Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
BMJ Mil Health. 2023 Aug;169(4):321-326. doi: 10.1136/bmjmilitary-2021-001913. Epub 2021 Aug 9.
Physical activity is an important component of military training. Although injuries and musculoskeletal disorders are the most common cause of medical retirement from the Armed Forces, the long-term risk of lower limb osteoarthritis in veterans is unknown. We used data on hip and knee replacement in Scottish military veterans as a proxy measure.
Retrospective cohort study of 78 000 veterans born between 1945 and 1995 and a comparison group of 253 000 non-veterans, matched for age, sex and area of residence, followed up for up to 37 years, using survival analysis to examine the risk of hip and knee replacement.
Veterans were significantly less likely to undergo hip replacement than non-veterans, Cox proportional HR 0.87, 95% CI 0.80 to 0.95, p<0.001. There was no significant difference between veterans and non-veterans in respect of knee replacement, HR 1.02, 95% CI 0.94 to 1.11, p=0.643, and there was no difference in the ages at which veterans and non-veterans underwent joint replacement. People who had served for longest in the military had similar risk to those with the shortest service.
Based on the likelihood of undergoing joint replacement surgery in later life, we found no evidence of a positive association between military service and an increased risk of lower limb osteoarthritis.
身体活动是军事训练的一个重要组成部分。虽然受伤和肌肉骨骼疾病是导致军人退役的最常见原因，但退伍军人下肢骨关节炎的长期风险尚不清楚。我们使用苏格兰军事退伍军人髋关节和膝关节置换的数据作为替代指标。
对出生于 1945 年至 1995 年的 78000 名退伍军人和 253000 名非退伍军人进行了回顾性队列研究，按照年龄、性别和居住地区进行了匹配，随访时间长达 37 年，使用生存分析来检查髋关节和膝关节置换的风险。
退伍军人髋关节置换的可能性明显低于非退伍军人，Cox 比例风险比为 0.87，95%CI 为 0.80 至 0.95，p<0.001。退伍军人和非退伍军人在膝关节置换方面没有显著差异，HR 为 1.02，95%CI 为 0.94 至 1.11，p=0.643，退伍军人和非退伍军人接受关节置换的年龄也没有差异。在军队服役时间最长的人和服役时间最短的人患下肢骨关节炎的风险相似。
根据晚年接受关节置换手术的可能性，我们没有发现军事服务与下肢骨关节炎风险增加之间存在正相关关系的证据。
