Article Text

Download PDFPDF
Recurrence and return to duty following patellar instability events in military personnel
  1. Vivek M Abraham1,
  2. K Wieschhaus1,
  3. A H Goldman1,2 and
  4. G C Balazs1,2
  1. 1Bone & Joints Sports Medicine Institute, Department of Orthopaedic Surgery, Naval Medical Center Portsmouth, Portsmouth, Virginia, USA
  2. 2Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
  1. Correspondence to Dr G C Balazs, Bone & Joint Sports Medicine Institute, Department of Orthopaedic Surgery, Naval Medical Center Portsmouth, Portsmouth, Virginia, USA; gcbalazs{at}gmail.com

Abstract

Introduction Military service members experience patellar dislocations at a rate 10 times that of civilians. The purpose of this study was to determine the return to duty rate of active duty military personnel following first-time or recurrent patellar dislocation. Secondary goals were to identify patient variables and radiographic parameters associated with recurrent instability and requiring medical separation from military service.

Methods The Military Health System Data Repository was used to identify all active-duty military personnel who sustained a patellar dislocation between 2013 and 2018. Medical records were searched for patient variables including demographics, clinical findings, radiographic findings, treatment, adverse outcomes and military disposition. Patient variables associated with recurrent instability and undergoing medical separation were determined using univariate analysis and multivariate logistic regression. A total of 207 patients met inclusion and exclusion criteria.

Results Following patellar instability event, 30% of the cohort underwent surgical treatment. Fourteen per cent (29 of 207) underwent medical separation from military service. Regardless of treatment, 9% (18 of 207) experienced recurrent dislocation and 3% (6 of 207) experienced recurrent instability without dislocation. On multivariate analysis, none of the studied patient variables were associated with recurrent instability or medical separation.

Conclusions Among military personnel, return to duty rates are similar to return to sport rates in civilians. This study demonstrates no difference in risk of recurrent instability or medical separation based on anatomical factors, which is useful during shared decision-making regarding treatment options and goals.

  • Adult orthopaedics
  • Knee
  • Orthopaedic & trauma surgery

Data availability statement

Data are available upon reasonable request.

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Data availability statement

Data are available upon reasonable request.

View Full Text

Footnotes

  • Contributors VMA assisted with project conception and design, data collection, manuscript drafting, manuscript editing, and approved the final manuscript. KW assisted with data collection, manuscript editing, and approved the final manuscript. AHG assisted with project conception and design, manuscript drafting, manuscript editing, and approved the final manuscript. GCB assisted with project conception and design, data collection, data analysis, manuscript drafting, manuscript editing, and approved the final manuscript. GCB is the guanator of the manuscript accepting overall responsibilty for the conduct of the study and the publication of this manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.