6 research outputs found
Predictors of Orthopaedic Surgery in NCAA Athletes
Objectives: Orthopaedic injury and surgery is relatively common in National Collegiate Athletic Association (NCAA) athletes and can have devastating career consequences. However, there is a paucity of data regarding predictors of orthopaedic surgery in collegiate athletes. The purpose of this study was to analyze player-related predictors of orthopaedic surgery, including that of the shoulder, hip, and knee, in NCAA athletes. Methods: All NCAA Division I collegiate athletes at a single institution who began participation from the 2003-2004 through 2008-2009 seasons were retrospectively identified. Player-related factors, including gender, sport, and any pre-college upper or lower extremity orthopaedic surgery, were elicited through pre-participation evaluations (PPEs). Athletes who underwent an orthopaedic surgery in college were identified through the Sports Injury Monitoring System and medical records. All patient-related independent variables were included in a multiple Cox regression model. Exposure time was calculated from the date of PPE to the date of surgery (event) or to the end of the collegiate athletic career (censored). Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated. Significance was set at P \u3c 0.05. Results: In total, 1,142 athletes in 12 sports (baseball/softball, basketball, football, golf, gymnastics, rowing, swimming & diving, soccer, tennis, track & field/cross country, volleyball, water polo) were identified. There were 262 documented orthopaedic surgeries, including those involving the shoulder (n = 34), hip (n = 25), and knee (n = 72), in 182 athletes. Using the multiple Cox regression model, pre-college lower extremity surgery was an independent predictor of orthopaedic (P = 0.004, HR = 1.88) and knee (P \u3c 0.001, HR = 3.91) surgery, and type of sport was an independent predictor of orthopaedic (P \u3c 0.001), shoulder (P = 0.002), and knee surgery (P \u3c 0.001) (Table 1). Participation in gymnastics, basketball, and volleyball were the strongest predictors of orthopaedic surgery. Similarly, participation in volleyball, gymnastics, and baseball/softball were the strongest predictors of shoulder surgery, and participation in basketball, football, and volleyball were the strongest predictors of knee surgery. Lastly, athletes with a history of a pre-college orthopaedic surgery were more susceptible to another surgery in the same extremity during college (P = 0.046, HR = 2.18). Gender was not a significant predictor of any surgery. No independent predictors of hip surgery were identified. Conclusion: NCAA athletes who underwent a pre-college lower extremity surgery were more likely to undergo orthopaedic and knee surgery during their collegiate careers. Those in overhead sports (e.g., volleyball, baseball/softball) were more likely to undergo shoulder surgery, and those in cutting and jumping sports (e.g., basketball, football) were more likely to undergo knee surgery. Furthermore, athletes with a history of a pre-college orthopaedic surgery were more likely to undergo another surgery in the same extremity during college, suggesting inadequate rehabilitation or less than full return of function after surgery. The time lost from athletic participation due to an orthopaedic surgery and its potential career impact underscores the need for injury prevention and improved surgical outcomes in the amateur athlete
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The Impact of Prior Upper-Extremity Surgery on Orthopedic Injury and Surgery in Collegiate Athletes
Background: The influence of prior upper-extremity (UE) surgery on a collegiate athletic career is poorly understood. This study aimed to investigate the impact of prior UE surgery on participation, injury, and surgery rates in collegiate athletes. Methods: Division I athletes who commenced collegiate athletics from 2003-2009 were retrospectively identified. Pre-participation evaluation forms were queried for the history of pre-collegiate UE surgery. Data on sport played, seasons played, injuries, days missed, and orthopedic imaging and surgical procedures were collected through athletic and medical records and compared with those of athletes without prior UE surgery. Subgroup analysis was performed for shoulder surgery, elbow surgery, and wrist and/or hand surgery. Results: Between 2003 and 2009, 1145 athletes completed pre-participation evaluations. Of these athletes, 77 (6.7%) underwent at least 1 pre-collegiate UE surgical procedure. Prior UE surgery was most common in men\u27s water polo (15.0%), baseball (14.9%), and football (12.6%). The UE surgery group had a higher rate of collegiate UE injury (hazard ratio, 4.127; P \u3c .01) and missed more days per season because of UE injury (16.5 days vs. 6.7 days, P = .03) than controls. Athletes with prior shoulder surgery (n = 20) also experienced more UE injuries compared with controls (hazard ratio, 15,083; P = .02). They missed more days per season (77.5 days vs. 29.8 days, P \u3c .01), underwent more magnetic resonance imaging scans (0.96 vs. 0.40, P \u3c .01), and underwent more orthopedic surgical procedures per season (0.23 vs. 0.08, P \u3c .01). The elbow subgroup and wrist and/or hand subgroup were comparable with controls on all measures. Conclusions: Collegiate athletes with prior shoulder surgery missed more days and underwent more magnetic resonance imaging scans and surgical procedures in college, whereas those with prior elbow surgical procedures and wrist and/or hand surgical procedures were comparable with controls
Precollegiate Knee Surgery Predicts Subsequent Injury Requiring Surgery in NCAA Athletes
Background: The effect of precollegiate orthopaedic surgery on injury risk in the elite collegiate athlete is unknown. Purpose: To (1) assess the relationship between precollegiate surgery and subsequent injury requiring surgery in National Collegiate Athletic Association (NCAA) Division I athletes at a single institution and (2) compare the risk of subsequent surgery in the ipsilateral versus contralateral extremity in those with a history of precollegiate surgery. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective chart review was performed of all athletes who began participation from 2003 to 2009 until completion of eligibility. Athletes who received orthopaedic surgery in college were identified through the Sports Injury Monitoring System and were cross-referenced with medical records. The risk of orthopaedic surgery was evaluated using multivariate Cox and Poisson regression models, with sex and sport as additional covariates. Risk of subsequent surgery in the ipsilateral versus contralateral extremity was compared using Kaplan-Meier survival estimates and Cox proportional hazards regression. Hazard ratios (HRs) and rate ratios (RRs) with corresponding 95% confidence intervals were used to compare groups. Results: In total, 1141 athletes were identified for analysis. Of these, 186 athletes (16.3%) had a history of precollegiate orthopaedic surgery. There were 261 documented intracollegiate orthopaedic surgeries in 181 athletes (15.9%). Precollegiate knee surgery was an independent predictor of orthopaedic surgery (HR, 1.85; 95% CI, 1.16-2.83) in college. When examining only surgeries resulting from acute or primary injuries, precollegiate knee surgery was an independent predictor of primary knee injury requiring surgery in college (HR, 4.45; 95% CI, 2.51-7.59). Athletes with a history of precollegiate surgery were more susceptible to subsequent surgery in their ipsilateral extremity compared with their other extremities (HR, 1.89; 95% CI, 1.03-3.53). In contrast, there was no additional risk of receiving subsequent surgery in the contralateral extremity (P = .54). Conclusion: Precollegiate knee surgery in the Division I athlete is associated with subsequent injury requiring surgery in college. Athletes with a history of precollegiate surgery are at higher risk of subsequent surgery in their ipsilateral extremity compared with other extremities