{"id":"https://openalex.org/W4416631646","doi":"https://doi.org/10.1186/s40798-025-00955-1","title":"Time to First Injury After Knee Surgery in U.S. Army Soldiers: A Survival Analysis","display_name":"Time to First Injury After Knee Surgery in U.S. Army Soldiers: A Survival Analysis","publication_year":2025,"publication_date":"2025-11-25","ids":{"openalex":"https://openalex.org/W4416631646","doi":"https://doi.org/10.1186/s40798-025-00955-1","pmid":"https://pubmed.ncbi.nlm.nih.gov/41288836"},"language":"en","primary_location":{"id":"doi:10.1186/s40798-025-00955-1","doi":"https://doi.org/10.1186/s40798-025-00955-1","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s40798-025-00955-1","pdf_url":"https://link.springer.com/content/pdf/10.1186/s40798-025-00955-1.pdf","source":{"id":"https://openalex.org/S2736513330","display_name":"Sports Medicine - Open","issn_l":"2198-9761","issn":["2198-9761","2199-1170"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","doyens","jufo-1","ki-jl-1","norway-1"],"host_organization":"https://openalex.org/P4310319965","host_organization_name":"Springer Nature","host_organization_lineage":["https://openalex.org/P4310319965"],"host_organization_lineage_names":["Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Sports Medicine - Open","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref","doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://link.springer.com/content/pdf/10.1186/s40798-025-00955-1.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5012373424","display_name":"Benjamin Adams","orcid":"https://orcid.org/0000-0001-7885-0521","observed_orcids":["https://orcid.org/0000-0001-7885-0521"]},"institutions":[{"id":"https://openalex.org/I121067369","display_name":"U.S. Army Research Institute of Environmental Medicine","ror":"https://ror.org/00rg6zq05","country_code":"US","type":"funder","lineage":["https://openalex.org/I106965489","https://openalex.org/I121067369","https://openalex.org/I1304082316","https://openalex.org/I1330347796","https://openalex.org/I2802581893"]},{"id":"https://openalex.org/I158133745","display_name":"MGH Institute of Health Professions","ror":"https://ror.org/037msyf12","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I158133745"]},{"id":"https://openalex.org/I4210087915","display_name":"Massachusetts General Hospital","ror":"https://ror.org/002pd6e78","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I4210087915","https://openalex.org/I48633490"]},{"id":"https://openalex.org/I4210088792","display_name":"United States Army","ror":"https://ror.org/00afsp483","country_code":"US","type":"government","lineage":["https://openalex.org/I1304082316","https://openalex.org/I1330347796","https://openalex.org/I4210088792"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"Benjamin G. Adams","raw_affiliation_strings":["Military Performance Division, U.S. Army Research Institute of Environmental Medicine, Natick, MA, USA. bgadams@mghihp.edu","School of Health and Rehabilitation Sciences, MGH Institute of Health Professions, 36 1\u2009st Ave, Boston, MA, 02129, USA. bgadams@mghihp.edu","Military Performance Division, U.S. Army Research Institute of Environmental Medicine, Natick, MA, USA"],"raw_orcid":"https://orcid.org/0000-0001-7885-0521","affiliations":[{"raw_affiliation_string":"Military Performance Division, U.S. Army Research Institute of Environmental Medicine, Natick, MA, USA. bgadams@mghihp.edu","institution_ids":["https://openalex.org/I121067369","https://openalex.org/I4210088792"]},{"raw_affiliation_string":"School of Health and Rehabilitation Sciences, MGH Institute of Health Professions, 36 1\u2009st Ave, Boston, MA, 02129, USA. bgadams@mghihp.edu","institution_ids":["https://openalex.org/I158133745","https://openalex.org/I4210087915"]},{"raw_affiliation_string":"Military Performance Division, U.S. Army Research Institute of Environmental Medicine, Natick, MA, USA","institution_ids":["https://openalex.org/I121067369","https://openalex.org/I4210088792"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5048870461","display_name":"Richard B. Westrick","orcid":"https://orcid.org/0000-0001-5582-8567","observed_orcids":["https://orcid.org/0000-0001-5582-8567"]},"institutions":[{"id":"https://openalex.org/I121067369","display_name":"U.S. Army Research Institute of Environmental Medicine","ror":"https://ror.org/00rg6zq05","country_code":"US","type":"funder","lineage":["https://openalex.org/I106965489","https://openalex.org/I121067369","https://openalex.org/I1304082316","https://openalex.org/I1330347796","https://openalex.org/I2802581893"]},{"id":"https://openalex.org/I4210088792","display_name":"United States Army","ror":"https://ror.org/00afsp483","country_code":"US","type":"government","lineage":["https://openalex.org/I1304082316","https://openalex.org/I1330347796","https://openalex.org/I4210088792"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Richard B. Westrick","raw_affiliation_strings":["Military Performance Division, U.S. Army Research Institute of Environmental Medicine, Natick, MA, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Military Performance Division, U.S. Army Research Institute of Environmental Medicine, Natick, MA, USA","institution_ids":["https://openalex.org/I121067369","https://openalex.org/I4210088792"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5015379614","display_name":"Perman Gochyyev","orcid":"https://orcid.org/0000-0002-4663-4426","observed_orcids":["https://orcid.org/0000-0002-4663-4426"]},"institutions":[{"id":"https://openalex.org/I158133745","display_name":"MGH Institute of Health Professions","ror":"https://ror.org/037msyf12","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I158133745"]},{"id":"https://openalex.org/I4210087915","display_name":"Massachusetts General Hospital","ror":"https://ror.org/002pd6e78","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I4210087915","https://openalex.org/I48633490"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Perman Gochyyev","raw_affiliation_strings":["School of Health and Rehabilitation Sciences, MGH Institute of Health Professions, 36 1\u2009st Ave, Boston, MA, 02129, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"School of Health and Rehabilitation Sciences, MGH Institute of Health Professions, 36 1\u2009st Ave, Boston, MA, 02129, USA","institution_ids":["https://openalex.org/I158133745","https://openalex.org/I4210087915"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5101536203","display_name":"Kathryn M. Taylor","orcid":"https://orcid.org/0000-0001-7013-1848","observed_orcids":["https://orcid.org/0000-0001-7013-1848"]},"institutions":[{"id":"https://openalex.org/I121067369","display_name":"U.S. Army Research Institute of Environmental Medicine","ror":"https://ror.org/00rg6zq05","country_code":"US","type":"funder","lineage":["https://openalex.org/I106965489","https://openalex.org/I121067369","https://openalex.org/I1304082316","https://openalex.org/I1330347796","https://openalex.org/I2802581893"]},{"id":"https://openalex.org/I4210088792","display_name":"United States Army","ror":"https://ror.org/00afsp483","country_code":"US","type":"government","lineage":["https://openalex.org/I1304082316","https://openalex.org/I1330347796","https://openalex.org/I4210088792"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Kathryn M. Taylor","raw_affiliation_strings":["Military Performance Division, U.S. Army Research Institute of Environmental Medicine, Natick, MA, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Military Performance Division, U.S. Army Research Institute of Environmental Medicine, Natick, MA, USA","institution_ids":["https://openalex.org/I121067369","https://openalex.org/I4210088792"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":4,"corresponding_author_ids":["https://openalex.org/A5012373424"],"corresponding_institution_ids":["https://openalex.org/I121067369","https://openalex.org/I158133745","https://openalex.org/I4210087915","https://openalex.org/I4210088792"],"apc_list":{"value":4290,"currency":"USD","value_usd":4290},"apc_paid":{"value":4290,"currency":"USD","value_usd":4290},"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.44353401,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"11","issue":"1","first_page":"147","last_page":"147"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10442","display_name":"Knee injuries and reconstruction techniques","score":0.6435999870300293,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10442","display_name":"Knee injuries and reconstruction techniques","score":0.6435999870300293,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12138","display_name":"Occupational Health and Performance","score":0.2793000042438507,"subfield":{"id":"https://openalex.org/subfields/3609","display_name":"Occupational Therapy"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11246","display_name":"Sports injuries and prevention","score":0.04580000042915344,"subfield":{"id":"https://openalex.org/subfields/2732","display_name":"Orthopedics and Sports Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/knee-surgery","display_name":"knee surgery","score":0.9120000004768372},{"id":"https://openalex.org/keywords/reinjury-risk","display_name":"reinjury risk","score":0.7260000109672546},{"id":"https://openalex.org/keywords/military-personnel","display_name":"military personnel","score":0.5830000042915344},{"id":"https://openalex.org/keywords/return-to-duty","display_name":"return to duty","score":0.8230000138282776},{"id":"https://openalex.org/keywords/physical-activity-limitation","display_name":"physical activity limitation","score":0.7549999952316284},{"id":"https://openalex.org/keywords/postoperative-rehabilitation","display_name":"postoperative rehabilitation","score":0.7229999899864197},{"id":"https://openalex.org/keywords/injury-prevention","display_name":"injury prevention","score":0.8180000185966492},{"id":"https://openalex.org/keywords/accelerated-failure-time-model","display_name":"accelerated failure time model","score":0.7979999780654907},{"id":"https://openalex.org/keywords/musculoskeletal-injuries","display_name":"musculoskeletal injuries","score":0.7099999785423279}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.7360000014305115},{"id":"https://openalex.org/C10515644","wikidata":"https://www.wikidata.org/wiki/Q543310","display_name":"Survival analysis","level":2,"score":0.48159998655319214},{"id":"https://openalex.org/C3020573985","wikidata":"https://www.wikidata.org/wiki/Q37425","display_name":"Knee surgery","level":4,"score":0.4221000075340271},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.38760000467300415},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.34200000762939453},{"id":"https://openalex.org/C1862650","wikidata":"https://www.wikidata.org/wiki/Q186005","display_name":"Physical therapy","level":1,"score":0.3337000012397766},{"id":"https://openalex.org/C194828623","wikidata":"https://www.wikidata.org/wiki/Q2861470","display_name":"Emergency medicine","level":1,"score":0.3190000057220459},{"id":"https://openalex.org/C177713679","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care medicine","level":1,"score":0.3070000112056732},{"id":"https://openalex.org/C2776283816","wikidata":"https://www.wikidata.org/wiki/Q332823","display_name":"Survival rate","level":2,"score":0.3061999976634979},{"id":"https://openalex.org/C545542383","wikidata":"https://www.wikidata.org/wiki/Q2751242","display_name":"Medical emergency","level":1,"score":0.2824999988079071},{"id":"https://openalex.org/C61434518","wikidata":"https://www.wikidata.org/wiki/Q932510","display_name":"General surgery","level":1,"score":0.26499998569488525},{"id":"https://openalex.org/C2779072820","wikidata":"https://www.wikidata.org/wiki/Q47064","display_name":"Military personnel","level":2,"score":0.2563999891281128}],"mesh":[],"locations_count":3,"locations":[{"id":"doi:10.1186/s40798-025-00955-1","doi":"https://doi.org/10.1186/s40798-025-00955-1","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s40798-025-00955-1","pdf_url":"https://link.springer.com/content/pdf/10.1186/s40798-025-00955-1.pdf","source":{"id":"https://openalex.org/S2736513330","display_name":"Sports Medicine - Open","issn_l":"2198-9761","issn":["2198-9761","2199-1170"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","doyens","jufo-1","ki-jl-1","norway-1"],"host_organization":"https://openalex.org/P4310319965","host_organization_name":"Springer Nature","host_organization_lineage":["https://openalex.org/P4310319965"],"host_organization_lineage_names":["Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Sports Medicine - Open","raw_type":"journal-article"},{"id":"pmid:41288836","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/41288836","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Sports medicine - open","raw_type":"Journal Article"},{"id":"pmh:oai:doaj.org/article:ce4f6d90f3964ebe9ecb0894b050a617","doi":null,"is_oa":true,"landing_page_url":"https://doaj.org/article/ce4f6d90f3964ebe9ecb0894b050a617","pdf_url":null,"source":{"id":"https://openalex.org/S4306401280","display_name":"DOAJ (DOAJ: Directory of Open Access Journals)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-sa","license_id":"https://openalex.org/licenses/cc-by-sa","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Sports Medicine - Open, Vol 11, Iss 1, Pp 1-8 (2025)","raw_type":"article"}],"best_oa_location":{"id":"doi:10.1186/s40798-025-00955-1","doi":"https://doi.org/10.1186/s40798-025-00955-1","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s40798-025-00955-1","pdf_url":"https://link.springer.com/content/pdf/10.1186/s40798-025-00955-1.pdf","source":{"id":"https://openalex.org/S2736513330","display_name":"Sports Medicine - Open","issn_l":"2198-9761","issn":["2198-9761","2199-1170"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","doyens","jufo-1","ki-jl-1","norway-1"],"host_organization":"https://openalex.org/P4310319965","host_organization_name":"Springer Nature","host_organization_lineage":["https://openalex.org/P4310319965"],"host_organization_lineage_names":["Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Sports Medicine - Open","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","score":0.9940000176429749,"display_name":"Good health and well-being"}],"sustainable_development_goals_aurora":[],"study_designs":[{"id":"https://openalex.org/study-designs/observational-study","display_name":"Observational Study"}],"awards":[],"funders":[{"id":"https://openalex.org/F4320338415","display_name":"U.S. Army Medical Research and Development Command","ror":null}],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W4416631646.pdf","grobid_xml":"https://content.openalex.org/works/W4416631646.grobid-xml"},"referenced_works_count":37,"referenced_works":["https://openalex.org/W419277636","https://openalex.org/W1995274659","https://openalex.org/W2013907907","https://openalex.org/W2034022208","https://openalex.org/W2038484163","https://openalex.org/W2071015382","https://openalex.org/W2116814040","https://openalex.org/W2161624339","https://openalex.org/W2166561686","https://openalex.org/W2186571993","https://openalex.org/W2189391828","https://openalex.org/W2289789572","https://openalex.org/W2298073360","https://openalex.org/W2544912613","https://openalex.org/W2632068564","https://openalex.org/W2771488589","https://openalex.org/W2786687024","https://openalex.org/W2786876538","https://openalex.org/W2796254170","https://openalex.org/W2804248080","https://openalex.org/W2888705663","https://openalex.org/W2908236450","https://openalex.org/W2910661445","https://openalex.org/W2965083651","https://openalex.org/W2965348792","https://openalex.org/W2969084762","https://openalex.org/W3014315049","https://openalex.org/W3025899229","https://openalex.org/W3083922357","https://openalex.org/W3119869960","https://openalex.org/W3149431900","https://openalex.org/W3155892284","https://openalex.org/W3161036210","https://openalex.org/W4200524214","https://openalex.org/W4248265664","https://openalex.org/W4385231081","https://openalex.org/W4390269869"],"related_works":[],"abstract_inverted_index":{"BACKGROUND:":[0],"Knee":[1],"injuries,":[2],"including":[3],"those":[4,161],"requiring":[5],"surgical":[6,169],"intervention,":[7],"are":[8,227],"a":[9,138,149,163],"leading":[10],"cause":[11],"of":[12,23,40,46,54,80,165,168,210,255],"disability":[13],"in":[14,61,248],"U.S.":[15,84],"Army":[16,85],"soldiers.":[17,63],"Previous":[18],"studies":[19,226],"investigating":[20],"the":[21,38,52,93,124,208,253],"risk":[22,57,68,118],"injury":[24,56,67,117,141,152,174,195],"after":[25,58,145,179,196],"surgery":[26,60,130,180],"have":[27],"primarily":[28],"focused":[29],"on":[30,37],"civilian":[31],"populations":[32],"and":[33,75,87,97,109,212,244],"lack":[34],"specific":[35],"information":[36],"timing":[39],"new":[41,139],"injuries.":[42],"OBJECTIVE:":[43],"The":[44],"purpose":[45],"this":[47],"study":[48],"was":[49,112],"to":[50,73,114,133,155,192,229],"identify":[51,115],"windows":[53,219],"peak":[55,70],"knee":[59,129],"active-duty":[62],"We":[64],"hypothesized":[65],"that":[66,205],"would":[69],"around":[71,176],"return":[72],"duty":[74],"remain":[76],"elevated":[77],"beyond":[78],"completion":[79],"post-operative":[81,116,250],"rehabilitation.":[82],"METHODS:":[83],"administrative":[86],"medical":[88],"data":[89],"were":[90,153,185,189],"extracted":[91],"from":[92,131],"Soldier":[94],"Performance,":[95],"Health,":[96],"Readiness":[98],"database.":[99],"An":[100],"accelerated":[101],"failure":[102],"time":[103],"model":[104],"adjusted":[105],"for":[106,173,220,240],"demographic-,":[107],"surgical-,":[108],"military-specific":[110],"variables":[111],"used":[113],"by":[119],"procedure":[120],"type.":[121],"RESULTS:":[122],"Of":[123],"7595":[125],"soldiers":[126,188],"who":[127],"had":[128],"2017":[132],"2020,":[134],"71%":[135],"(5357)":[136],"sustained":[137],"musculoskeletal":[140],"within":[142],"4":[143],"years":[144],"surgery.":[146],"Soldiers":[147],"with":[148,252],"prior":[150],"non-knee":[151],"estimated":[154],"sustain":[156,193],"re-injury":[157],"11%":[158],"sooner":[159],"than":[160],"without":[162],"history":[164],"injury,":[166],"regardless":[167],"procedure.":[170],"Peak":[171],"hazard":[172],"occurred":[175],"2.5":[177],"months":[178,199],"when":[181],"physical":[182],"activity":[183],"restrictions":[184],"lifted.":[186],"Furthermore,":[187],"more":[190],"likely":[191],"an":[194],"reaching":[197],"14.3":[198],"post-surgery.":[200],"CONCLUSIONS:":[201],"These":[202,235],"results":[203],"indicate":[204],"both":[206],"at":[207],"end":[209],"rehabilitation":[211],"1":[213],"year":[214],"post-surgery":[215],"may":[216],"represent":[217],"critical":[218],"targeted":[221],"injury-prevention":[222],"strategies;":[223],"however,":[224],"future":[225,246],"needed":[228],"confirm":[230],"these":[231],"opportunities.":[232],"CLINICAL":[233],"RELEVANCE:":[234],"findings":[236],"suggest":[237],"potential":[238],"implications":[239],"guiding":[241],"provider":[242],"care":[243],"informing":[245],"policy":[247],"military":[249],"management,":[251],"goal":[254],"improving":[256],"long-term":[257],"outcomes.":[258]},"counts_by_year":[],"updated_date":"2026-09-26T08:19:03.415552","created_date":"2025-11-25T00:00:00"}