Enhancing Military Musculoskeletal Readiness: A Proposal for Collaboration

Despite the dedicated efforts of a wide breadth of musculoskeletal (MSK) physicians and providers across the Military Health System (MHS), musculoskeletal injuries (MSKIs) continue to represent the most significant threat to the readiness, deployability and retention of United States military personnel. MSK readiness is warfighter readiness. There is a compelling need to align and integrate the multitude of programs and initiatives currently in place and to increase the number and value of civilian military partnerships. We must use and share existing data repositories, such as the Military Orthopaedic Tracking Injuries and Outcomes Network, to guide our MSK research agenda with the goal of eliminating preventable injuries and to optimize the care we provide for unavoidable MSK injuries and diseases. Formalizing relationships among the current military and civilian organizations and programs focused on MSK prevention and treatment is also a critical necessity. Enhanced collaboration between the Society of Military Orthopedic Surgeons, the Military Advanced Surgical Training initiative, the Consortium for Health and Military Performance and the Musculoskeletal Injury Rehabilitation Research for Operational Readiness programs at the Uniformed Services University will pay tremendous readiness dividends when their efforts are formally aligned and integrated with the Defense Health Agency and the service medical departments. This will also create the foundation necessary for the MHS to establish itself as a national exemplar for the provision of value based MSK care. Despite the existence of a robust database, skilled practitioners, and the backing of academic and civilian expertise, there is room for improvement in our ability to improve the outcomes of the MSK care we provide. We need to integrate and share siloed data to optimize the operative and non-operative MSK care we provide. We also need to foster enhanced collaboration among all the entities dedicated to decreasing the burden of MSK injuries and disease on both our warfighters and our veterans. The essential elements are there but lack the alignment and integration necessary to optimize MSK readiness. With the commitment of engaged MHS leadership, concerted effort at the point of care, and increased collaboration by key stakeholders we can maximize readiness while creating a cohesive system of value-based MSK care worthy of national emulation. The time to act is now.