American Academy of Orthopaedic Surgeons Annual Meeting

American Academy of Orthopaedic Surgeons Annual Meeting

March 21, 2013
2 min read

Study: Rate of ACL injury in NCAA football players higher on third-generation artificial turf

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CHICAGO — NCAA football players have a greater number of ACL injuries when they play on artificial turf surfaces, particularly on artificial surfaces with fill, compared to natural grass surfaces, according to a presenter at the American Academy of Orthopaedic Surgeons Annual Meeting.

“The rate of ACL injury in NCAA football is significantly greater on third-generation artifical turf,” said Jason L. Dragoo, MD, here.

To determine the incidence of ACL injury in NCAA football players and the effect of playing surface, Dragoo and colleagues computed the injury rate for competition and practice exposures. Their study reviewed the injury code of “anterior cruciate ligament complete tear” in the NCAA Injury Surveillance System men’s football ACL injury database for the 2004-2005 through 2008-2009 seasons for complete ACL injuries. Sampling rates were used to convert the raw data into values representative of all NCAA teams.

The researchers found an incidence rate of 1.42 ACL injuries per 10,000 athlete-exposures on artificial playing surfaces and an incidence rate of 1.24 per 10,000 athlete exposures on natural grass. The rate of ACL injury on artificial surfaces was 1.36 times greater than the injury rate on natural grass. Non-contact injuries also occurred more frequently on artificial turf surfaces, according to the findings.

Dragoo said the rate of injury during games was increased by more than 10 times vs. during practice. Additionally, surfaces with higher amounts of artificial fill, including sand and rubber components or third-generation types of turf, had higher levels of injuries in comparison to the first- and second-generation types of turf that typically have a shorter blade length.

“There may be many reasons why artifical turf is used by so many universities. It improves the playing surface more consistently with weather variations. It achieves faster and more consistent play, but we also may run the risk of increasing the shoe-surface interactions, which also may be a problem as far as ACL and other prevention programs are concerned,” Dragoo said.

Of the injuries that occurred on artificial turf surfaces, special teams players, linebackers, wide receivers, running backs and quarterbacks were most frequently injured. Of the injuries that occurred on natural grass surfaces, running backs, linebackers, wide receivers, special teams players and cornerbacks were most frequently injured.


Dragoo JL. Paper #47. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 19-23, 2013; Chicago.

Disclosure: Dragoo has no relevant financial disclosures.