Background: Rates of cartilage degeneration in asymptomatic elite basketball players are significantly higher compared with the general population due to excessive loads on the knee. Compositional quantitative magnetic resonance imaging (qMRI) techniques can identify local biochemical changes of macromolecules observed in cartilage degeneration.
Purpose/hypothesis: The purpose of this study was to utilize multiparametric qMRI to (1) quantify how T 1ρ and T 2 relaxation times differ based on the presence of anatomic abnormalities and (2) correlate T 1ρ and T 2 with self-reported functional deficits. It was hypothesized that prolonged relaxation times will be associated with knees with MRI-graded abnormalities and knees belonging to basketball players with greater self-reported functional deficits.
Study Design: Cross-sectional study; Level of evidence, 3.
Methods: A total of 75 knees from National Collegiate Athletic Association Division I basketball players (40 female, 35 male) were included in this multicenter study. All players completed the Knee injury and Osteoarthritis Outcome Score (KOOS) and had bilateral knee MRI scans taken. T 1ρ and T 2 were calculated on a voxel-by-voxel basis. The cartilage surfaces were segmented into 6 compartments: lateral femoral condyle, lateral tibia, medial femoral condyle, medial tibia (MT), patella (PAT), and trochlea (TRO). Lesions from the MRI scans were graded for imaging abnormalities, and statistical parametric mapping was performed to study cross-sectional differences based on MRI scan grading of anatomic knee abnormalities. Pearson partial correlations between relaxation times and KOOS subscore values were computed, obtaining r value statistical parametric mappings and P value clusters.
Results: Knees without patellar tendinosis displayed significantly higher T 1ρ in the PAT compared with those with patellar tendinosis (average percentage difference, 10.4%; P = .02). Significant prolongation of T 1ρ was observed in the MT, TRO, and PAT of knees without compared with those with quadriceps tendinosis (average percentage difference, 12.7%, 13.3%, and 13.4%, respectively; P ≤ .05). A weak correlation was found between the KOOS-Symptoms subscale values and T 1ρ /T 2 .
Conclusion: Certain tissues that bear the brunt of impact developed tendinosis but spared cartilage degeneration. Whereas participants reported minimal functional deficits, their high-impact activities resulted in structural damage that may lead to osteoarthritis after their collegiate careers.
Competing Interests: One or more of the authors has declared the following potential conflict of interest or source of funding: Research support was received from the GE/NBA research consortium. M.F.K. has received consulting fees from EpiBone. G.E.G. has received consulting fees from Canon Medical Systems and Stryker, nonconsulting fees from GE Healthcare, royalties from Medtronic, and acquisitions from Medtronic. H.G.P. has received research support from GE Healthcare and Siemens Medical Solutions; consulting fees from Stryker, Arthrex, Cytex Therapeutics, NHL, and Ortho Regenerative Technologies; and nonconsulting fees from Arthrex and is an equity holder for Imagen technologies, a cofounder of Imagen Technologies, and a paid associate editor for Sports Health. S.M. has received institutional research support from GE Healthcare and Siemens Healthineers. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto. Ethical approval for this study was obtained from the University of California - San Francisco (ref No. 351632).
(© The Author(s) 2023.)