2017 ISAKOS Biennial Congress ePoster #2401

 

The Effect of Prior Upper Extremity Surgery on Orthopaedic Injury and Surgery in Elite Collegiate Athletes

Sharon L. Hame, MD, Los Angeles, CA UNITED STATES
Caitlin M. Rugg, MD, MS, San Francisco, CA UNITED STATES
Dean Wang, MD, Orange, CA UNITED STATES
Erik Norman Mayer, MD, Los Angeles, CA UNITED STATES
Jeremy Vail, PT, OCS, SCS, ATC, Los Angeles, CA UNITED STATES
Pamela Sulzicki, ATC, Fairfield, CT UNITED STATES
Neal Berger, MD, Los Angeles, CA UNITED STATES

University of California, Los Angeles, Los Angeles, CA, UNITED STATES

FDA Status Not Applicable

Summary

Pre-Collegiate upper extremity surgery in athletes increased the risk of collegiate upper extremity injury and missed days due to upper extremity injury.

Abstract

Objectives:
Prediction of potential injury in the collegiate athlete has become an important issue for collegiate coaches, athletic trainers and team physicians. The influence of a prior surgery on subsequent athletic participation, injury, and surgery in college is not well understood. The purpose of this study was to investigate the effect of prior upper extremity surgery including shoulder surgery in Division I collegiate athletes on participation, injury rates, and surgery rates in college.

Methods

Athletes who began participation in collegiate athletics from 2003 - 2009 were identified. and represented 21 sports teams at a single institution. Athletes with prior upper extremity orthopaedic surgery, including shoulder, elbow, and wrist/hand surgery, were identified through training room records. Sport, seasons played, injuries sustained during college, days missed, diagnostic imaging performed and orthopaedic surgeries were collected through sports archives, medical records, and the Sports Injury Monitoring System (SIMS). Athletes with no prior history of upper extremity surgery served as a control group. Subgroup analysis was performed for athletes with a history of shoulder, elbow, and wrist/hand surgeries.

Results

Between 2003 and 2009, 1,145 athletes met the criteria for inclusion in the study. In total, 77 athletes (6.7%) were identified as having one or more upper extremity surgeries prior to collegiate athletics. Prior history of upper extremity surgery was most common in men’s water polo (15.0%), baseball (14.9%), and football (12.6%). Athletes with a history of a prior upper extremity surgery demonstrated a higher rate of upper extremity injury in college compared to controls (Hazard Ratio = 4.127, p <0.01), and missed more days for upper extremity injuries per season (16.5 days vs. 6.7 days, p = 0.03). Athletes with a prior shoulder surgery (n=20) also had a higher rate of upper extremity injury in college compared to controls (Hazard Ratio= 15,083, p=0.02). They missed more total athletic days per season (77.5 days vs. 29.8 days, p <0.01), had more MRIs (0.96 vs. 0.40, p <0.01), and underwent more total orthopaedic surgeries per season in college compared to controls (0.23 vs. 0.08, p <0.01). Career length was not significantly different between athletes with a history of upper extremity surgery and control athletes.

Conclusion

Collegiate athletes who have had an upper extremity surgery prior to college have increased rates of upper extremity injury and miss more days due to upper extremity injury in college. Athletes with prior shoulder surgery additionally have more diagnostic imaging and orthopaedic surgery in college. Careful consideration of these athletes, particularly those who have had prior shoulder surgery, may be beneficial in the recruitment process, including identifying incoming athletes at risk for injury and in the development of injury prevention programs.