Sheean Andrew J, Dickens Jonathan F, Provencher Matthew T
From the Department of Orthopaedic Surgery, San Antonio Military Medical Center, San Antonio, TX (Sheean), the Walter Reed National Military Medical Center, Orthopaedic Surgery Department, Uniformed Services University of Health Sciences, Bethesda, MD (Dickens and Provencher), and the The Steadman Clinic, Vail, CO.
J Am Acad Orthop Surg. 2022 Mar 1;30(5):189-194. doi: 10.5435/JAAOS-D-20-00930.
Despite the recent decrease in high tempo combat operations, threats to the medical readiness of Service Members remain a persistent issue. In fact, recent research efforts have demonstrated that musculoskeletal disease nonbattle injury represents perhaps the most immediate threat to the medical readiness of Service Members over the past several years. Innovations in a number of therapeutic options, particularly orthobiologics, have shown substantial promise in accelerating recovery and returning tactical athletes to full, unrestricted duties. Posttraumatic osteoarthritis remains a vexing topic but at the same time an intersectional opportunity for a multidisciplinary approach to better understand its pathogenesis, limit its prevalence, and mitigate the functional consequences of its sequalae. The expansion of a clinical infrastructure capable of the prospective collection of Service Members' functional outcomes across military treatment facilities promises to sharpen clinicians' understanding of both the impact of novel treatments for common injuries and the success of efforts to prevent recurrence (Military Orthopaedics Tracking Injury Network, Bethesda, MD). However, policy makers and stakeholders will increasingly find themselves in an environment of increasingly limited resources, which will necessitate creative strategies to maintain the lethality of a fit, fighting force.
尽管近期高强度作战行动有所减少，但对军人医疗战备状态的威胁仍是一个长期存在的问题。事实上，最近的研究表明，肌肉骨骼疾病非战斗损伤可能是过去几年对军人医疗战备状态最直接的威胁。多种治疗选择的创新，特别是骨科生物制剂，在加速康复并使战术运动员恢复全面、不受限制的职责方面显示出巨大潜力。创伤后骨关节炎仍然是一个棘手的话题，但同时也是一个跨学科的契机，可通过多学科方法更好地理解其发病机制、限制其患病率并减轻其后遗症的功能后果。能够在军事治疗设施中前瞻性收集军人功能结果的临床基础设施的扩展，有望加深临床医生对常见损伤新治疗方法的影响以及预防复发努力的成功程度的理解（军事骨科创伤跟踪网络，马里兰州贝塞斯达）。然而，政策制定者和利益相关者将越来越发现自己处于资源日益有限的环境中，这将需要创造性的策略来维持一支健康、有战斗力部队的杀伤力。
