Anterior Knee Pain Risk in Male and Female Military Tactical Athletes

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 the risk of this condition among male and female tactical athletes in diverse military occupations. Objective: To assess sex and occupation with respect to the AKP risk in military members. Design: Descriptive epidemiology study. Setting: United States Armed Forces. Patients or Other Participants: All military members diagnosed with anteropatellar or retropatellar pain, patellar instability, or knee tendinopathy on their initial encounter from 2006 to 2015. Main Outcome Measure(s): The Defense Medical Epidemiology Database was queried for the number of individuals with AKP. Relative risk (RR) and v2 statistics were calculated in the assessment of sex and occupational category. Regressions were calculated to determine associations between service branch, sex, and AKP across time. Results: From 2006 to 2015, a total of 151 263 enlisted and 14335 officer service members were diagnosed with AKP. Enlisted females had an incidence rate of 16.7 per 1000 person years compared with enlisted males' incidence rate of 12.7 per 1000 person-years (RR = 1.32; 95% CI = 1.30, 1.34; P < .001) across all AKP diagnoses. Female officers had an incidence rate of 10.7 per 1000 person-years; male officers had 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 occupations for both enlisted and officer service members (P values < .05). Conclusions: Sex and military occupation were salient factors for the AKP risk. Evaluating training requirements and developing intervention programs across military occupations could serve as a focus for future research aiming to decrease the incidence of chronic knee pain.