The AFL is in the dark about a concerning spike in failed knee reconstructions, with the figure at an all-time high in 2013.
The league released its annual injury survey on Tuesday, tracking injury incidence, prevalence and recurrence rates across the competition.
Concussion, a major issue due to the associated concerns of long-term brain damage, remained steady with an average one player per club missing a game in 2013 due to a blow to the head.
The recurrence of calf strains was up 10 per cent from the previous year, but that paled in comparison to the rate of anterior cruciate ligament (ACL) injuries.
There were 23 knee reconstructions in total last year, with eight of those being 'revisions' after a player returned from ACL surgery and hurt the same knee.
It is the highest number or percentage of ACL recurrence recorded in 22 years of the survey.
Fremantle's Anthony Morabito, Sydney defender Alex Johnson and Geelong forward Daniel Menzel were among the luckless players.
Ligament augmentation and reconstruction system (LARS) surgery, considered by many surgeons to leave a player more prone to re-injury, was responsible for only three of the eight recurrences.
So why the high failure rate?
"All the cause side of it is fairly speculative," said associate professor John Orchard, one of the report's authors.
"Maybe last year was just an unlucky year ... but that's an area that we'll direct some of the research dollars to.
"We're doing a greater audit of ACL surgical techniques to see whether that collerates with reoccurrence rates."
The rate of ACL injuries in 2013 was again far higher in pre-season and early rounds, while the league is also looking into the role different grounds play in what was a season-ending setback prior to LARS.
"We're proposing to put to the research board a proposal for an audit of the last 15 years of all ACL injury reconstructions, to analyse them in more detail," said leading AFL doctor Hugh Seward, another of the report's authors.
"Looking at how successful (different operations have been) or where the failures have been and try and draw better conclusions, so we can more wisely advise the injured player."
Cadaver grafts, popular in the US, were not necessarily the solution according to Orchard.
"It wouldn't answer our recurrence rate problem," he said.
Orchard and Seward, who presented their findings on Tuesday, were pressed on the link between the number of interchanges in games and the higher overall rate of injuries.
Orchard suggested interchanges would need to be cut to about 40 a match to have a significant impact.
"We'd have to rewind the clock a lot to be confident that injuries would go down," he said.
AFL football operations manager Mark Evans confirmed that would not happen, adding further that the survey would not guide the league's approach to interchange numbers.
"Injury data will not direct what we do with interchange," Evans said.
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