Injuries Preceding Severe Knee Tear Injuries in Collegiate Athletes

Severe knee injuries in collegiate athletes pose significant challenges in sports medicine. Although extensive research exists on the outcomes of these injuries, little is known about the preceding injury patterns that may predispose athletes to severe knee tears. A thorough examination of antecedent injuries may uncover valuable insights, equipping all involved parties (e.g., team doctor, athletic trainer, physical therapist, strength and conditioning coach) with the information needed to craft targeted prevention and monitoring strategies. PURPOSE: To identify common injury patterns preceding severe knee injuries in collegiate athletes. METHODS: A retrospective analysis was conducted using de-identified injury data spanning 18 athletic seasons from a university’s electronic medical records. A total of 256 severe knee injuries (i.e., complete ruptures of any soft-tissue structure surrounding the knee) among 223 athletes in 19 sports were identified. Injuries preceding the severe knee events were categorized by location and diagnosis according to US Olympic & Paralympic Committee guidelines. RESULTS: Among 537 preceding musculoskeletal injuries, 264 (49.16%) were classified as Preceding-Local Body Area, 173 (32.22%) as Preceding-Nonlocal, 84 (15.64%) as Preceding-Local Body Part, and 16 (2.98%) as previous severe knee tears. The median interval between a preceding injury and the severe knee tear was 116 days (IQR = 219 days). The most common chronological patterns observed in 89 (34.8%) cases were a hamstring strain preceding a knee tear (n = 24), an ankle sprain preceding a knee tear (n = 15), and a knee tear preceding a subsequent knee tear (n = 30). CONCLUSION: The findings indicate that specific antecedent injuries (particularly hamstring strains, ankle sprains, and prior knee tears) are associated with severe knee injuries. Enhanced monitoring and targeted interventions for athletes with these preceding injury patterns could mitigate future injury risk. Future research should focus on sport-specific prevention strategies to optimize athlete safety.