Epidemiology of Meniscus Injuries in the Military Health System and Predictive Factors for Arthroscopic Surgery

Abstract

Meniscus injuries occur at a higher rate in the military than the general population. Appropriate management and rehabilitation of meniscus injuries is important for maintaining readiness. The purpose of this study was to describe the health burden of meniscus injuries in the Military Health System (MHS) to identify the surgical intervention rate for meniscus injuries, and to determine which injury characteristics and demographic variables were associated with the likelihood of surgery after injury. The U.S. Department of Defense Management Analysis and Reporting Tool, a database of health care encounters by military personnel and dependents, was queried for encounters associated with a meniscal injury diagnosis between January 1, 2010, and December 31, 2011. Meniscus injuries were categorized into (1) isolated medial, (2) isolated lateral, (3) combined medial and lateral, and (4) unspecified cohorts. Patients under 18 and over 51 years were excluded, as well as patients without records at least 1 year prior to diagnosis or 2 years after. Relevant surgical procedures were identified with the Current Procedural Terminology (CPT) codes for arthroscopic surgery of the knee, meniscus repair, meniscectomy, and anterior cruciate ligament (ACL) reconstruction. There were 2,969 meniscus injuries meeting inclusion criteria during the study period. There were 1,547 (52.1%) isolated medial meniscus injuries, 530 (17.9%) isolated lateral meniscus injuries, 452 (15.3%) involved both menisci, and 435 (14.7%) were unspecified. The mean age was 35.5 years (standard deviation [SD] = 9.3). An adjacent ligamentous injury occurred in 901 patients (30.3%). The treatment course led to arthroscopic surgery in 52.8% (n = 1,568) of all meniscus injuries. Eighty-five percent (n = 385) of combined medial and lateral tears, 54.9% of medial tears, and 51.6% of lateral tears underwent surgery. Partial meniscectomy was the most common procedure performed while 47.2% (n = 1,401) of tears were not treated surgically. Bilateral meniscus injuries had 4.57 greater odds of undergoing knee arthroscopy (95% confidence interval [CI]: 3.46, 6.04), 2.42 times odds of undergoing a meniscus repair, and 4.59 times odds for undergoing a meniscus debridement (95% CI: 3.62, 5.82). The closed nature of the MHS allows reliable capture of surgical rates for meniscus injuries within the military population. Meniscus injuries are common in the military and impose a significant burden on the MHS. Appropriate management and rehabilitation of this injury is important for maintaining readiness.

Examining the Evidence Regarding Smoking and Patient Outcomes for Isolated Meniscus Pathology: A Comprehensive Systematic Review and Meta-Analysis

“…The current literature estimates isolated meniscus injuries to comprise 17-22% of all meniscal injuries; the remainder of meniscal injury types tend to be secondary to ACL injury [99][100][101]. When comparing isolated meniscus tears to secondary to ligamentous injury in the literature, it appears that secondary meniscus tear and smoking were associated with worse outcomes across all KOOS subscales [102].…”

Influence of cryotherapy with pulse compression on the functional condition of the knee joint after partial meniscectomy in the process of rehabilitation

“…Згідно статистичних даних, ушкодження менісків виникають в 60-70 випадках на 100 000 осіб упродовж року. Лише у США, щорічно виконується близько 1 мільйон артроскопічних втручань на колінному суглобі через травматичні ушкодження менісків [1,9].…”

Association of Knee Pain in Long Standing and Sitting among University Teachers

“…The horns of the medial meniscus are significantly farther apart than those of the lateral meniscus, creating the appearance that the medial meniscus is shaped like an 'O' rather than a "C." This is because the medial meniscus has grown in size, exposing a large region that may be vulnerable to damage. 4,5 Knee pain affects 46.2% of the population over the age of 60, with women (58%) being more prevalent than males (32%). Older patients more than 60 years of age and complaints of knee discomfort and illness have a poor quality of life.…”