Context: Anterior knee pain (AKP) is ubiquitous in early-career military members and exacerbated during functional tasks required during military duties. Therefore, it is important to understand risk of this condition in male and female tactical athletes in diverse military occupations.

Objective: To assess sex and occupation on AKP risk in military members.

Design: Descriptive Epidemiology Study.

Setting: United States Armed Forces.

Patients All military members diagnosed with anterior or retro-patellar pain, patellar instability, knee tendinopathy on their initial encounter from 2006 to 2015.

Outcome Measures: The Defense Medical Epidemiology Database was queried for the number of individuals with 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.

Results: From 2006-2015, a total of 151,263 enlisted and 14,335 officer services members were diagnosed with AKP. Enlisted females had an incidence rate of 16.7 per 1000 person-years compared to the enlisted male service members with an incidence rate of 12.7 per 1000 person-years (RR: 1.32, 95%CI: 1.30–1.34, p<0.001) across all AKP diagnoses. Female officers had an incidence rate of 10.7 per 1,000 person-years compared to male officers at an incidence rate of 5.3 per 1000 person-years (RR: 2.01, 95%CI: 1.94–2.09). Differences in risk were also noted across military occupation for both enlisted and officer service members (p<.05).

Conclusion: Sex 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 mitigate associated risk factors of AKP.

This content is only available as a PDF.

Author notes

The preprint of this manuscript is archived on MedRxiv at doi: 10.1101/2020.09.17.20196741