No abstract

The incidence of patellar dislocation injuries among US service members was an order of magnitude greater than that previously reported in civilian population studies. Gender, age, race, rank, and branch of military service are important risk factors related to the incidence of patellar dislocation injuries in this population.

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.

No abstract

Hamstring and patellar tendon autografts provide similar objective, subjective, and functional outcomes when assessed at least 2 years after anterior cruciate ligament reconstruction.

The results of our study suggest a cumulative effect of serial anesthesia and should be an important consideration when interpreting hematology and serum biochemistry in rhesus macaques.

Female gender was a risk factor for lateral but not medial epicondylitis. Age greater than 40 and white race were significant risk factors for both conditions.

Mild traumatic brain injury (mTBI) has been described as the most common form of traumatic brain injury within military populations; however, few epidemiologic studies have examined incidence rates for mTBI in this population. The objective of this study was to examine trends in the incidence of mTBI among active-duty U.S. service members between 1997 and 2007. Specifically, we were interested in evaluating trends in the incidence rates in relation to the initiation of combat operations in Iraq and Afghanistan. A retrospective cohort study was conducted utilizing data extracted from the Defense Medical Surveillance System to identify all incident cases of mTBI within the study population. The primary outcome of interest was the incidence rate of mTBI per 1000 person-years. Multivariable Poisson regression was used to analyze the data. There were 98,012 mTBI cases and 14,956,955 person-years of follow-up, for an overall incidence rate of 6.55 (95% CI 6.51,6.59) per 1000 person-years. There was a steady increase in the mTBI rate over time. The average change in the mTBI rate was 8.5% (95% CI 8.2%,8.8%) per year; however, the rate rose dramatically in the last 2 years of the study period. Overall, for 2006-2007 versus 1997-2005, the rate ratio was 1.61 (95% CI 1.58,1.65). The greatest increase in the rate of mTBI was observed among those serving in Iraq, who experienced a 38.4% (95% CI 35.4%,41.1%) annual increase in new cases. The observed increase in the incidence of mTBI in this population has significant policy implications in terms of allocating appropriate health care resources.