PERIACETABULAR OSTEOTOMY IN ACTIVE DUTY U.S. MILITARY PERSONNEL: A SINGLE CENTER’S EXPERIENCE WITH A MINIMUM OF TWO YEARS FOLLOW-UP

Background: The primary focus of periacetabular osteotomy (PAO) literature has been survivorship until hip arthroplasty. This endpoint overlooks its impact on young, active patients. Hypothesis/Purpose: This study sought to assess the impact of the PAO on the careers of active duty members of the United States Armed Forces. Methods: A retrospective review identified 38 patients who underwent PAO performed by a single surgeon at an academic, military medical center from January 2014 through April 2017. Twenty-one of the patients were active duty United States military service members (16 female, 5 male) and had a minimum 28 months of post-operative follow-up at the time of review. Preoperative and postoperative duty restrictions were noted and referrals to the U.S Army and U.S. Air Force Medical Evaluation Boards (MEB) were queried. Results: The average age at surgery was 25.6 years (range, 19-40y). Preoperatively, sixteen patients (94.1%) were on duty restrictions, one had been referred to the MEB, and records were not available on three patients who separated from the military prior to review. Average follow-up was 3.4 years (range, 2.3 – 5.4y). Among the patients without a preoperative MEB referral, 85.0% remained on active duty (n = 12) or completed their military service commitment (n=5). Of the fourteen patients with temporary duty restrictions preoperatively, 35.7% (n=5) were relieved of their restrictions and returned to full duty and 50% (n=7) were retained on active service with permanent duty restrictions. Such permanent duty restrictions typically consisted of modifications to the aerobic component of the semiannual military fitness testing. Six patients (28.6%) were referred to the MEB including one who was referred prior to PAO. Of these patients, two were deemed fit to retain on active service with permanent duty restrictions, two were medically separated for non-hip conditions, and two were medically separated for a hip condition. The average Veteran Affairs (VA) disability score related to hip pathology in patients referred to MEB was 16% (range 0-40%). Conclusion: This is the first study to look at the PAO in active duty military service members. In patients with symptomatic acetabular dysplasia, PAO may provide an opportunity to relieve preoperative duty restrictions and allow for continued military service. Further study with the inclusion of patient reported outcomes are necessary assess the impact of the procedure in this active patient population.

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Health and Service-related Impact of Sexual and Stalking Victimization During United States Military Service on LGBT Service Members

Journal of Interpersonal Violence ◽

10.1177/0886260520970312 ◽

2020 ◽

pp. 088626052097031

Author(s):

Cary Leonard Klemmer ◽

Ashley C. Schuyler ◽

Mary Rose Mamey ◽

Sheree M. Schrager ◽

Carl Andrew Castro ◽

...

Keyword(s):

United States ◽

Military Service ◽

The United States ◽

Active Duty ◽

Service Members ◽

United States Military ◽

Service Outcomes ◽

Study Participants ◽

The Military ◽

Stalking Victimization

Prior research among military personnel has indicated that sexual harassment, stalking, and sexual assault during military service are related to negative health sequelae. However, research specific to LGBT U.S. service members is limited. The current study aimed to explore the health, service utilization, and service-related impact of stalking and sexual victimization experiences in a sample of active-duty LGBT U.S. service members ( N = 248). Respondent-driven sampling was used to recruit study participants. U.S. service members were eligible to participate if they were 18 years or older and active-duty members of the U.S. Army, U.S. Navy, U.S. Marine Corps, or U.S. Air Force. This study included a sizeable portion of transgender service members ( N = 58, 23.4%). Sociodemographic characteristics, characteristics of military service, health, and sexual and stalking victimization in the military were assessed. Regression was used to examine relationships between health and service outcomes and sexual and stalking victimization during military service. Final adjusted models showed that experiencing multiple forms of victimization in the military increased the odds of visiting a mental health clinician and having elevated somatic symptoms, posttraumatic stress disorder symptomatology, anxiety, and suicidality. Sexual and stalking victimization during U.S. military service was statistically significantly related to the mental and physical health of LGBT U.S. service members. Interventions to reduce victimization experiences and support LGBT U.S. service members who experience these types of violence are indicated. Research that examines the role of LGBT individuals’ experiences and organizational and peer factors, including social support, leadership characteristics, and institutional policies in the United States military is needed.

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Incidence of insomnia and obstructive sleep apnea in active duty United States military service members

SLEEP ◽

10.1093/sleep/zsab024 ◽

2021 ◽

Author(s):

Brian A Moore ◽

Lynn M Tison ◽

Javier G Palacios ◽

Alan L Peterson ◽

Vincent Mysliwiec

Keyword(s):

United States ◽

Obstructive Sleep Apnea ◽

Military Service ◽

Active Duty ◽

Incidence Rates ◽

Service Members ◽

United States Military ◽

Obstructive Sleep ◽

Military Service Members ◽

The U.S

Abstract Study Objectives Epidemiologic studies of obstructive sleep apnea (OSA) and insomnia in the U.S. military are limited. The primary aim of this study was to report and compare OSA and insomnia diagnoses in active duty the United States military service members. Method Data and service branch densities used to derive the expected rates of diagnoses on insomnia and OSA were drawn from the Defense Medical Epidemiology Database. Single sample chi-square goodness of fit tests and independent samples t-tests were conducted to address the aims of the study. Results Between 2005 and 2019, incidence rates of OSA and insomnia increased from 11 to 333 and 6 to 272 (per 10,000), respectively. Service members in the Air Force, Navy, and Marines were diagnosed with insomnia and OSA below expected rates, while those in the Army had higher than expected rates (p < .001). Female service members were underdiagnosed in both disorders (p < .001). Comparison of diagnoses following the transition from ICD 9 to 10 codes revealed significant differences in the amounts of OSA diagnoses only (p < .05). Conclusion Since 2005, incidence rates of OSA and insomnia have markedly increased across all branches of the U.S. military. Despite similar requirements for overall physical and mental health and resilience, service members in the Army had higher rates of insomnia and OSA. This unexpected finding may relate to inherent differences in the branches of the military or the role of the Army in combat operations. Future studies utilizing military-specific data and directed interventions are required to reverse this negative trend.

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Incidence of physician-diagnosed osteoarthritis among active duty United States military service members

Arthritis & Rheumatism ◽

10.1002/art.30498 ◽

2011 ◽

Vol 63 (10) ◽

pp. 2974-2982 ◽

Cited By ~ 56

Author(s):

Kenneth L. Cameron ◽

Mark S. Hsiao ◽

Brett D. Owens ◽

Robert Burks ◽

Steven J. Svoboda

Keyword(s):

United States ◽

Military Service ◽

Active Duty ◽

Service Members ◽

United States Military ◽

Military Service Members

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Handbook of Military and Veteran Suicide

10.1093/med:psych/9780199873616.001.0001 ◽

2017 ◽

Cited By ~ 1

Keyword(s):

Mental Health Professionals ◽

Military Service ◽

Suicide Risk ◽

National Guard ◽

Psychological Trauma ◽

The United States ◽

Active Duty ◽

Service Members ◽

Care Providers ◽

The Impact

There are approximately 30,000 suicides in the United States each year. Over 20% of these suicides are completed by active duty service members and military veterans. Experts in the field of military suicide collaboratively contributed to this textbook to summarize the current state of research on this important topic. The text encompasses various themes; it defines the scope of the problem, outlines current methods for screening and assessing suicide risk, summarizes both evidence-based treatments and risk management techniques, and describes current suicide prevention efforts. Specific topics among such themes explore the effect of psychological trauma, traumatic brain injury, and the impact of military culture on suicide risk. In addition, the text provides an overview of suicide efforts targeted for special population veteran and active duty service members, such as the Army National Guard and Special Operations Forces. Ethical considerations, challenges of research, as well as future directions are highlighted to provide the reader with a critical analysis of military and veteran suicide research. The information provided herein is ideal for care providers such as physicians, psychologists, and mental health professionals—as well as academics whose work involves military service members and veterans.

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The incidence of low back pain in active duty United States military service members. Knox J, Orchowski J, Scher DL, Owens BD, Burks R, Belmont PJ. Spine (Phila Pa 1976) 2011;36(18):1492–500.

The Spine Journal ◽

10.1016/j.spinee.2012.08.007 ◽

2012 ◽

Vol 12 (9) ◽

pp. 874-875

Keyword(s):

United States ◽

Low Back Pain ◽

Back Pain ◽

Military Service ◽

Active Duty ◽

Service Members ◽

Low Back ◽

United States Military ◽

Military Service Members

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Incidence of Acute Traumatic Patellar Dislocation among Active-Duty United States Military Service Members

The American Journal of Sports Medicine ◽

10.1177/0363546510371423 ◽

2010 ◽

Vol 38 (10) ◽

pp. 1997-2004 ◽

Cited By ~ 73

Author(s):

Mark Hsiao ◽

Brett D. Owens ◽

Robert Burks ◽

Rodney X. Sturdivant ◽

Kenneth L. Cameron

Keyword(s):

United States ◽

Military Service ◽

Patellar Dislocation ◽

Active Duty ◽

Service Members ◽

United States Military ◽

Military Service Members

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Anteromedializing Tibial Tubercle Osteotomy for Patellofemoral Instability: Occupational and Functional Outcomes in U.S. Military Service Members

The Journal of Knee Surgery ◽

10.1055/s-0037-1603639 ◽

2017 ◽

Vol 31 (04) ◽

pp. 306-313 ◽

Cited By ~ 2

Author(s):

Philip Belmont ◽

Julia Bader ◽

Joseph Lanzi ◽

Brett Owens ◽

Brian Waterman ◽

...

Keyword(s):

Military Service ◽

Patellofemoral Instability ◽

Active Duty ◽

Service Members ◽

Tibial Tubercle ◽

Tibial Tubercle Osteotomy ◽

Military Service Members ◽

Patellar Subluxation ◽

Pain Improvement

AbstractThis article sought to determine rates for return to work, pain relief, and recurrent patellofemoral instability for military service members undergoing tibial tubercle osteotomy (TTO) for persistent lateral patellar subluxation or dislocation. Patient demographic and surgical variables were isolated from the medical records of active duty service members with at least 2 years of postoperative follow-up, and correlated with return to work, pain improvement, recurrent patellofemoral instability, and perioperative complications. There were 51 service members (58 primary TTOs) with an average follow-up of 3.3 (range, 2.0–6.7) years. Service members had an average of 2.8 (1–12) instability events preoperatively. At a minimum of 2 years postoperatively, 41 (80%) military service members returned to full active duty service. Among the 58 TTOs, there was a 46% improvement in the patient-reported visual analog score from 4.1 to 2.2 (p < 0001). The postoperative recurrent instability rates were patellar dislocation (5.1%) and patellar subluxation (15.5%). Concomitant proximal realignment was performed in 48% of cases, which did not affect return to service, postoperative patellar instability events, or pain improvement (p > 0.05). The overall complication rate was 10%. Postoperative tibial fractures occurred in 6.9% of TTOs. At short- to mid-term follow-up, 80% of service members undergoing TTO for patellofemoral instability returned to military duty with significant improvement in pain scores and a moderate perioperative complication and postoperative instability rate. This study is a level IV therapeutic case series.

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