High prevalence of prior contact sports play and concussion among orthopedic and neurosurgical department chairs

J Neurosurg Pediatr. 2018 Jul;22(1):1-8. doi: 10.3171/2018.1.PEDS17640. Epub 2018 Apr 27.


OBJECTIVE Increased understanding of the consequences of traumatic brain injury has heightened concerns about youth participation in contact sports. This study investigated the prevalence of high school and collegiate contact sports play and concussion history among surgical department chairs. METHODS A cross-sectional survey was administered to 107 orthopedic and 74 neurosurgery chairs. Responses were compared to published historical population norms for contact sports (high school 27.74%, collegiate 1.44%), football (high school 10.91%, collegiate 0.76%), and concussion prevalence (12%). One-proportion Z-tests, chi-square tests, and binary logistic regression were used to analyze differences. RESULTS High school contact sports participation was 2.35-fold higher (65.3%, p < 0.001) for orthopedic chairs and 1.73-fold higher (47.9%, p = 0.0018) for neurosurgery chairs than for their high school peers. Collegiate contact sports play was 31.0-fold higher (44.7%, p < 0.001) for orthopedic chairs and 15.1-fold higher (21.7%, p < 0.001) for neurosurgery chairs than for their college peers. Orthopedic chairs had a 4.30-fold higher rate of high school football participation (46.9%, p < 0.001) while neurosurgery chairs reported a 3.05-fold higher rate (33.3%, p < 0.001) than their high school peers. Orthopedic chairs reported a 28.1-fold higher rate of collegiate football participation (21.3%, p < 0.001) and neurosurgery chairs reported an 8.58-fold higher rate (6.5%, p < 0.001) compared to their college peers. The rate at which orthopedic (42.6%, p < 0.001) and neurosurgical (42.4%, p < 0.001) chairs reported having at least 1 concussion in their lifetime was significantly higher than the reported prevalence in the general population. After correction for worst possible ascertainment bias, all results except high school contact sports participation remained significant. CONCLUSIONS The high prevalence of youth contact sports play and concussion among surgical specialty chairs affirms that individuals in careers requiring high motor and cognitive function frequently played contact sports. The association highlights the need to further examine the relationships between contact sports and potential long-term benefits as well as risks of sport-related injury.

Keywords: CI = confidence interval; CTE = chronic traumatic encephalopathy; OR = odds ratio; SRC = sport-related concussion; TBI = traumatic brain injury; benefits; contact sports; mTBI = mild TBI; resilience; surgeon; trauma; traumatic brain injury.

MeSH terms

  • Adolescent
  • Athletic Injuries / complications*
  • Athletic Injuries / epidemiology*
  • Athletic Injuries / surgery
  • Brain Concussion / epidemiology*
  • Brain Concussion / etiology*
  • Brain Concussion / surgery
  • Chi-Square Distribution
  • Cross-Sectional Studies
  • Female
  • Humans
  • Logistic Models
  • Male
  • Neurosurgery / psychology
  • Orthopedics
  • Prevalence
  • United States / epidemiology
  • Young Adult