Survey of underlying risk factors and epidemiology of anterior knee pain in semi-professional male basketball players.

backgroundAnterior knee pain (AKP) is highly prevalent in jumping sports and represents a frequent cause of functional limitation among basketball players, with patellar tendinopathy considered the most common underlying cause. While AKP has been extensively studied in elite and collegiate athletes, limited evidence is available for semi-professional players, who represent the majority of competitive basketball participants and often face high training demands with limited medical support. This study aimed to investigate the epidemiology of AKP and identify associated risk factors in semi-professional male basketball players.

methodsA cross-sectional, web-based survey was conducted among players competing in Serie B-D in two regions of Italy. AKP was defined using a combined screening question and anatomical pain localization. Prespecified demographic, anthropometric, training-related, competitive, occupational, and lifestyle predictors were collected via a self-administered questionnaire. Knee-related functional impairment was assessed using the Oslo Sports Trauma Research Centre Overuse Injury Questionnaire (OSTRC-O2-IT). Associations between predictors and AKP were examined using Bayesian multivariable logistic regression. Model-based predicted probabilities were also estimated across weekly training load.

resultsA total of 371 valid responses were included in the final analysis from 549 survey responses, corresponding to approximately 36.6% of the estimated target population. The prevalence of self-reported AKP was 23.5% (95% CrI 19.4-28.0). Players with AKP reported substantially greater functional impairment than AKP-negative players (mean OSTRC Severity Index Score 32.9 ± 20.9 vs. 3.7 ± 13.0). Higher weekly training volume was associated with increased odds of AKP (OR 1.18 per 60-minute increase in weekly training volume; 95% CrI 1.04-1.35), while a greater playing experience was associated with lower odds of AKP (OR 0.89; 95% CrI 0.80-0.98). Smoking was associated with higher odds of AKP (OR 2.38; 95% CrI 1.20-4.77). Model-based predicted probabilities demonstrated a progressive increase in AKP risk with higher weekly training load.

conclusionsAKP affected nearly one in four semi-professional male basketball players and was associated with significant functional impairment. Higher training load and smoking were associated with increased probability of AKP, whereas greater playing experience showed an inverse association. These findings highlight the importance of early screening and load monitoring to identify players at risk and support preventive strategies aimed at reducing progression toward chronic patellar tendinopathy in semi-professional basketball.