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