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First published on April 27, 2007, doi:10.1177/0363546507301256
This version was published on August 1, 2007
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The American Journal of Sports Medicine 35:1308-1314 (2007)
© 2007 American Orthopaedic Society for Sports Medicine

Incidence of Major Tendon Ruptures and Anterior Cruciate Ligament Tears in US Army Soldiers

LTC Daniel W. White, MD{dagger},*, Joseph C. Wenke, PhD{ddagger}, MAJ Dan S. Mosely, MD§, Sally B. Mountcastle, PhD|| and Carl J. Basamania, MD

From the {dagger} Tripler Army Medical Center, Honolulu, Hawaii, {ddagger} US Army Institute of Surgical Research, Fort Sam Houston, Texas, § DeWitt Army Hospital, Fort Belvoir, Virginia, || Keller Army Hospital, West Point, New York, and Duke University Medical Center, Durham, North Carolina

* Address correspondence to LTC Daniel W. White, MD, 1 Jarrett White Road, Tripler AMC, HI, 96859 (e-mail: daniel.w.white{at}us.army.mil).

Background: Although a rare event, the prevalence of major tendon rupture has increased in recent decades. Identification of risk factors is important for prevention purposes.

Hypothesis: Race is a risk factor for major tendon ruptures.

Study Design: Cohort study (prevalence); Level of evidence, 2.

Methods: All patients admitted for surgical management of a rupture of a major tendon at Womack Army Medical Center, Fort Bragg, North Carolina, in 1995 and 1996 were identified and evaluated for risk factors.

Results: The authors identified 52 major tendon ruptures: 29 Achilles, 12 patellar, 7 pectoralis major, and 4 quadriceps tendon ruptures. All patients were active-duty soldiers, and 1 was a female soldier. Forty-one tendon ruptures occurred among black soldiers, 8 occurred among white soldiers, and 3 occurred among Latino soldiers. The population at risk included 93 224 exposures during the 2-year period, of which 67.1% were white, 24.5% were black, and 8.4% were self-classified as other race. The rate ratio for tendon rupture, adjusted for gender and age, was 13.3 (95% confidence interval, 6.2–28.5) between blacks and whites and 2.9 (95% confidence interval, 0.8–10.9) between Latinos and whites.

Conclusion: The rate of major tendon rupture was 13 times greater for black men in this study population when compared with whites. Interventions among those at a higher risk for injury should be considered.

Key Words: pectoralis major tendon rupture • quadriceps tendon rupture • patellar tendon rupture • Achilles tendon rupture • race • mechanism of injury






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