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Incident Musculoskeletal Conditions Among Men and Women Veterans Returning From Deployment.

Haskell SG, Brandt C, Bastian L, Driscoll M, Bathulapalli H, Dziura J. Incident Musculoskeletal Conditions Among Men and Women Veterans Returning From Deployment. Medical care. 2020 Dec 1; 58(12):1082-1090.

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BACKGROUND: Military service confers an increased risk for musculoskeletal (MSK) injury among women and men Veterans. OBJECTIVE: The objective of this study was to determine the prevalence of MSK conditions at first visit to Veterans Affairs (VA), and the incidence rates of new MSK conditions in women and men Veterans with and without a baseline MSK condition. DESIGN: A cohort study including Veterans whose end of last deployment was between October 1, 2001 and October 1, 2015. SUBJECTS: A total of 765,465 Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn Veterans. MAIN OUTCOME MEASURES: Prevalent and incident MSK conditions identified through the International Classification of Diseases, ninth Revision, Clinical Modification diagnostic codes. RESULTS: Twenty-six percent of women and 29% of men present to the VA with a MSK condition. In those without an MSK diagnosis at baseline, the unadjusted rate of developing at least 1 MSK condition was 168 and 180 per 1000 person-year [hazard ratio (HR) = 0.94; 95% confidence interval (CI) = 0.92-0.95] in women and men. Women were more likely to develop newly diagnosed MSK conditions of the hip (HR = 1.9; 95% CI = 1.83-1.98) or the ankle/foot (HR = 1.17; 95% CI = 1.15-1.20) and less likely to develop MSK conditions of the upper extremity (HR = 0.75; 95% CI = 0.73-0.78), knee (HR = 0.87; 95% CI = 0.86-0.89), and spine (HR = 0.94; 95% CI = 0.93-0.96). In those with prevalent MSK conditions at baseline, the rate of developing a second MSK condition was higher in women than men (151 and 133/1000 person-year; HR = 1.13; 95% CI = 1.11-1.15). CONCLUSIONS: A high proportion of Veterans present to the VA with MSK conditions. Women are less likely to develop conditions related to the upper extremities, spine or knee, and more likely to have conditions of the hip or ankle/foot.

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