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Predicting Postoperative Injury and Military Discharge Status After Knee Surgery in the US Army

Journal Article · · American Journal of Sports Medicine
 [1];  [2];  [3];  [2];  [2]
  1. Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA; School of Health & Rehabilitation Sciences, MGH Institute of Health Professions, Boston, Massachusetts, USA
  2. Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
  3. John A. Feagin Sports Medicine Fellowship, Keller Army Hospital, United States Military Academy, West Point, New York, USA; Department of Physical Medicine and Rehabilitation, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
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Background:

Researchers have assessed postoperative injury or disability predictors in the military setting but typically focused on 1 type of surgical procedure at a time, used relatively small sample sizes, or investigated mixed cohorts with civilian populations.

Purpose:

To identify the relationship between baseline variables and injury incidence or military discharge status in US Army soldiers after knee surgery.

Study Design:

Case-control study; Level of evidence, 3.

Methods:

Data were obtained from a repository containing personnel, performance, and medical records for all active-duty US Army soldiers. Multivariate logistic regressions were used to estimate the effects of numerous variables on postoperative injury or on medical discharge. Variable selection and model validation were conducted using the k-fold method.

Results:

A total of 7567 soldiers underwent knee surgery between 2017 and 2019. Meniscal procedures were the most common type of surgery (39%), and approximately 71% of the cohort had a postoperative injury. Significant predictors for sustaining a postoperative injury included having a previous nonknee injury (odds ratio [OR], 1.5), female sex (OR, 1.3), and Black race (OR, 1.2). Within 4 years after surgery, 17% of soldiers were discharged from the military because of knee-related disability. Significant predictors for discharge from duty included enlisted rank (OR, 2.3), recent fitness test failure (OR, 1.9), number of previous knee surgeries (OR, 1.7), and having a previous nonknee injury (OR, 1.6).

Conclusion:

After knee surgery, nearly three-fourths of the soldiers in this cohort sustained a postoperative injury and almost one-fifth of soldiers were medically discharged from the military within 4 years. This study identified variables that indicate statistically increased risk for these postoperative outcomes and highlighted potentially modifiable factors.

Research Organization:
Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, TN (United States)
Sponsoring Organization:
USDOE Office of Science (SC)
DOE Contract Number:
SC0014664
OSTI ID:
2425767
Journal Information:
American Journal of Sports Medicine, Journal Name: American Journal of Sports Medicine Journal Issue: 11 Vol. 51; ISSN 0363-5465
Publisher:
SAGE
Country of Publication:
United States
Language:
English

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