Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
Background/Purpose: Traumatic knee injuries, such as injuries to the anterior cruciate ligament (ACL) and menisci, are associated with early onset osteoarthritis (OA). Our understanding of the pathobiology underlying this association is limited, and detailed studies of knee injury populations are needed. This longitudinal study examined the association between knee injury and function, pain, and OA in a cohort of military officers. The precipitating effect of injury on OA has not previously been studied in this population, which has a high rate of knee injury.
Methods: We assessed pain, function, and OA in military officers with a prior history of ACL/meniscal injuries (knee injury subcohort) and compared them to a group of injury-free participants (injury-free subcohort). Both subcohorts were drawn from an existing cohort of 6452 military officers enrolled between 2004 and 2008, when participants were matriculating cadets at the U.S. Air Force Academy, U.S. Military Academy, or U.S. Naval Academy. The knee injury subcohort had ACL or meniscal injuries prior to, or during, their 4-year academy career (n=106). The injury-free subcohort was site-matched from the same source cohort and had no history of ACL/meniscal injuries (n=108). Injury status was verified via re-administration of injury history questionnaire (all injuries) and clinical record review (post-matriculation injuries). Both groups completed a questionnaire between 08/11/15 and 05/10/16 that assessed physician-diagnosed OA, patient-reported knee outcomes (Knee injury and OA Outcome Score, or KOOS), and a single-item measure for knee pain, aching, or stiffness (5-point Likert scale) in the past 30 days. Data were analyzed using descriptive statistics and log-binomial regression models. KOOS scores were scaled (0=extreme deficit, 100=no deficit).
Results: Mean age was 27.7 years (injured: 27.7 years; non-injured 27.7 years) and 38% were women (injured: 34%; non-injured: 42%). Mean weight was 77.4 kg and body mass index was 25.1 kg/m2. Mean time from first ACL/meniscal injury to follow-up assessment was 8.5 years. Among the subjects with a history of ACL/meniscal injuries, nearly one in ten (10/108) had been diagnosed with knee OA. In comparison, none of the non-injured (0/106) had been diagnosed with knee OA (p=0.0357). ACL/meniscal injury subjects had clinically-relevant deficits on KOOS symptoms, sports/recreation (SR) and quality of life (QOL) scales (mean differences: -7.1, -7.6 and -10.5 respectively, all p<0.0001). Deficits on KOOS pain and activities of daily living scales were smaller and not clinically-relevant (mean differences: -4.3 and -2.6 respectively, both p<0.01). Over one-third of ACL/meniscal injury subjects endorsed (moderate/severe) the single-item question about knee pain, aching, or stiffness in the past 30 days (39/108), compared to 11% of non-injured (12/106, p=0.0001).
Conclusion: By the midpoint of their military careers, officers with a history of ACL/meniscal injury have deficits in knee-related QOL and physically-vigorous knee function (KOOS SR). Their OA prevalence (10% by age 28) is concerning given their youth and the physically-demanding nature of their profession.
To cite this abstract in AMA style:Marshall SW, Golightly YM, Nocera M, Guermazi A, Lohmander LS, Cantrell J, Padua DA, Renner JB, Cameron KL, Svoboda SJ, Loeser RF, Jordan JM, Kraus VB, Beutler AI. Association of Anterior Cruciate Ligament/Meniscal Injury with Knee Function, Knee Pain, and Knee Osteoarthritis in Military Officers [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/association-of-anterior-cruciate-ligamentmeniscal-injury-with-knee-function-knee-pain-and-knee-osteoarthritis-in-military-officers/. Accessed November 28, 2020.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/association-of-anterior-cruciate-ligamentmeniscal-injury-with-knee-function-knee-pain-and-knee-osteoarthritis-in-military-officers/