Orthopaedic Injuries of the Knee - Unique considerations in Military Service Members: Part I

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Military service members by nature of their occupational hazards are highly susceptible to musculoskeletal injury. Orthopaedic disorders of the knee are some of the most prevalent, causing a tremendous impact on military readiness. In 2017 and 2018, there were over 2.5 million and 1.8 million lost workdays, respectively, related due to knee injuries in the U.S. Army alone (not including the Air Force, Navy, or Marines). The U.S. Defense Health Agency manages one of the largest health systems in the world. The data contained within this closed single-payer government health system allows for a robust assessment of care pathways, where care is captured longitudinally almost exclusively within one system. Instead of samples of the population, the Military Health System (MHS) Data Repository allows for population-level assessment of large cohorts of individuals sustaining various knee injuries and the real-world care patterns associated with the management of those injuries.

To improve care for these individuals, understanding epidemiological trends and expected outcomes can help set the stage for changes in care delivery, identification of problems that need to be addressed, and new questions that can be answered in prospective trials. In Part I of a two-part series on knee injuries, four studies within this special issue of the Journal of Knee Surgery address efforts to better understand the impact of knee injuries. Specifically, these four papers ask the following questions:

What does usual care look like and what are initial treatment options for patellar tendinopathy?[1]

Does surgery for an isolated meniscus tear reduce risk of pain-related comorbidities?[2]

How many individuals with a meniscus injury undergo surgical repair versus conservative care?[3]

How do outcomes differ for patellar dislocations managed in emergent versus nonemergent care settings?[4]

Each of these articles provides real-world perspectives to the management of various knee disorders in the MHS. These patterns reflect what is actually being done across a wide spectrum of provider types and clinical settings.

We are very grateful to all of the authors for contributing their time and expertise into a series of knowledge products that improve our understanding of the management of common knee disorders in this health system. It provides valuable data that is necessary for the planning of prospective longitudinal studies. It is clear that there is still much work to be done to highlight clinically relevant and feasible solutions to improve management of these conditions in this setting.

Publication History

Article published online:
27 July 2022

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