One Weak Link Affects the Chain: Incidence of Lumbar, Hip, and Ankle Injuries in Patients with Patellofemoral Pain in the MHS — MHSRS 2021
Young J, Greenlee T, Rhon D
Abstract submitted to Military Health System Research Symposium 2021
Over half of all musculoskeletal injuries incurred by service members take place in the lower extremity and lumbar spine. In the first 6 months of 2019, musculoskeletal injuries alone were attributed to 59% of limited duty days. Knee disorders are some of the most common injuries of the lower extremity, contributing to high rates of osteoarthritis in service members and veterans. What is not seen as clearly is the potential influence that knee disorders have on the genesis of adjacent joint injuries. When pain and dysfunction affect the knee, do the compensatory adjustments required to manage these symptoms increase injuries in an adjacent joint (ankle, hip, spine)? Some evidence suggests that the presence of one lower extremity disorder may be a risk factor for the development of a more proximal or distal musculoskeletal disorder. Hip strength deficits have been shown to contribute to knee and foot/ankle disorders, foot disorders can impact the knee and lumbar spine, and foot and ankle symptoms have led to knee pain in patients with knee osteoarthritis. However, it is unclear what proportion of patients with a knee disorder end up sustaining an adjacent-joint injury, or what proportion of patients with a knee disorder had an adjacent joint injury prior to their knee disorder. This information can help clinicians and research teams better understand what patients may be at risk for additional injury sequelae and can help determine the content for optimal injury prevention or risk reduction strategies for these patients. Therefore, the purpose of this study was to investigate the incidence of lumbar, hip, and ankle injuries after a diagnosis of patellofemoral pain in the Military Health System. Because some evidence has shown a relationship between the spine, hip and ankle and subsequent knee disorders, a secondary aim was to identify the incidence of lumbar, hip, and ankle injuries prior to a patellofemoral pain diagnosis.