Suchergebnisse

Background Although some studies have reported an increased incidence of patellar dislocations within active populations, few studies have reported incidence rates and examined risk factors for this injury. Purpose To examine the incidence of patellar dislocation injuries and the influence of demographic and occupational risk factors associated with injury among active-duty United States (US) service members between 1998 and 2007. Study Design Cohort study; Level of evidence, 3. Methods Using the Defense Medical Surveillance System, a search was performed for International Classification of Disease, 9th Revision (ICD-9) code 836.3 among all US service members on active duty during the study period. Multivariable Poisson regression analysis was used to estimate the rate of patellar dislocation per 1000 person-years at risk to injury. Incidence rates (IRs) and incidence rate ratios (IRRs) for patellar dislocation along with 95% confidence intervals (CIs) were estimated by gender, age, race, branch of military service, and rank while controlling for the other variables in the model. Results There were a total of 9299 individuals with documented patellar dislocation injuries among a population at risk of 13 443 448 person-years. The IR was 0.69 per 1000 person-years at risk. Women were 61% more likely (IRR, 1.61; 95% CI, 1.53-1.69) to sustain a patellar dislocation injury than men. Rates were highest in the youngest age group and decreased with increasing age. Service members aged <20 years were 84% more likely (IRR, 1.84; 95% CI, 1.61-2.10) to sustain a patellar dislocation injury as service members aged ≥40 years. Differences were also noted by race, service, and rank. Conclusion The incidence of patellar dislocation injuries among US service members was an order of magnitude greater than that previously reported in civilian population studies. Gender, age, race, rank, and branch of military service are important risk factors related to the incidence of patellar dislocation injuries in this population.

Background Ankle sprain is a common injury in athletic populations that results in significant time lost to injury. Hypothesis The incidence rates (IRs) of ankle ligament sprains are influenced by gender, height, weight, body mass index (BMI), physical conditioning, level of competition, type of sport, and athlete exposure to sport. Study Design Cohort study; Level of evidence, 2. Methods A longitudinal cohort study was performed to determine the effect of risk factors for ankle sprain at the United States Military Academy between 2005 and 2007. Results A total 614 cadets sustained new ankle sprains during 10 511 person-years at risk, resulting in an overall IR of 58.4 per 1000 person-years. Women (96.4), compared with men (52.7), had a significantly increased rate ratio (IRR) for ankle sprain of 1.83 (95% confidence interval [CI], 1.52-2.20). Men with ankle sprains had higher mean height, weight, and BMI than uninjured men (P < .001). Men with ankle sprains had higher average scores in push-ups, sit-ups, and run time than uninjured men (P < .001). Ankle sprain occurred most commonly during athletics (64.1%). Ankle sprain IR did not significantly differ between intercollegiate and intramural athletic competition after controlling for athlete-exposure (IRR, 1.05; 95% CI, 0.81-1.37). The ankle sprain IRR of female compared with male intercollegiate athletes was 0.93 (95% CI, 0.67-1.32) per 1000 person-years and 1.04 (95% CI, 0.74-1.47) per 1000 athlete-exposures. The intercollegiate sports of men's rugby, women's cheerleading, and men's/women's basketball, soccer, and lacrosse had the highest ankle sprain IR. Conclusion Higher mean height and weight in men, increased BMI in men, greater physical conditioning in men, and athlete exposure to selected sports were all risk factors for ankle sprain.