title: Prolonged mounted patrolling is a risk factor for developing knee pain in Danish military personnel deployed to the Helmand Province.
abstract: BACKGROUND
  Non-battle injuries have been the leading cause of medical evacuation in the recent wars in Afghanistan and Iraq. This study investigates the hypothesis, that the occurrence of knee problems could be associated with mounted patrolling in armoured vehicles independent of other risk factors.
  
  
  METHODS
  Retrospective questionnaire-based cohort study of Danish soldiers deployed to Afghanistan during 1 February-31 July 2013.
  
  
  RESULTS
  307 soldiers included. Response rate 70%. 33% reported knee pain.
  
  
  RESULTS
  Significant association between knee pain and time spent weekly on mounted patrols (OR 1.23, CI 1.07 to 1.41, p=0.003). Controlled for confounders age, body mass index and duration of military employment (OR 1.22, CI 1.06 to 1.41, p=0.006). Adjusted for confounders and all other risk factors (OR 1.25, CI 1.07 to 1.48, p=0.007). The main finding in a subset of the 33% with knee pain: Significant association between more severe knee problems with Knee injury and Osteoarthritis Outcome Score below 400 and time spent weekly on mounted patrols (OR 1.49, CI 1.17 to 1.56, p=0.002).
  
  
  CONCLUSIONS
  A major concern regarding knee problems among Danish deployed military personnel is identified. The risk of suffering from knee problems and the severity of symptoms increase with the amount of time spent inside a vehicle on mounted patrols.
authors.affiliation: Danish Armed Forces Health Service, Gadstrup, Denmark.
authors.forename: Christina Rydahl
authors.initials: CR
authors.lastname: Lundin
authors.affiliation: Center for Elective Orthopedic Surgery, Naestved Hospital, Naestved, Denmark.
authors.forename: T
authors.initials: T
authors.lastname: Houe
authors.affiliation: Faculty of Health and Medical Sciences, Copenhagen Prospective Studies on Asthma in Childhood, University of Copenhagen & Danish Pediatric Asthma Center, Gentofte Hospital, Copenhagen, Denmark.
authors.forename: A
authors.initials: A
authors.lastname: Sevelsted
authors.affiliation: Danish Armed Forces Health Service, Gadstrup, Denmark.
authors.forename: L
authors.initials: L
authors.lastname: Nissen
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D018771:Arthralgia / Q000453:epidemiology*; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D007719:Knee Joint; D008297:Male; D008889:Military Personnel / Q000706:statistics & numerical data*; D018986:Motor Vehicles; D016273:Occupational Exposure / Q000706:statistics & numerical data*; D011187:Posture; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult
keywords: ORTHOPAEDIC & TRAUMA SURGERY; PAIN MANAGEMENT