Research Summary

Preseason Tendon Thickness Predicts In-Season Patellar Tendinopathy in NCAA Basketball Athletes

Kate Young

Key Highlights:

  • Preseason patellar tendon thickness significantly predicted in-season symptomatic tendinopathy.
  • Players with 8 mm tendon thickness had an 86% chance of requiring medical attention vs 3.4% for those with 4 mm thickness.
  • Preseason VISA-P scores were not predictive of future symptoms or time-loss tendinopathy.
  • Ultrasound-based screening may help identify high-risk athletes for early intervention.

In a recent study, increased anteroposterior thickness of the proximal patellar tendon measured at preseason was a strong predictor of symptomatic patellar tendinopathy and its sequelae in NCAA Division I basketball players. Thicker tendons were associated with significantly higher odds of seeking treatment and time-loss due to symptoms, suggesting that early-season tendon characteristics may forecast in-season clinical outcomes.

Patellar tendinopathy is a common condition in elite jumping athletes, with substantial implications for performance and injury risk. Identifying predictive markers could facilitate earlier intervention and potentially reduce the incidence or severity of tendinopathy. This study addressed the clinical need for a non-invasive, preseason screening tool to stratify risk in high-performance athletes.

Researchers evaluated 52 patellar tendons from 27 male NCAA Division I basketball players at three time points: preseason, midseason, and postseason. Assessments included tendon thickness via portable ultrasound, presence of hypoechoic regions, tenderness, and VISA-P scores. Outcomes analyzed were training room visits, time-loss tendinopathy, and tendon rupture. Multivariable regression considered body mass index and self-reported tendinopathy history as covariates.

Preseason mean tendon thickness was 4.78 mm. A total of 17.3% of tendons became symptomatic, necessitating medical attention. Increased tendon thickness was significantly associated with higher odds of both seeking treatment (aOR = 3.68; P < .01) and developing time-loss patellar tendinopathy (aOR = 1.96; P = .04). The risk of training room visit rose with increasing tendon thickness—ranging from 3.4% at 4 mm to 86% at 8 mm. Conversely, preseason VISA-P scores did not predict clinical outcomes.

“Ultrasound identification of at-risk individuals may allow triage toward additional physical therapy and activity modification for these athletes to prevent progression to irreversible patellar tendon disease,” the study authors concluded. “These data support the use of ultrasound as a screening tool for elite jumping athletes.”

Reference:

Desai SS, Mueller JD, Wong TT, et al. Preseason Patellar Tendon Thickness Predicts Symptomatic Patellar Tendinopathy in Male NCAA Division I Basketball Players. J Bone Joint Surg Am. 2025;107(10):e51. doi:10.2106/JBJS.24.00680