Which NCAA Sports Require the Most Surgeries?

Women’s gymnastics, men’s football, men’s wrestling, and men’s and women’s basketball are the National Collegiate Athletic Association sports with the highest risk of surgery, according to a Mount Sinai study.

Anterior cruciate ligament (ACL) tears were the types of injury that had the highest surgery incidence rate per 100,000 athletic exposures (AES) for all sports combined (7.95; 95% CI = 7.5 to 8.5), the researchers said. ACL tears also represented the injuries with the lowest rate of return to sport.

The study analyzed surgery rates among 25 National Collegiate Athletic Association (NCAA) sports.

“Participation in sports facilitates lifelong skills such as teamwork, effective communication, and physical fitness. However, there is the risk of injury and associated long-term consequences, especially for some collegiate-level athletes,” said corresponding author Daniel A. Charen, M.D., resident, department of orthopedic surgery at the Icahn School of Medicine at Mount Sinai.

“The focus of the NCAA, other governing bodies and health care providers should be on developing more successful injury prevention strategies for athletes—whether that involves adjusting training regimens or implementing changes to game rules. Health care professionals involved in the care of athletes, particularly at the collegiate level, should also be knowledgeable in managing these common injuries and treating athletes who compete in high-risk sports.”

The findings of the study, “Analysis of surgery rates among 25 national collegiate athletic association sports,” published in the December 2020 issue of The Physician and Sportsmedicine, are based on data from the NCAA Injury Surveillance Program for the academic years 2004-2005 to 2013-2014.

Surgery incidence rates were calculated for each sport (per 10,000 AES) and for the most common types, by academic year. The researchers also calculated the absolute numbers of performed surgeries and rates of return to sport.

The sports with the highest surgery incidence rate (per 10,000 AES) were women’s gymnastics (8.9; 95% CI 7.2-10.9), men’s football (6.1; 95% CI 5.8-6.4), and men’s wrestling (5.3; 95% CI 4.5-6.3). 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).

Dr. Charen and colleagues hope that their findings can help guide the NCAA and doctors in which sports require additional focus and future research, new injury prevention strategies, and improved health care personnel allocation.