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This review investigates the association between field surface type and the risk of ACL injuries in NFL players.

August 7, 2026CureusOpen Access

Association Between Playing Surface and Anterior Cruciate Ligament (ACL) Injury Risk in the National Football League: A Systematic Review and Exploratory Meta-Analysis

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Systematic review examines ACL injury risks on artificial turf versus natural grass in NFL players, suggesting concerns for athlete safety.

This review investigates the association between field surface type and the risk of ACL injuries in NFL players.
Systematic review adhering to PRISMA 2020 guidelines.
Ten studies included: eight on NFL, one systematic review, and one biomechanical study.
Data focused on ACL injury rates comparing artificial turf and natural grass within the NFL.
No individual study showed a statistically significant increase in ACL injuries on artificial turf.
Adjusted data indicated similar or higher ACL injury rates on artificial turf after accounting for surface exposure.
Pooled meta-analysis suggested a small increase in injury rates on turf, though not statistically significant.

Vemugunta et al. (2026) studied this question.

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Systematic review examines ACL injury risks on artificial turf versus natural grass in NFL players, suggesting concerns for athlete safety.