Injuries caused be the tram tracks over the last seven years have resulted in a bill for the NHS of more than £1m, and the vast majority happened to cyclists.
Prof Chris Oliver, a consultant at the Edinburgh Royal Infirmary, has counted 252 tram track incidents, 191 involving cyclists.
The trauma and orthopaedic surgeon says that 119 men and 72 women were injured, with the most common incident being a wheel caught in the tracks, followed sliding on a track, which was particularly likely in wet weather.
The accidents caused 55 upper limb fractures or dislocations, eight sustained lower limb fractures and two facial fractures.
One sustained both upper and lower limb fractures and one had facial and lower limb fractures.
Prof Oliver told the BBC: "We deal with thousands of fractures a year in the Royal and it's become a new work stream for us.
"It's not the £1m cost to the NHS, the problem is the suffering caused by the accidents and people having time off work, often ending up with some chronic disability with reduced function in a wrist or a shoulder and perhaps not getting back to sport, not being inclined to get back to cycling.
"These are more significant things that are less tangible to measure."
Lesley Hinds, City of Edinburgh Council's transport convener, said: "We have yet to be shown the full report but the safety of pedestrians and cyclists is of utmost importance to the council and transport for Edinburgh.
"Since the launch of Edinburgh trams we have gone to every effort to raise awareness of its impact on all road users and have ensured clear signage to guide cyclists along the safest routes throughout the city."
Back in 2015 we reported how lawyers called for action to prevent what they see is an "inevitable" cycling fatality on Edinburgh's tram lines, following a raft of injuries to cyclists, including broken collarbones and broken legs.
Thompsons Solicitors was dealing with nearly 100 claims against Edinburgh City Council following tram track injuries. One rider reportedly broke three teeth and lost the end of a finger as well as suffering a damaged shoulder and pulled hip after falling on the tracks.
Thompsons says it is the council's statutory duty to act, and are calling, along with the local cycle campaign, Spokes, for a cycle route to guide riders over the tram lines at a safe angle.
Patrick McGuire, a partner at the firm, told BBC Scotland: "We’ve had people who’ve lost finger tips, we’ve had people who’ve had broken collar bones, we’ve had people who’ve had broken legs.
"To my mind, it’s absolutely inevitable that unless something happens we will see a death on the streets of our capital city."