Anterior Knee Pain Risk Differs Between Male and Female Military Tactical Athletes

ABSTRACTBackgroundAnterior knee pain (AKP) is commonly diagnosed in military members and is a threat to operational readiness. AKP includes a range of conditions, with localized pain around the patella being a frequent location of pain and disability. Mechanical overuse is one suggested etiology for many of these conditions, suggesting occupational demands in the military may influence AKP frequency amongst the service members. Previous research suggests females are at a greater risk for AKP, however, it is unknown how occupation affects AKP risk.Study DesignEpidemiological cohort.Level of EvidenceLevel 2.MethodsThe Defense Medical Epidemiology Database was queried for the number of individuals with ICD-9 diagnosis codes on their initial encounter from 2006 to 2015. Diagnoses were categorized into anterior or retropatellar pain, patellar instability, knee tendinopathy, as well the sum of the three groups which was defined as AKP. Relative risk (RR) and chi-square statistics were calculated in the assessment of sex and occupational category. Regressions were calculated to determine association between service branch, sex, and AKP across time.ResultsFrom 2006-2018, a total of 151, 263 enlisted and 14,335 officer services members were diagnosed with AKP. The incidence rate was 13.2 in enlisted members and 6.2 in in officers. Females were significantly at greater risk of developing AKP compared to males within both the enlisted (relative risk=1.32) and officer (relative risk=2.01) service members. Differences in risk were also noted across military occupation for both enlisted and officer service members, p<.05.ConclusionSex and military occupation were salient factors for AKP risk. Evaluation of training requirements and developing interventions programs across military occupation could serve as a focus for future research aiming to decrease the incidence of chronic knee pain.