title: Incidence of acute traumatic patellar dislocation among active-duty United States military service members.
abstract: BACKGROUND
  Although some studies have reported an increased incidence of patellar dislocations within active populations, few studies have reported incidence rates and examined risk factors for this injury.
  
  
  OBJECTIVE
  To examine the incidence of patellar dislocation injuries and the influence of demographic and occupational risk factors associated with injury among active-duty United States (US) service members between 1998 and 2007.
  
  
  METHODS
  Cohort study; Level of evidence, 3.
  
  
  METHODS
  Using the Defense Medical Surveillance System, a search was performed for International Classification of Disease, 9th Revision (ICD-9) code 836.3 among all US service members on active duty during the study period. Multivariable Poisson regression analysis was used to estimate the rate of patellar dislocation per 1000 person-years at risk to injury. Incidence rates (IRs) and incidence rate ratios (IRRs) for patellar dislocation along with 95% confidence intervals (CIs) were estimated by gender, age, race, branch of military service, and rank while controlling for the other variables in the model.
  
  
  RESULTS
  There were a total of 9299 individuals with documented patellar dislocation injuries among a population at risk of 13 443 448 person-years. The IR was 0.69 per 1000 person-years at risk. Women were 61% more likely (IRR, 1.61; 95% CI, 1.53-1.69) to sustain a patellar dislocation injury than men. Rates were highest in the youngest age group and decreased with increasing age. Service members aged <20 years were 84% more likely (IRR, 1.84; 95% CI, 1.61-2.10) to sustain a patellar dislocation injury as service members aged ≥40 years. Differences were also noted by race, service, and rank.
  
  
  CONCLUSIONS
  The incidence of patellar dislocation injuries among US service members was an order of magnitude greater than that previously reported in civilian population studies. Gender, age, race, rank, and branch of military service are important risk factors related to the incidence of patellar dislocation injuries in this population.
authors.affiliation: John A. Feagin Jr Sports Medicine Fellowship, Department of Orthopedic Surgery, Keller Army Hospital, West Point, New York 10996, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Hsiao
authors.forename: Brett D
authors.initials: BD
authors.lastname: Owens
authors.forename: Robert
authors.initials: R
authors.lastname: Burks
authors.forename: Rodney X
authors.initials: RX
authors.lastname: Sturdivant
authors.forename: Kenneth L
authors.initials: KL
authors.lastname: Cameron
mesh_terms: D000208:Acute Disease; D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008889:Military Personnel / Q000706:statistics & numerical data*; D031222:Patellar Dislocation / Q000453:epidemiology* / Q000209:etiology; D016012:Poisson Distribution; D011159:Population Surveillance; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult