Evidence map›Paper›PMID 40789695›Full record

ArticleBMJ military health2025

Pre-academy knee pain as a predictor of overuse knee injuries in first-year military cadets.

Jeffrey A Turner, K L Kucera, K L Cameron, G S Bullock, A W Kiefer, M C Boling, S W Marshall, D A Padua

Abstract read
In one paragraph

Article in BMJ military health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Jeffrey A TurnerHuman Movement Science, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA jeffturner7@gmail.com.ORCID http://orcid.org/0000-0003-3908-2667
K L KuceraThe University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
K L CameronKeller Army Community Hospital, West Point, New York, USA.
G S BullockDepartment of Orthopaedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
A W KieferExercise and Sport Science, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
M C BolingClinical and Applied Movement Sciences, University of North Florida, Jacksonville, Florida, USA.
S W MarshallEpidemiology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
D A PaduaExercise and Sport Science, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.

Funding

Epidemiology of Jump-landing Movements and ACL InjuryR01AR050461 · NIAMS · UNIV OF NORTH CAROLINA CHAPEL HILL · PI MARSHALL, STEPHEN WILLIAM · 2005 to 2009
$2.7M
NIAMS NIH HHS R01 AR050461
6 · The paper itself

Abstract

introductionMusculoskeletal injuries, particularly overuse knee injuries, pose a significant challenge to military readiness, accounting for over 50% of medical visits and substantial healthcare costs. Military academy training presents unique physical demands, with cadets undergoing 15-20 hours of physical training weekly. This study aimed to determine whether a history of knee pain, independently or combined with other injuries, influences the rate of overuse knee injuries among first-year military cadets.

methods5820 first-year cadets from US service academies completed baseline questionnaires assessing 6-month pre-academy injury history. Overuse knee injuries during the first academic year were identified using Defense Medical Surveillance System data. Risk ratios (RR) and incidence rate ratios (IRR) were calculated to compare injury risk and rate between cadets with different injury histories, adjusting for sex, age, academy and year.

resultsThe overall incidence rate was 240 overuse knee injuries per 1000 person-years. Incidence rates varied substantially by injury history-149 per 1000 among those without prior injury versus 613 per 1000 among those with prior knee pain only. Cadets with prior knee pain demonstrated significantly higher risk (RR=3.09; 95% CI 2.63 to 3.65; p<0.001) and rate (IRR=4.08; 95% CI 3.31 to 5.02; p<0.001) of overuse knee injury compared with those without prior lower extremity injury. Notably, the combination of prior knee pain with other injuries did not produce additive risk effects, suggesting anatomically specific injury history may be the primary driver of future injury risk.

conclusionRather than implementing resource-intensive screening methods, careful assessment of prior knee pain history provides a practical approach for identifying high-risk cadets who could benefit from targeted screening and prevention strategies during their first year of military training.

Indexed as

EPIDEMIOLOGYKneeMilitary PersonnelMusculoskeletal disordersSPORTS MEDICINE

Identifiers

PMID40789695
PMCPMC12352609

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.