Abstract
Despite some anecdotal evidence, the racial differences in tendon injuries have received
little attention in the literature. We sought to determine the effect of race on major
tendon injuries. A search was performed according to the International Classification
of Diseases, Ninth Revision, Clinical Modification code 727.65 (rupture of quadriceps
tendon), 727.66 (rupture of patellar tendon), and 727.67 (rupture of Achilles tendon)
using the U. S. Defense Medical Epidemiology Database (DMED). Multivariate poisson
regression was used to estimate the rate of major tendon rupture per 1000 person-years,
while controlling for differences in gender, service, rank, and age for each code.
We computed rate ratios and 95 % confidence intervals using whites as the referent
category. The adjusted rate ratio for black service members when compared to white
service members was 2.89 (95 % CI 2.42, 3.44) for quadriceps tendon tears, 4.52 (95
% CI 3.94, 5.19) for patellar tendon tears, and 3.58 (95 % CI 3.31, 3.88) for Achilles
tendon tears. There appears to be a significant relative predisposition toward lower-extremity
major tendon rupture in black U. S. service members when compared to white service
members. Investigation of the racial differences in risk factors is warranted.
Key words
military - epidemilogy - tendon
References
- 1
Davis J J, Mason K T, Clark D A.
Achilles tendon rupture stratified by age race and cause of injury among active duty
US military members.
Mil Med.
1999;
164
872-873
- 2
Fukashiro S, Abe T, Shibayama A, Brechue W F.
Comparison of viscoelastic characteristics in triceps surae between black and white
athletes.
Acta Physiol Scand.
2002;
175
183-187
- 3
Garratty G, Glynn S A, McEntire R.
ABO and Rh(D) phenotype frequencies of different racial/ethnic groups in the United
States.
Transfusion.
2004;
44
703-706
- 4
Heir T, Eide G.
Age, body composition, aerobic fitness, and health condition as risk factors for musculoskeletal
injuries in conscripts.
Scand J Med Sci Sports.
1996;
6
222-227
- 5
Ilan D I, Tejwani N, Keschner M, Leibman M.
Quadriceps tendon rupture.
J Am Acad Orthop Surg.
2003;
11
192-200
- 6
Jarvinen M.
Epidemiology of tendon injuries in sports.
Clin Sports Med.
1992;
11
493-504
- 7
Jozsa L, Balint J B, Kannus P, Reffy A, Barzo M.
Distribution of blood groups in patients with tendon rupture: an analysis of 832 cases.
J Bone Joint Surg Br.
1989;
71
272-274
- 8
Kannus P, Natri A.
Etiology and pathophysiology of tendon rupture in sports.
Scand J Med Sci Sports.
1997;
7
107-112
- 9
Kujala U M, Jarvinen M, Natri A, Lehto M, Nelimarkka O, Hurme M, Virta L, Finne J.
ABO blood groups and musculoskeletal injuries.
Injury.
1992;
23
131-133
- 10
Leppilahti J, Puranen J, Orava S.
ABO blood group and Achilles tendon rupture.
Ann Chir Gynaecol.
1996;
85
369-371
- 11
Lincoln A E, Smith G S, Baker S P.
The use of existing military administrative and health databases for injury surveillance
and research.
Am J Prev Med.
2000;
18
8-13
- 12
Lindquist C H, Bray R M.
Trends in overweight and physical activity among U.S. military personnel, 1995 - 1998.
Prev Med.
2001;
32
57-65
- 13
Maffulli N, Reaper J A, Waterston S W, Ahya T.
ABO blood groups and achilles tendon ruptures in the Grampian region of Scotland.
Clin J Sports Med.
2000;
10
269-271
- 14
Mokone G G, Gajjar M, September A V, Schwellnus M P, Greenberg J, Noakes T D, Collins M.
The guanine-thymine dinucleotide repeat polymorphism within the tenascin-c gene is
associated with Achilles tendon injuries.
Am J Sports Med.
2005;
33
1016-1021
- 15
Moller A, Astrom M, Westin N E.
Increasing incidence of Achilles tendon rupture.
Acta Orthop Scand.
1996;
67
479-481
- 16
Nillius S A, Nilsson B E, Westlin N E.
The incidence of Achilles tendon rupture.
Acta Orthop Scand.
1976;
47
118-121
- 17
Ogden C L, Carroll M D, Curtin L R, McDowell M A, Tabak C J, Flegal K M.
Prevalence of overweight and obesity in the United States, 1999 - 2004.
JAMA.
2006;
295
1549-1555
MD Brett Owens
Department of Orthopaedic Surgery
Keller Army Hospital
West Point, New York
USA
Email: b.owens@us.army.mil