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Predicting Subsequent Overuse Knee Injury Among Military Cadets and Midshipmen.

Jeffrey A Turner1,2, Garrett Bullock3,4, Adam W Kiefer2

  • 1STRONG Lab, 711 Human Performance Wing, Air Force Research Laboratory, Wright-Patterson Air Force Base, OH 45433, United States.

Military Medicine
|December 22, 2025
PubMed
Summary
This summary is machine-generated.

Military cadets with a history of knee injury are at high risk for overuse knee injuries. A new prediction model can help identify these individuals for targeted prevention strategies.

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Area of Science:

  • Sports Medicine
  • Military Health
  • Injury Epidemiology

Background:

  • Musculoskeletal injuries, particularly overuse knee injuries, are common in military training.
  • The initial phase of military academy life presents a high-risk period for injury development, especially for those with a prior knee injury history.

Purpose of the Study:

  • To develop and internally validate a multivariable prediction model for overuse knee injuries.
  • To identify first-year military cadets with a history of knee injury who are at higher risk.

Main Methods:

  • Prospective cohort study of 1,265 cadets and midshipmen with a recent knee injury history.
  • Baseline data included training history, strength, and biomechanics.
  • Overuse knee injuries were tracked over 9 months; multivariable logistic regression and decision curve analysis were used.

Main Results:

  • 30.8% of trainees sustained at least one overuse knee injury in their first academic year.
  • The prediction model showed moderate discrimination (AUC = 0.66) and stable calibration.
  • The model could identify 29 additional high-risk individuals per 100 compared to no model.

Conclusions:

  • A novel, internally validated prediction model for overuse knee injuries in high-risk military trainees was developed.
  • Subgrouping by prior injury status improved model performance.
  • The model demonstrates potential clinical utility for targeted prevention in military trainees.