Elizabeth Hofheinz, M.P.H., M.Ed.
You can’t make improvements if you don’t know where the “trouble spots” are. In sports medicine, interestingly, little is known about which sports and injury types have the highest operation rates. To rectify this, a team from the Icahn School of Medicine at Mount Sinai in New York set out on a descriptive epidemiology study.
Their work, “Analysis of surgery rates among 25 national collegiate athletic association sports,” was published in the December 21, 2020 edition of The Physician and Sportsmedicine. 
The researchers looked at all injuries requiring surgery as recorded in the National Collegiate Athletic Association (NCAA) Injury Surveillance Program (academic years 2004–2005 to 2013–2014). Surgery incidence rates were calculated for each sport and for the most common injury types, by academic year.
Co-author Daniel Charen, M.D. is an orthopedic resident at Icahn, and told OSN, “We found that women’s gymnastics, men’s football, men’s wrestling, and men’s and women’s basketball are NCAA sports with an elevated risk of surgery. ACL [anterior cruciate ligament] tears constituted by far the injuries with the highest surgery rates.”
Surgery incidence rate (per 10,000 Athletic Exposures [AE]) were as follows: women’s gymnastics (8.9), men’s football (6.1), and men’s wrestling (5.3). Absolute numbers of injury-related surgeries performed were greatest for men’s football (n = 31,043), women’s basketball (6,625), and men’s basketball (5,717). Anterior cruciate ligament tears had the greatest surgery incidence rate per 100,000 AEs for all sports combined (7.95), and also represented the injuries with the lowest rate of return to sport.
“We hypothesized that athletes competing in football and men’s and women’s basketball had higher surgery risks, but we did not anticipate women’s gymnastics would actually have the highest surgery rate,” stated Dr. Charen.
Asked what might be done to lower the risk of surgery in these sports, Dr. Charen noted, “The focus of the NCAA, other governing bodies and providers should be on developing more successful injury prevention strategies for athletes participating in these aforementioned sports, whether that involves adjusting training regimens, implementing rules changes, or directing future research.”
