Use of Micro-Fragmented, Autologous Adipose Tissue to Treat Meniscal Injuries in Active-Duty Military Personnel

Meniscus tears are among the most common knee injuries in both general and military populations. This is not surprising, as military training and deployments often expose soldiers to high physical demands that can affect the knee. A 2012 study found a meniscal tear incidence rate of 8.3 per 1,000 person-years among active-duty service members, compared with about 0.61 per 1,000 in the general population. Incidence increased with age; however, incidence in the youngest members (<20 years old) was 3.0 per 1,000, a 5-fold increase compared to the general population. Soldiers who were in the enlisted ranks, were men, and served in the Army and Marines had the highest incidence of meniscal tears.

Non-battle musculoskeletal injuries are the leading cause of medical evacuation among deployed soldiers, and are derived from injuries caused by physical training and sports. During a 15-month period, 1.0% of lower extremity non-battle injuries in an Army Brigade Combat Team (Operation Iraqi Freedom) were related to the meniscus. Goodman et al. found that 19.3% of soldiers who had not been medically evaluated during combat consulted an orthopedic surgeon upon return for a musculoskeletal complaint. Of these consultations, a staggering 20.8% of lower extremity procedures were meniscal debridement or repair.

While the immediate consequences of meniscal injuries can be troublesome, long-term effects may be devastating to the soldier and the military at large. Galvin, et al. reported that out of 178 individuals who received meniscal repairs, 18.5% were separated from the military for an average time of 29 months while 28% required a permanent activity limiting duty profile. Meniscal tears may also increase the risk for other knee injuries such as osteoarthritis (OA), which is one of the most common medical reasons for discharge from active duty service. In a 2017 study, 23% of soldiers who were diagnosed with meniscal injuries ultimately received total knee replacements as a result of OA. Out of 14 subjects who were interviewed by the Army Physical Evaluation Board, 11 were medically discharged because of OA and/or their total knee replacement. It is imperative to evaluate alternative rehabilitative treatments that limit the negative outcomes, discharge rates, and time of separation associated with meniscal injuries.