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J Shoulder Elbow Surg. 2015 Sep;24(9):1486-92. doi: 10.1016/j.jse.2015.02.021. Epub 2015 Apr 10.

Shoulder impingement in the United States military.

Author information

1
Department of Orthopaedic Surgery & Rehabilitation, William Beaumont Army Medical Center/Texas Tech University Health Science Center, El Paso, TX, USA.
2
Department of Orthopaedic Surgery, John A. Feagin Jr. Sports Medicine Fellowship, Keller Army Hospital, West Point, NY, USA.
3
Department of Orthopaedics and Rehabilitation, Fort Belvoir Community Hospital, Fort Belvoir, VA, USA.
4
US Special Operations Command, MacDill Air Force Base, Tampa, FL, USA.
5
Department of Orthopaedics and Rehabilitation, Yale Medical School/Yale New Haven Hospital, New Haven, CT, USA.
6
Department of Orthopaedic Surgery, John A. Feagin Jr. Sports Medicine Fellowship, Keller Army Hospital, West Point, NY, USA. Electronic address: b.owens@us.army.mil.

Abstract

BACKGROUND:

Little is known about the incidence and characteristics of primary, or external, shoulder impingement in an occupationally and physically active population. A longitudinal, prospective epidemiologic database was used to determine the incidence and risk factors for shoulder subacromial impingement in the United States (U.S.) military. Our hypothesis was that shoulder impingement is influenced by age, sex, race, military rank, and branch of service.

METHODS:

The Defense Medical Epidemiology Database was queried for all shoulder impingement injuries using International Classification of Disease, Ninth Addition, Clinical Modification code 726.10 within a 10-year period from 1999 through 2008. An overall injury incidence was calculated, and a multivariate analysis performed among demographic groups.

RESULTS:

In an at-risk population of 13,768,534 person-years, we identified 106,940 cases of shoulder impingement resulting in an incidence of 7.77/1000 person-years in the U.S. military. The incidence of shoulder impingement increased with age and was highest in the group aged ≥40 years (incidence rate ratio [IRR], 4.90; 95% confidence interval [CI], 4.61-5.21), was 9.5% higher among men (IRR, 1.10, 95% CI, 1.06-1.13), and compared with service members in the Navy, those in the Air Force, Army, and Marine Corps were associated with higher rates of shoulder impingement (IRR, 1.46 [95% CI, 1.42-1.50], 1.42 [95% CI, 1.39-1.46], and 1.31 [95% CI, 1.26-1.36], respectively).

CONCLUSIONS:

The incidence of shoulder impingement among U.S. military personnel is 7.77/1000 person-years. An age of ≥40 years was a significant independent risk factor for injury.

KEYWORDS:

DMED; Shoulder; U.S. military; epidemiology; impingement; incidence

PMID:
25865088
DOI:
10.1016/j.jse.2015.02.021
[Indexed for MEDLINE]
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