Incidence and Risk Factors Associated with Meniscal Injuries Among Active-Duty US Military Service Members

Abstract

Context: Few population-based studies have examined the incidence of meniscal injuries, and limited information is available on the influence of patient's demographic and occupational factors.Objective: To examine the incidence of meniscal injuries and the influence of demographic and occupational factors among active-duty US service members between 1998 and 2006.Design: Cohort study. Setting: Using the International Classification of Diseases (9th revision) codes 836.0 (medial meniscus), 836.1 (lateral meniscus), and 836.2 (meniscus unspecified), we extracted injury data from the Defense Medical Surveillance System to identify all acute meniscal injuries among active-duty military personnel.Patients or Other Participants: Active-duty military personnel serving in all branches of military service during the study period.Main Outcome Measure(s): Incidence rate (IR) per 1000 person-years at risk and crude and adjusted rates by strata for age, sex, race, rank, and service.Results: During the study period, 100201 acute meniscal injuries and 12115606 person-years at risk for injury were documented. The overall IR was 8.27 (95% confidence interval [CI] = 8.22, 8.32) per 1000 person-years. Main effects were noted for all demographic and occupational variables (P< .001), indicating that age, sex, race, rank, and service were associated with the incidence of meniscal injuries. Men were almost 20% more likely to experience an acute meniscal injury than were women (incidence rate ratio = 1.18, 95% CI = 1.15, 1.20). The rate of meniscal injury increased with age; those older than 40 years of age experienced injuries more than 4 times as often as those under 20 years of age (incidence rate ratio = 4.25, 95% CI=4.08,4.42).Conclusions: The incidence of meniscal injury was substantially higher in this study than in previously reported studies. Male sex, increasing age, and service in the Army or Marine Corps were factors associated with meniscal injuries.Key Words: knee injuries, lower extremity injuries, military athletes, injury epidemiology Key Points• To our knowledge, this is the largest population-based study to examine the incidence of meniscal tears within a physically active population that is at elevated risk of sport-and training-related knee injuries. • The overall incidence rate for meniscal injury was more than 10 times that previously documented in civilian populations.• Factors associated with a greater incidence of meniscal injury were male sex, increasing age, and Army or Marine Corps service.

Epidemiology of Posttraumatic Osteoarthritis

“…23 Incidence rates for meniscal injuries range from 0.33 to 0.61 per 1000 person-years 24,25 in physically active individuals but are as high as 8.27 per 1000 among active-duty military personnel. 26 Unfortunately, incidence rates for meniscal injuries among physically active persons are believed to be underestimated because of people not seeking medical treatment. 27 Both ACL and meniscal injuries carry a high risk of PTOA development.…”

Osteoarthritis and the Tactical Athlete: A Systematic Review

“…Military service members experience incidence rates for acute traumatic joint injuries that are an order of magnitude higher than rates observed in the general population, [15][16][17]19,39 and acute traumatic joint injury has been identified as an important risk factor for OA. 4,5,40,41 Although estimates are that posttraumatic OA accounts for 12% of all OA cases in the general population, 42 the prevalence of posttraumatic OA in tactical athletes remains unclear and is probably much higher.…”

“…Because of the physical training requirements and the nature of their work, tactical athletes are at increased risk for acute traumatic joint injury. [15][16][17][18][19] Furthermore, the physical training and occupational demands placed upon most tactical athletes require a significant amount of repetitive bending, squatting, kneeling, and lifting. Finally, even though most tactical athletes are not obese, many are required to endure heavy equipment loads during training and the performance of their occupational tasks.…”

Synthetic meniscus replacement: a review

“…Previously reported incidence rates for hospital admission after meniscal injury vary between 0.35 and 0.7 per 1,000 person-years [1,2]. However, in a large, recently published study amongst active duty US military service members, the incidence of meniscal injury (treated and non-treated) was found to be as high as 8.27 per 1,000 person-years [4].…”