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Biomechanics and situational patterns associated with anterior cruciate ligament injuries in the National Basketball Association (NBA)
  1. Vikram S Gill1,
  2. Sailesh V Tummala2,
  3. Sayi P Boddu1,
  4. Joseph C Brinkman2,
  5. Kade S McQuivey2,
  6. Anikar Chhabra2
  1. 1School of Medicine, Mayo Clinic Arizona, Scottsdale, Arizona, USA
  2. 2Department of Orthopedic Surgery, Mayo Clinic Arizona, Phoenix, Arizona, USA
  1. Correspondence to Mr Vikram S Gill, Mayo Clinic School of Medicine - Scottsdale Campus, Scottsdale, Arizona, USA; gill.vikram{at}


Objectives Perform a comprehensive video analysis of all anterior cruciate ligament (ACL) injuries in National Basketball Association (NBA) athletes from 2006 to 2022 to determine the associated biomechanics, injury mechanism and game situation.

Methods NBA players diagnosed with an ACL tear from 2006 to 2022 were identified and videos of each injury evaluated by two reviewers. Visual evaluation included assessment of joint kinematics at three time points: initial contact of the injured leg with the ground (IC), 33 milliseconds later (IC+33) and 66 milliseconds later (IC+66). Game situation was assessed qualitatively.

Results Videos of 38 out of 47 (80.9%) ACL tears were obtained. 9 injuries were non-contact, while 29 involved indirect contact. Between IC and IC+33, average knee valgus increased from 5.1° to 12.0° and knee flexion increased from 12.6° to 32.6°. At all time points, the majority of injuries involved trunk tilt and rotation towards the injured leg, hip abduction and neutral foot rotation. The most common game situations for injury included the first step when attacking the basket following picking up the ball (n=13), landing following contact in the air (n=11) and jump stop (n=5).

Conclusion Three major mechanisms predominate ACL tears in NBA players: the first step following picking up the ball when attacking, landing and jump stops. None of the injuries reviewed demonstrated direct contact to the knee, emphasising the importance of body kinematics in this injury pattern. The increase in knee valgus and knee flexion between IC and IC+33 should be noted as a possible precipitant to injury.

  • Anterior Cruciate Ligament
  • Basketball
  • Biomechanical Phenomena
  • Athletic Injuries
  • Preventive Medicine

Data availability statement

Data are available on reasonable request made to the corresponding author.

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Data availability statement

Data are available on reasonable request made to the corresponding author.

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  • Contributors All authors contributed to study conceptualisation. VSG and SPB completed data collection. SVT, JCB, KSM and AC assisted with confirmation and validation of the collected data. VSG completed data analysis and original draft preparation. SVT, JCB, KSM and AC performed thorough manuscript reviewing and editing. VSG is the guarantor of this study.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.