Sports Medicine Research: In the Lab & In the Field: Injury Before College May Increase the Risk of Surgery During College (Sports Med Res)


Wednesday, May 4, 2016

Injury Before College May Increase the Risk of Surgery During College

Precollegiate knee surgery predicts subsequent injury requiring surgery in NCAA athletes

Wang D, Rugg CM, Mayer E, Lai WC, Sulziki P, Vail J, and Hame SL. Am J Sports Med. 2016. [Epub Ahead of Print].

Take Home Message: An athlete who sustained an injury requiring surgery prior to college is more likely to sustain an injury that needs surgery during their college career.

Participation in high-level athletics is beginning at increasingly younger ages. This leads to more numerous and severe injuries prior to competing in collegiate athletics. We previously highlighted a study of athletes at one university (see below), which indicated that these athletes were more likely to have a new injury if they had surgery before college. However, it would be helpful if we had a better understanding of the risk of reinjury among athletes with a history of surgery before college. Therefore, Wang and colleagues completed a retrospective cohort study to assess the relationship between precollege surgeries and injury in college. Researchers reviewed all medical charts of student athletes who participated in athletics at the University of California at Los Angeles between 2003 and 2009 (n = 1141, 587 males, 557 females, 20 sports). Pre-collegiate surgeries were recorded via athlete’s pre-participation physical examination. The authors used injury data from the university’s Sports Injury Monitoring System to identify acute or chronic injuries that required orthopaedic surgery. Overall, 186 (16%) athletes had surgery before college. The most common joints requiring surgery were knee (88 athletes, 8%) and wrist or hand (32 athletes, 3%). During collegiate athletics, 181 (16%) athletes underwent 261 surgeries. The authors found that an athlete with a history of knee surgery before college was more likely to have a surgery in college. This was found even after accounting for an athlete’s sex or sport. Furthermore, an athlete with a history of surgery before college was more likely to have a subsequent surgery to the same limb compared with other extremities.

The current study presents some interesting results that further support the notion that athletes who sustained an injury severe enough to require surgery prior to college were more likely to sustain another injury during college that would also require surgery. This may suggest that the wear and tear of sport has a cumulative effect on the body. Thus, the younger an athlete is when they begin participating in sport the more susceptible they may become. Furthermore, the data presented in the current study suggest that these athletes may benefit from further rehabilitation and training. This additional rehabilitation and training may help address deficiencies in mechanics or strength and may help protect an athlete from further injury. This study suggests that pre-college level athletes who sustain injuries, especially knee injuries should be educated regarding their potential increased risk of subsequent injury and be evaluated to determine if they need additional rehabilitation or training.
Questions for Discussion: How do you educate your patients on the potential risk of future injury? Do you feel your athletes would be receptive to this counseling?

Written by: Kyle Harris
Reviewed by:  Jeffrey Driban

Related Posts:
Knee Injuries Sustained Prior to Collegiate Athletics may be a Factor in Identifying Athletesat Risk for Reinjury

Wang, D., Rugg, C., Mayer, E., Lai, W., Sulzicki, P., Vail, J., & Hame, S. (2016). Precollegiate Knee Surgery Predicts Subsequent Injury Requiring Surgery in NCAA Athletes The American Journal of Sports Medicine DOI: 10.1177/0363546516634306


Ryan Duffy said...

I guess this is why we see many collegiate coaches refusing to recruit oft-injured athletes. Going forward, I think a good athletes training and strength & conditioning staff should be able to address certain deficits or deficiencies in these athletes. Suffering a serious injury in high school may be detrimental to future athletic endeavors but can certainly be addressed by those who know what to look for. It's important for athletic trainers at all levels to talk with incoming athletes about their past injury history so that a plan can be created going forward to keep the athlete on the field as much as possible.

Jeffrey Driban said...

Thanks Ryan! I agree. I think the best point was the need for ATs to talk to incoming athletes about their past injury history so a plan can be developed.

Kyle said...


I really like your comment as well. I think that communicating this to the coaches would be helpful as well. This shows a proactive approach and may help the coach feel more comfortable making a commitment to the athlete.

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