Serial Ultrasonography for the Assessment of Healing of Lower Extremity Bone Stress Injury and Correlation With Return to Sport/Exercise.

BACKGROUND: Lower extremity bone stress injuries (BSIs) are common among athletes who participate in high-impact activities. Conventional imaging is limited in assessing healing of BSIs. HYPOTHESIS: Serial ultrasonography (US) can identify changes in appearance of lower extremity BSIs over time that can be correlated with symptoms and return to exercise/sport. STUDY DESIGN: Cohort observational study. LEVEL OF EVIDENCE: Level 3. METHODS: Adults 18 to 50 years old with a recent exercise-associated BSI of distal tibia/fibula or metatarsals diagnosed by magnetic resonance imaging (MRI) were enrolled. US was performed every 2 weeks for 12 weeks. The sonographic appearance (soft tissue edema, periosteal reaction, hyperemia on power Doppler, callus) was correlated with the numerical rating scale (NRS) for pain and ability to return to sport/exercise. RESULTS: A total of 30 patients were enrolled (mean age, 35.3 ± 7.7 years; 21 [70.0%] female). The tibia was most frequently affected (n = 15, 50.0%), followed by metatarsals (n = 14, 46.7%) and fibula (n = 1, 3.3%). At week 4, 25 of 30 (83.3%) had at least 1 US finding associated with the BSI. The degree of hyperemia was correlated with NRS at weeks 4 and 6 (Spearman correlations [ρ] 0.45 [0.09, 0.69] and 0.42 [0.07, 0.67], respectively), as well as return to sport/exercise at week 6 (ρ -0.45 [-0.68, -0.09]). US soft tissue edema was also correlated with NRS at week 6 (ρ 0.38 [0.02, 0.65]). CONCLUSION: Serial US of lower extremity BSIs can provide objective measures of healing. US findings were correlated with clinical outcomes at multiple timepoints. CLINICAL RELEVANCE: US may have advantages over conventional imaging for monitoring healing of lower extremity BSIs. Further research is needed to better understand the prognostic value of these sonographic indicators of BSI healing and role in assessing readiness for return to sport/exercise.

Prevalence of Vitamin D Insufficiency and Deficiency in Young, Female Patients With Lower Extremity Musculoskeletal Complaints.

BACKGROUND: Low levels of vitamin D have well-known impacts on bone health, but vitamin D also has a more global role throughout many tissues, including skeletal muscle. The high prevalence of hypovitaminosis D and the vast physiological features of vitamin D have led researchers to examine the influence of vitamin D on physical performance and injury. Because of the critical role of vitamin D in maintaining musculoskeletal health and function, a high rate of hypovitaminosis D among female patients with a variety of musculoskeletal issues could be of high clinical relevance. HYPOTHESIS: There is a high prevalence of low vitamin D in female patients with both acute and overuse sports-related issues of both soft tissue and bone. STUDY DESIGN: Prospective cohort study. LEVEL OF EVIDENCE: Level 3. METHODS: Female patients, aged 16 to 40 years, presenting with lower extremity injury diagnosed within the past 4 weeks, no use of multivitamin or vitamin D supplement, and no history of malabsorption syndrome met the inclusion criteria. Vitamin D levels were assessed and categorized as normal (≥32 ng/mL) and low, which includes insufficient (20.01-31.9 ng/mL) and deficient (≤20 ng/mL). RESULTS: Of the 105 patients enrolled, 65.7% had low vitamin D. Within the low vitamin D cohort, 40.6% were deficient and 59.4% were insufficient. Injuries were grouped into overuse or acute with 74 overuse injuries and 31 acute injuries, exhibiting low vitamin D prevalence of 60.8% and 77.4%, respectively. Patients with ligamentous/cartilaginous injuries exhibited the highest percentage of low vitamin D (76.5%), followed by those with patellofemoral-related complaints (71.0%), muscle/tendon injuries (54.6%), and bone stress injuries (45.5%). In univariable analysis, older age, non-White race, less physical activity, less high-intensity interval training days, less endurance training days, and more rest days showed an association with low vitamin D, but none showed an independent association in multivariable analysis. CONCLUSION: The prevalence of low vitamin D in female patients with various musculoskeletal complaints was high. Clinicians should evaluate for low vitamin D in both acute and overuse injuries. CLINICAL RELEVANCE: In addition to screening, this study suggests that clinicians should evaluate for low vitamin D levels beyond bone stress injuries in the setting of acute and overuse injuries.

Evaluation and Restoration of Competence to Stand Trial: Intercepting the Forensic System Using the Sequential Intercept Model.

The sequential intercept model (SIM) is used to reduce the penetration of persons with mental illness and substance use disorders in the criminal legal system. Its framework recommends identifying individuals with mental illness at various decision points of criminal case processing, from arrest to return from incarceration, so that they can be diverted toward treatment rather than permeate deeper into the criminal justice system. Communities frequently use the model to augment and inform jail diversion services. Despite the model's widespread adoption, individuals with serious mental illness, intellectual and developmental disabilities, and disorders affecting neurocognition and behavior are often found ineligible for such diversion because their competence to stand trial (CST) warrants evaluation, which effectively pauses their criminal case processes. If found incompetent to stand trial, these people can be ordered for competence restoration treatment, creating a pathway that is different from jail diversion options. Traditional community mental health services and courts await resolution by the "forensic system" before linking these individuals to needed services, and often these linkages are lacking. This review aims to describe and demystify these forensic processes and to highlight the potential use of the SIM to decrease jail stays and maximize community service connections for individuals with some of the most impairing mental health conditions who are involved in the justice system and for whom diversion is a safe option. The authors offer specific examples of intercept opportunities at each step involved in evaluations of CST and in the competence restoration processes.

Challenges to Reforming the Competence to Stand Trial and Competence Restoration System.

Many mental health and justice professionals have noted that the system that manages both competence to stand trial (CST) evaluation and competence restoration (CR) processes in criminal cases is in crisis. Public mental health services often are inundated with court referrals and are challenged to address them in a timely manner, resulting in waits for competence-related services for people in jail as well as substantial risks to criminal defendants for whom competence issues are raised. In this review, the authors describe the current CST-CR system and offer preliminary solutions to its challenges. In addition, they examine published works on the legal foundation of CST to help support the basis for this analysis. The results of this review point to the need to more effectively address the complexities of the CST-CR systems and highlight the importance of collaboration across legal and clinical systems. Guidance to states can be best facilitated by support for empirical research on the individual- and system-level factors that contribute to the waitlists and system paralysis that have a negative impact on people with serious mental illness in the criminal justice system.

Lytic Lesion in the Proximal Humerus After a Flu Shot: A Case Report.

CASE: There has been a recent campaign to vaccinate patients in an effort to prevent widespread flu pandemic. Although the complication rate after vaccine is low, there have been reports of Guillain-Barré syndrome and shoulder injury related to vaccine administration (SIRVA). In this case presentation, we discuss a patient who developed a large lytic lesion in the proximal humerus after a deeply administered flu shot. CONCLUSIONS: SIRVA is a rare cause of shoulder pain after injections, but one that progresses and often necessitates operative management. Clinicians should be wary of persistent shoulder pain after a flu shot.

The Establishment and Refinement of the National Basketball Association Player Injury and Illness Database.

The National Basketball Association (NBA; also referred to as "the league") has established a centralized, audited electronic medical record system that has been linked with external sources to provide a platform for robust research and to allow the NBA to conduct player health and safety reviews. The system is customized and maintained by the NBA and individual teams as part of the employment records for each player and is deployed uniformly across all 30 teams in the league, thereby allowing for standardized data on injuries, illnesses, and player participation in NBA games and practices. The electronic medical record data are enriched by linkage with other league external data sources that provide additional information about injuries, players, game and practice participation, and movement. These data linkages allow for the assessment of potential injury trends, development of injury-prevention programs, and rule changes, with the ultimate goal of improving player health and wellness. The purpose of this article is to describe this NBA injury database, including the details of data collection, data linkages with external data sources, and activities related to reporter training and data quality improvement.

Prevalence of Inadequate Immunity to Measles, Mumps, Rubella, and Varicella in MLB and NBA Athletes.

BACKGROUND: Multiple outbreaks of vaccine-preventable viral diseases have occurred in professional sports in recent years. Currently, there is no established protocol for vaccination or immunity screening for professional athletes. HYPOTHESIS: There are significant differences in the prevalence of inadequate immunity dependent on age, sport, country of birth, and participation in collegiate sports. STUDY DESIGN: Cross-sectional cohort study. LEVEL OF EVIDENCE: Level 4. METHODS: A sample of Major League Baseball (MLB) and National Basketball Association (NBA) players were screened for serologic evidence of immunity to measles, mumps, rubella, and varicella prior to the 2015 and 2016 seasons. The results were designated as adequate (immune) or inadequate (equivocal or nonimmune) based on laboratory criteria. Comparison with an age-matched control group was performed using data from the National Health and Nutrition Examination Survey (NHANES). RESULTS: A total of 98 athletes (62 MLB, 36 NBA) were screened. The prevalence of inadequate immunity for any virus was 35.5% in MLB players and 33.3% in NBA players. There was a significantly greater risk of inadequate immunity to rubella (risk ratio, 6.38; P < 0.01) and varicella (risk ratio, 4.21; P < 0.01) in athletes compared with the age-matched NHANES population. Our analysis did not reveal differences in rates of immunity based on sport, country of birth (US born vs international), or participation in college athletics. There was a lower rate of inadequate immunity to varicella with increasing age (odds ratio, 0.72; P = 0.05). CONCLUSION: One-third of athletes studied had inadequate immunity to 1 of the 4 viruses tested. Younger players had a significantly greater risk of inadequate immunity to varicella. Birth outside the US and lack of participation in college athletics were not found to influence immunity rates. CLINICAL RELEVANCE: These results can inform the development of future screening programs to prevent outbreaks of viral infections in professional athletes.

Electrocardiographic Findings in National Basketball Association Athletes.

Importance: While it is known that long-term intensive athletic training is associated with cardiac structural changes that can be reflected on surface electrocardiograms (ECGs), there is a paucity of sport-specific ECG data. This study seeks to clarify the applicability of existing athlete ECG interpretation criteria to elite basketball players, an athlete group shown to develop significant athletic cardiac remodeling. Objective: To generate normative ECG data for National Basketball Association (NBA) athletes and to assess the accuracy of athlete ECG interpretation criteria in this population. Design, Setting, and Participants: The NBA has partnered with Columbia University Medical Center to annually perform a review of policy-mandated annual preseason ECGs and stress echocardiograms for all players and predraft participants. This observational study includes the preseason ECG examinations of NBA athletes who participated in the 2013-2014 and 2014-2015 seasons, plus all participants in the 2014 and 2015 NBA predraft combines. Examinations were performed from July 2013 to May 2015. Data analysis was performed between December 2015 and March 2017. Exposures: Active roster or draft status in the NBA and routine preseason ECGs and echocardiograms. Main Outcomes and Measures: Baseline quantitative ECG variables were measured and ECG data qualitatively analyzed using 3 existing, athlete-specific interpretation criteria: Seattle (2012), refined (2014), and international (2017). Abnormal ECG findings were compared with matched echocardiographic data. Results: Of 519 male athletes, 409 (78.8%) were African American, 96 (18.5%) were white, and the remaining 14 (2.7%) were of other races/ethnicities; 115 were predraft combine participants, and the remaining 404 were on active rosters of NBA teams. The mean (SD) age was 24.8 (4.3) years. Physiologic, training-related changes were present in 462 (89.0%) athletes in the study. Under Seattle criteria, 131 (25.2%) had abnormal findings, compared with 108 (20.8%) and 81 (15.6%) under refined and international criteria, respectively. Increased age and increased left ventricular relative wall thickness (RWT) on echocardiogram were highly associated with abnormal ECG classifications; 17 of 186 athletes (9.1%) in the youngest age group (age 18-22 years) had abnormal ECGs compared with 36 of the 159 athletes (22.6%) in the oldest age group (age 27-39 years) (odds ratio, 2.9; 95% CI, 1.6-5.4; P < .001). Abnormal T-wave inversions (TWI) were present in 32 athletes (6.2%), and this was associated with smaller left ventricular cavity size and increased RWT. One of the 172 athletes (0.6%) in the lowest RWT group (range, 0.24-0.35) had TWIs compared with 24 of the 163 athletes (14.7%) in the highest RWT group (range, 0.41-0.57) (odds ratio, 29.5; 95% CI, 3.9-221.0; P < .001). Conclusions and Relevance: Despite the improved specificity of the international recommendations over previous athlete-specific ECG criteria, abnormal ECG classification rates remain high in NBA athletes. The development of left ventricular concentric remodeling appears to have a significant influence on the prevalence of abnormal ECG classification and repolarization abnormalities in this athlete group.

Internal Carotid Artery Dissection After Indirect Blunt Cervical Trauma in an Ice Hockey Goaltender.

Internal carotid artery dissections are rare injuries that can result from both direct cervical trauma and indirect trauma causing sudden cervical hyperextension. Depending on the magnitude of the dissection, clinical presentation ranges from neurologic symptoms, such as Horner syndrome, to relatively mild but persistent headache symptoms, as in the case reported in this article. High clinical suspicion with subsequent neuroimaging is recommended in similar clinical scenarios. Our patient, an ice hockey goaltender, was conservatively treated with rest and serial neuroimaging studies to ensure resolution of the dissection. Eight weeks later, he returned to athletic competition with resolved symptoms and radiologically improved arterial stenosis.

Brain contusion with aphasia following an ice hockey injury.

Head injuries are relatively common in ice hockey, with the majority represented by concussions, a form of mild traumatic brain injury. More severe head injuries are rare since the implementation of mandatory helmet use in the 1960s. We present a case of a 27 year-old male who sustained a traumatic intraparenchymal hemorrhage with an associated subdural hematoma resulting after being struck by a puck shot at high velocity. The patient presented with expressive aphasia, with no other apparent neurologic deficits. Acutely, he was successfully treated with observation and serial neuroimaging studies ensuring an absence of hematoma expansion. After a stable clinical picture following 24 hours of observation, the patient was discharged and managed with outpatient speech therapy with full resolution of symptoms and return to play 3 months later. We will outline the patient presentation and pertinent points in the management of acute head injuries in athletes.

Criminal justice and behavioral health care costs of mental health court participants: a six-year study.

OBJECTIVE: This study examined whether there were differences in costs for mental health court (MHC) participants and a matched comparison group for three years after a target arrest. METHODS: Data from the MacArthur Mental Health Court Study, the first multisite study of MHCs, were used to compare behavioral health treatment and criminal justice costs for MHC participants and a matched group (using coarsened exact matching) of jail detainees who were not enrolled in an MHC but who received jail-based psychiatric services in the same cities. Cost data for three years before and after a target arrest were calculated separately for each year and for each participant at three sites of the multisite study-296 MHC participants and 386 matched jail detainees. High-cost MHC participants were identified. RESULTS: Total annual costs for MHC participants averaged $4,000 more for all three follow-up years. The additional costs resulted from treatment costs, which were not offset by criminal justice cost savings. The highest-cost MHC participants were those with diagnoses of co-occurring substance use disorders and those who had more arrest incarceration days before their target arrest. Separate analyses determined that the higher average costs were not the result of outlier cases. CONCLUSIONS: Participation in an MHC may not result in total cost savings in the three years after enrollment. To become more efficient and to serve participants with the greatest needs, MHCs need to more effectively define the target group for intervention.

Atypical presentation of appendicitis in an adolescent cheerleader.

A 15-year-old female cheerleader presented to a sports medicine physician for evaluation of a suspected hip flexor injury. Five weeks before presentation, the patient developed acute right lower quadrant (RLQ) pain. She was seen in a local emergency room where her vital signs, abdominal computed tomography, and ultrasound were normal. No definitive diagnosis was made. Her initial symptoms resolved. The patient then attended cheerleading camp where her RLQ pain recurred and she was referred to sports medicine for further evaluation. Her examination was significant for exquisite tenderness at McBurney point. She was referred for surgical evaluation for probable appendicitis.

Law & psychiatry: what can we say about mental health courts today?

Mental health courts (MHCs) are a popular type of problem-solving court, and there is ample evidence that they reduce recidivism and increase participation in community-based treatment. The authors summarize evidence for the effectiveness of MHCs and present findings from a study in which they identified and characterized 346 adult and 51 juvenile MHCs currently operating in the United States. The continued growth of MHCs will be based in large part on funding for services. The Affordable Care Act will have major consequences for services provided to this population, and its implementation may therefore affect the future of MHCs. The authors note that it is preferable that people with mental illness not become involved in the criminal justice system in the first place. Despite the success of MHCs, they are not a substitute for an adequate mental health system.

Injury profile in elite female basketball athletes at the Women's National Basketball Association combine.

BACKGROUND: Anterior cruciate ligament (ACL) and meniscus injuries are common in female athletes participating in cutting and pivoting sports such as basketball. The epidemiological characteristics of injury in athletes seen at the Women's National Basketball Association (WNBA) combine and the effect of ACL reconstruction and meniscus surgery on longevity in the WNBA are unknown. PURPOSE: To evaluate the details and spectrum of injuries in athletes entering the WNBA combine and to assess the potential effect of specific injuries on the round drafted into the WNBA and career length. STUDY DESIGN: Descriptive epidemiology study. METHODS: Demographic data and the documented collegiate injury profile were reviewed from the WNBA database for all players entering the WNBA combine in 2000-2008. The study included injury data on 506 athletes. Complete demographic data were available for 496 players. RESULTS: Of the athletes taking part in the combine, 45.2% were guards, 33.7% were forwards, and 21.1% were centers. Ankle sprain (47.8% of players), hand injury (20.8%), patellar tendinitis (17.0%), ACL injury (15.0%), meniscus injury (10.5%), stress fracture (7.3%), and concussion (7.1%) were the most common injuries reported. Seventy-three athletes (14.4%) reported ACL reconstruction before entering the WNBA combine, and meniscus surgery was the next most common surgery (n = 50 players; 9.9%). There were no differences in ACL or meniscus surgery when analyzed by player position or round drafted. History of ACL or meniscus surgery did not affect career length in the WNBA. Excluding ACL and meniscus surgery, other reported surgical procedures were knee arthroscopic surgery (11.7%), ankle reconstruction (2.6%), and shoulder stabilization (2.0%). CONCLUSION: The ankle is the most common site of injury and ACL reconstruction is the most common surgery in elite female athletes participating in the WNBA combine. A history of injury or surgery did not affect the round drafted or career length.

A multi-site study of the use of sanctions and incentives in mental health courts.

Mental health courts (MHCs) have become widespread in the United States as a form of diversion for justice-involved individuals with mental illness. Sanctions and incentives are considered crucial to the functioning of MHCs and drug courts, yet with little empirical guidance to support or refute their use, and there are no definitions of what they are. The use of sanctions and to a lesser degree incentives is the focus of this article, with particular emphasis on jail sanctions. Subjects are participants (n = 447) in four MHCs across the United States. Results show that jail sanctions are used in three of four MHCs, and other sanctions are similarly used across the four MHCs. Participants charged with "person crimes" are the least likely to receive any sanctions, including jail, whereas those charged with drug offenses are most often sanctioned. The factors associated with receiving a jail sanction are recent drug use, substance use diagnosis, and drug arrests; being viewed as less compliant with court conditions, receiving more bench warrants, and having more in-custody hearings; and MHC program termination. No personal characteristics are related to receiving sanctions. Knowing which MHC participants are more likely to follow court orders and avoid sanctions, and identifying those who have difficulty adhering to court conditions, can help guide court officials on adjusting supervision, perhaps avoiding reoffending and program failure.

A national survey of U.S. juvenile mental health courts.

OBJECTIVE: The authors surveyed U.S. juvenile mental health courts (JMHCs). METHODS: Forty-one were identified in 15 states, and 34 returned surveys; one was completed on the basis of published information. Topics included the court's history, youths served, inclusion and exclusion criteria, the court process, and services provided. RESULTS: Half (51%) reported that the juvenile court was responsible for the program; for 11% the probation agency had the responsibility, and 17% reported shared responsibility by these entities. Fifty-one percent reported that all youths with any mental disorder diagnosis are eligible. The most commonly reported participant diagnoses are bipolar disorder (27%), depression (23%), and attention-deficit hyperactivity disorder (16%). Seventy percent currently include participants with felony offenses, and 91% with misdemeanors; 67% exclude status offenses, and 21% exclude violent offenses. A guilty plea was required by 63%. Incentives to participate included dismissal of charges (40%), reduction in court hearings (43%), praise by the judge and probation officer (60%), reduction in curfew restrictions (23%), and gift cards or gifts (71%). Sanctions for not participating included increased supervision or hearings (60%), performing community service (54%), and placement in residential detention (60%). Most JMHCs reported use of a multidisciplinary team to coordinate community-based services to prevent protracted justice system involvement. CONCLUSIONS: JMHCs are being developed in the absence of systematically collected outcome data. Although they resemble adult mental health courts, they have unique features that are specific to addressing the complex needs of youths with mental disorders involved in the justice system. These include diagnostic and treatment challenges and issues related to involving families and schools.

Effect of mental health courts on arrests and jail days: a multisite study.

CONTEXT: Mental health courts are growing in popularity as a form of jail diversion for justice system-involved people with serious mental illness. This is the first prospective multisite study on mental health courts with treatment and control groups. OBJECTIVES: To determine if participation in a mental health court is associated with more favorable criminal justice outcomes than processing through the regular criminal court system and to identify defendants for whom mental health courts produce the most favorable criminal justice outcomes. DESIGN: Longitudinal study. SETTING: Four mental health courts in San Francisco County, CA, Santa Clara County, CA, Hennepin County (Minneapolis), MN, and Marion County (Indianapolis), IN. PARTICIPANTS: A total 447 persons in the mental health court (MHC) and 600 treatment-as-usual (TAU) controls. INTERVENTION: Eighteen months of pre-entry and postentry data for 4 jurisdictions. All subjects were interviewed at baseline, and 70% were interviewed at 6 months. Objective outcome data were obtained on all subjects from Federal Bureau of Investigation arrest records, jails, prisons, and community treatment providers. MAIN OUTCOME MEASURES: Annualized rearrest rates, number of rearrests, and postentry incarceration days. RESULTS: The MHC and TAU samples are similar on the major outcome measures in the pre-entry 18-month period. In the 18 months following treatment, defined as entry into mental health court, the MHC group has a lower annualized rearrest rate, fewer post-18-month arrests, and fewer post-18-month incarceration days than the TAU group. The MHC graduates had lower rearrest rates than participants whose participation was terminated both during MHC supervision and after supervision ended. Factors associated with better outcomes among the MHC participants include lower pre-18-month arrests and incarceration days, treatment at baseline, not using illegal substances, and a diagnosis of bipolar disorder rather than schizophrenia or depression. CONCLUSIONS: Mental health courts meet the public safety objectives of lowering posttreatment arrest rates and days of incarceration. Both clinical and criminal justice factors are associated with better public safety outcomes for MHC participants.

The use of mental health court appearances in supervision.

A defining feature of mental health courts (MHCs) is the requirement that enrollees appear periodically for status review hearings before the MHC judge. Although the research base on these specialty courts is growing, MHC appearances have yet to be examined. In the present study, the authors followed more than 400 MHC clients from four courts. We examined the number of court appearances that were mandated versus attended, the number of bench warrants issued, and the proportion of court appearances that were made in-custody versus out-of-custody. Finally, we describe and report on the proportion of clients at each court who had graduated, had been terminated, or who were still in the court one year following enrollment.

Injury in the national basketball association: a 17-year overview.

BACKGROUND: Injury patterns in elite athletes over long periods continue to evolve. The goal of this study was to review of the injuries and medical conditions afflicting athletes competing in the National Basketball Association (NBA) over a 17-year period. DESIGN: Descriptive epidemiological study. METHODS: Injuries and player demographic information were reported by each team's athletic trainer. Criteria for reportable injuries were those that resulted in (1) physician referral, (2) a practice or game being missed, or (3) emergency care. The demographics, frequency of injury, time lost, and game exposures were tabulated, and game-related injury rates and 95% confidence intervals were calculated. RESULTS: A total of 1094 players appeared in the database 3843 times (3.3 ± 2.6 seasons). Lateral ankle sprains were the most frequent orthopaedic injury (n, 1658; 13.2%), followed by patellofemoral inflammation (n, 1493; 11.9%), lumbar strains (n, 999; 7.9%), and hamstring strains (n, 413; 3.3%). The most games missed were related to patellofemoral inflammation (n, 10 370; 17.5%), lateral ankle sprains (n, 5223; 8.8%), knee sprains (n, 4369; 7.4%), and lumbar strains (n, 3933; 6.6%). No correlations were found between injury rate and player demographics, including age, height, weight, and NBA experience. CONCLUSION: Professional athletes in the NBA experience a high rate of game-related injuries. Patellofemoral inflammation is the most significant problem in terms of days lost in competition, whereas ankle sprains are the most common injury. True ligamentous injuries of the knee were surprisingly rare. Importantly, player demographics were not correlated with injury rates. Further investigation is necessary regarding the consequences and sport-specific treatment of various injuries in NBA players. CLINICAL RELEVANCE: Knowledge of these injury patterns can help to guide treatments and provide more accurate guidelines for an athlete to return to play.