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

JC, Burks R, Owens BD, Sturdivant RX, Svoboda SJ, & Cameron KL. Journal of
Athletic Training. 2012; 47: 67-73.

to the meniscus are relatively common in the physically active population and
can cause limitations in activity levels, possible surgical intervention, as
well as long-term complications due to early-onset osteoarthritis.  Despite population-based estimates for the
risk of meniscal injuries that require surgery there is limited information
about incidence rates and risk factors for meniscal injuries in a young,
physically active population; particularly among military service members.  The purpose of this retrospective study was
to investigate the meniscal injury rate among active-duty US military
population between the years of 1998 through 2006.  Injury data was collected utilizing diagnosis
codes (ICD-9) for lateral, medial, or unspecified meniscal injury from the
Defense Medical Surveillance System, which gathers all medical encounter
information for the 4 branches of the military. 
During the 9 year period of interest, there was an overall acute
meniscal injury incidence rate of 8.27 per 1000 person-years (number of
meniscal injuries divided by the total number of service members during study
time period), with approximately 11,100 acute meniscal injuries occurring per
year.  Approximately 50% of the meniscal
injuries occurred to the medial meniscus, while approximately 22% occurred to
the lateral and 27% were unspecified to medial or lateral.  Demographic and occupational factors of sex,
age, race, branch of service, and rank were all found to be associated with
meniscal injury.  Being male, of greater
age, black or white, in the Army or Marine Corps, or a junior-enlisted ranking
were all independently associated with higher meniscal injury rates.      
study confirmed clinical findings that medial meniscal injuries occur more
often than lateral meniscal injuries, and that increased age is associated with
higher rates of meniscal injuries.  An
interesting and novel finding of this study was that those who were in the Army
or Marine Corp in addition to those with a rank of junior enlisted service
member had higher meniscal injury incidence rates than the other branches or
ranks.  Junior enlisted members had
higher rates than senior enlisted members, which seems to contradict the fact
that older age was found to be an increased risk factor.  Could it be that junior enlisted members may
have different activity levels or demands such as cutting/pivoting in
comparison to senior members?  It would
be interesting to collect information regarding the mechanism of knee injury,
as well as any concomitant injuries, across these demographic and occupational
factors to determine if there are differences in activities.  In regards to the association of branches, it
is possible that the training activities that the Army or Marine Corps were
involved in seem to be leading to higher incidence rates.  Since this study was a retrospective study,
the authors did not collect outcomes post-injury, but it may be extremely
interesting to see surgical rates, drop-out rates, performance effects, as well
as onset of early osteoarthritis.  This
is a population, who has a higher incidence of meniscal injuries compared to
the general US population, is also at a higher risk for long-term complications
(e.g., osteoarthritis; Cameron et al. 2011).  This would be an ideal population to test and
implement preventative programs, investigate long-term complications, or
intervention efficacy.  Lastly, this
study seemed to find an association between meniscal injury rates and
gender/race.  This may not be a good
sampling of population due to the lower number of members classified with gender
of women or race category of “other.”  There
were no differences found between African Americans and Caucasians.  While this study is primarily applicable to
military service member, it is possible that clinicians working with the
college level athletes may see similar patterns of gender, race, and age influencing
the risk of meniscal injuries.  Has
anyone seen anything clinically or in other literature to support the findings
that that men experience meniscal injury at a much higher rate than women? 

by: Nicole Cattano
by: Jeffrey Driban

Related Posts:

Jones JC, Burks R, Owens BD, Sturdivant RX, Svoboda SJ, & Cameron KL (2012). Incidence and Risk Factors Associated with Meniscal Injuries Among Active-Duty US Military Service Members. Journal of Athletic Training, 47 (1), 67-73 PMID: 22488232