females in our population and whether they have different patterns of injuries compared to males.

Ethical approval:

Ethical approval was obtained from the Institutional Review Board (IRB), Faculty of Medicine, Syrian Private University.

Funding statement:

No specific funding was received from any bodies in the public, commercial or not-for-profit sectors to carry out the work described in this article.

Availability of supporting data:

The data that support the findings of this study are available from the Corresponding author, upon reasonable request.

Competing interests:

The authors declare that they have no competing interests.

Acknowledgments:

Not applicable.

Yang J, Marshall SW, Bowling JM, et al. Use of discretionary protective equipment and rate of lower extremity injury in high school athletes. Am J Epidemiol 2005;161:511–19.
Nicolini, A. P., de Carvalho, R. T., Matsuda, M. M., Sayum, J. F., & Cohen, M. (2014). Common injuries in athletes' knee: experience of a specialized center. Acta ortopedica brasileira, 22(3), 127–131. https://doi.org/10.1590/1413-78522014220300475
Pochini AC, Ingham SJM, Oliveira DA, Ejnisman B, Cohen M. Cohen M. Guia de Medicina do Esporte -Barueri,SP. Manole; 2008. Lesões Musculares; pp. p.571–p.579.
Louw Q, Grimmer K, Vaughan K. Knee injury patterns among young South African basketball players. S Afr J Sports Med 2003;15:9–15.
McKeag DB. Primary care sports medicine. Dubuque, IA: Benchmark Press; 1993. Epidemiology of athletic injuries; pp. p. 63–p. 63.
Swenson, D. M., Collins, C. L., Best, T. M., Flanigan, D. C., Fields, S. K., & Comstock, R. D. (2013). Epidemiology of knee injuries among U.S. high school athletes, 2005/2006-2010/2011. Medicine and science in sports and exercise, 45(3), 462–469. https://doi.org/10.1249/MSS.0b013e318277acca
Hergenroeder AC. Prevention of sports injuries. Pediatrics. 1998;101(6):1057–1063.
Leadbetter WB. Sports injuries. In: Fu F, Stone D, editors. Soft tissue athletic injury. Baltimore: Williams & Wilkins; 1994. pp. p.733–p.780.
Patel DR, Baker RJ. Musculoskeletal injuries in sports. Prim Care. 2006;33(2):545–579.
Vad VB, Bhat AL. The athlete with early knee arthritis. Phys Med Rehabil Clin N Am. 2000;11(4):881–94.
Louw, Q., K. Grimmer, and K. Vaughan, Knee injury patterns among young basket ball players in Cape Town. South African Journal of Sports Medicine, 2003. 15(1): p. 9-15.
Clayton, R.A. and C.M. Court-Brown, The epidemiology of musculoskeletal tendinous and ligamentous injuries. Injury, 2008. 39(12): p. 1338-44.
Lešić, A. and M. Bumbaširević, The clinical anatomy of cruciate ligaments and its relevance in anterior cruciate ligament (ACL) reconstruction. 1999.
Fu, F.H., et al., Current trends in anterior cruciate ligament reconstruction. Part 1: Biology and biomechanics of reconstruction. Am J Sports Med, 1999. 27(6): p. 821-30.
Rahnemai-Azar, A.A., et al., Increased lateral tibial plateau slope predisposes male college football players to anterior cruciate ligament injury. JBJS, 2016. 98(12): p. 1001-1006.
Swart, E., et al., Prevention and screening programs for anterior cruciate ligament injuries in young athletes: a cost-effectiveness analysis. J Bone Joint Surg Am, 2014. 96(9): p. 705-11.
Brophy, R.H., et al., Anterior cruciate ligament reconstruction and concomitant articular cartilage injury: incidence and treatment. Arthroscopy, 2010. 26(1): p. 112-20.
Belzer, J.P. and W.D. Cannon, Jr., Meniscus Tears: Treatment in the Stable and Unstable Knee. J Am Acad Orthop Surg, 1993. 1(1): p. 41-47.
Vad, V.B. and A.L. Bhat, The athlete with early knee arthritis. Phys Med Rehabil Clin N Am, 2000. 11(4): p. 881-94.
Kujala, U.M., et al., Knee osteoarthritis in former runners, soccer players, weight lifters, and shooters. Arthritis Rheum, 1995. 38(4): p. 539-46.
Kumar, V., et al., Prevalence and pattern of sport injuries among college students in Delhi, India. Saudi Journal of Sports Medicine, 2014. 14(2): p. 109.
Almaawi, A., et al., Prevalence of knee injuries among male college students in Riyadh, Kingdom of Saudi Arabia. Journal of Orthopaedic Surgery and Research, 2020. 15(1): p. 126.
Louw, Q.A., J. Manilall, and K.A. Grimmer, Epidemiology of knee injuries among adolescents: a systematic review. Br J Sports Med, 2008. 42(1): p. 2-10.
Ibeachu, C., et al., Knee problems are common in young adults and associated with physical activity and not obesity: the findings of a cross-sectional survey in a university cohort. BMC musculoskeletal disorders, 2019. 20(1): p. 1-7.
Piercy, K.L., et al., The Physical Activity Guidelines for Americans. Jama, 2018. 320(19): p. 2020-2028.
Clifton, D.R., et al., Epidemiology of knee sprains in youth, high school, and collegiate American football players. Journal of athletic training, 2017. 52(5): p. 464-473.
Hawkins, R.D. and C.W. Fuller, A prospective epidemiological study of injuries in four English professional football clubs. Br J Sports Med, 1999. 33(3): p. 196-203.
John, R., et al., Epidemiological profile of sports-related knee injuries in northern India: an observational study at a tertiary care centre. Journal of clinical orthopaedics and trauma, 2016. 7(3): p. 207-211.
Arendt, E. and R. Dick, Knee injury patterns among men and women in collegiate basketball and soccer. NCAA data and review of literature. Am J Sports Med, 1995. 23(6): p. 694-701.
Kaplan, T.A., et al., Effect of obesity on injury risk in high school football players. Clin J Sport Med, 1995. 5(1): p. 43-7.
Pihlajamäki, H.K., et al., Incidence and risk factors of exercise-related knee disorders in young adult men. BMC Musculoskeletal Disorders, 2017. 18: p. 1-7.
Shankar, P.R., et al., Epidemiology of high school and collegiate football injuries in the United States, 2005-2006. Am J Sports Med, 2007. 35(8): p. 1295-303.
Feeley, B.T., et al., Epidemiology of National Football League training camp injuries from 1998 to 2007. Am J Sports Med, 2008. 36(8): p. 1597-603.
Gage, B.E., et al., Epidemiology of 6.6 million knee injuries presenting to United States emergency departments from 1999 through 2008. Acad Emerg Med, 2012. 19(4): p. 378-85.
Nielsen, A.B. and J. Yde, Epidemiology of acute knee injuries: a prospective hospital investigation. J Trauma, 1991. 31(12): p. 1644-8.
Swenson, D.M., et al., Epidemiology of knee injuries among US high school athletes, 2005/06–2010/11. Medicine and science in sports and exercise, 2013. 45(3): p. 462.
Chew, K.T., et al., Current evidence and clinical applications of therapeutic knee braces. American journal of physical medicine & rehabilitation, 2007. 86(8): p. 678-686.
Greenwald, A.E., et al., A biomechanical and clinical evaluation of a patellofemoral knee brace. Clinical Orthopaedics and Related Research (1976-2007), 1996. 324: p. 187-195.
Timm, K.E., Randomized controlled trial of Protonics on patellar pain, position, and function. Medicine and science in sports and exercise, 1998. 30(5): p. 665-670.
Lun, V.M., et al., Effectiveness of patellar bracing for treatment of patellofemoral pain syndrome. Clin J Sport Med, 2005. 15(4): p. 235-40.
Miller, M.D., D.T. Hinkin, and J.W. Wisnowski, The efficacy of orthotics for anterior knee pain in military trainees. A preliminary report. Am J Knee Surg, 1997. 10(1): p. 10-3.
Swirtun, L.R., A. Jansson, and P. Renström, The effects of a functional knee brace during early treatment of patients with a nonoperated acute anterior cruciate ligament tear: a prospective randomized study. Clin J Sport Med, 2005. 15(5): p. 299-304.
Wojtys, E.M., S.U. Kothari, and L.J. Huston, Anterior cruciate ligament functional brace use in sports. Am J Sports Med, 1996. 24(4): p. 539-46.
Hewson, G.F., Jr., R.A. Mendini, and J.B. Wang, Prophylactic knee bracing in college football. Am J Sports Med, 1986. 14(4): p. 262-6.
Rovere, G.D., H.A. Haupt, and C.S. Yates, Prophylactic knee bracing in college football. Am J Sports Med, 1987. 15(2): p. 111-6.
Kujala, U.M., et al., Acute injuries in soccer, ice hockey, volleyball, basketball, judo, and karate: analysis of national registry data. Bmj, 1995. 311(7018): p. 1465-8.
Lam, K.C., et al., Previous knee injury and health-related quality of life in collegiate athletes. Journal of athletic training, 2017. 52(6): p. 534-540.
Cameron, K.L., et al., Normative values for the KOOS and WOMAC in a young athletic population: history of knee ligament injury is associated with lower scores. Am J Sports Med, 2013. 41(3): p. 582-9.
Muthuri, S.G., et al., History of knee injuries and knee osteoarthritis: a meta-analysis of observational studies. Osteoarthritis Cartilage, 2011. 19(11): p. 1286-93.
Barenius, B., et al., Increased risk of osteoarthritis after anterior cruciate ligament reconstruction: a 14-year follow-up study of a randomized controlled trial. The American journal of sports medicine, 2014. 42(5): p. 1049-1057.
Driban, J.B., et al., Knee pain and a prior injury are associated with increased risk of a new knee injury: data from the osteoarthritis initiative. The Journal of rheumatology, 2015. 42(8): p. 1463-1469.

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Assessing prevalence of knee injuries among athletes

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Introduction

Methods

Study design and participants:

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Statistical Analysis:

Results

Sample characteristics:

Characteristics of sports practices:

knee injury characteristics:

Discussion

Study's limitations:

Conclusion

Declarations

References

Status:

Version 1