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Orthop J Sports Med. 2019 Apr 23;7(4):2325967119840712. doi: 10.1177/2325967119840712. eCollection 2019 Apr.

Epidemiological Patterns of Patellofemoral Injuries in Collegiate Athletes in the United States From 2009 to 2014.

Author information

Tulane University School of Medicine, New Orleans, Louisiana, USA.
Department of Emergency Medicine, Cooper University Hospital, Camden, New Jersey, USA.
Department of Orthopaedic Surgery, St Joseph's University Medical Center, Paterson, New Jersey, USA.
Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA.



As many as 30% of patients with knee pain seen in sports medicine clinics have complaints related to the patellofemoral joint. There is a paucity of research available regarding patellofemoral injuries, mechanism of injury, and playing time lost in collegiate athletes.


To describe the rates, mechanisms, severity, and potential sex-based differences of patellofemoral injuries in collegiate athletes across 25 National Collegiate Athletic Association (NCAA) sports.

Study Design:

Descriptive epidemiology study.


Data from the 2009-2010 through the 2013-2014 academic years were obtained from the NCAA Injury Surveillance Program and were analyzed to calculate patellofemoral injury rates, mechanisms of injury, time lost, and need for surgery. Rate ratios and injury proportion ratios were used to quantify discernible differences between sex-comparable sports and timing of injury (ie, practice vs competition), respectively.


The overall patellofemoral injury incidence rate was 16.10 per 100,000 athlete-exposures (AEs). Women's volleyball had the highest incidence of all sports (39.57 per 100,000 AEs). Injuries were 66% more likely to occur in competition than during practice. Female athletes experienced significantly more patellofemoral injuries than males in similar sports. Patellar tendinitis accounted for 49.2% of all patellofemoral injuries and was the most common injury in 20 of 25 studied sports. Patellar subluxation accounted for the most total days missed, and patellar dislocation had the highest mean days missed per injury (11.42 days). Patella fracture was the most likely injury to require surgery (80%).


Patellofemoral injuries were most common in sports that require jumping and quick changes of direction, specifically women's volleyball, men's and women's basketball, and women's soccer. The majority of patellofemoral injuries in this cohort were classified as patellar tendinitis caused by overuse. Most injuries resulted in no competition or practice time lost. This information may contribute to the development of prevention programs aimed at addressing the most prevalent types and mechanisms of injury in each sport to reduce the incidence of patellofemoral injury in these athletes.


athlete; collegiate; epidemiology; patellofemoral injuries

Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: M.K.M. has received educational support from Arthrex and Quest Medical and has received hospitality payments from Arthrex, Tornier, and Zimmer Biomet. 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.

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