{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T20:17:37Z","timestamp":1788553057291,"version":"build-2803163510"},"reference-count":0,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Hip and pelvic bone stress injuries (BSIs) represent a small but clinically significant subset of overuse injuries sustained during U.S. Army Basic Combat Training (BCT). However, the long-term military service and healthcare implications remain unclear. This study examined the impact of hip and pelvic BSIs sustained during BCT on subsequent military career outcomes and musculoskeletal healthcare utilization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>In this case-control study, BCT graduates from fiscal years 2015 to 2017 were analyzed. Cases included 895 BCT graduates with MRI-confirmed hip or pelvic BSI, representing 63.6% of all BSI-diagnosed trainees; controls (n=2,685) were BCT graduates without BSI, matched 3:1 by age and sex. Adjusted logistic regression models evaluated differences in Advanced Individual Training (AIT) graduation, service retention, and satisfactory completion of obligated service. Time-to-discharge was analyzed using Cox proportional hazards models, and annual musculoskeletal healthcare encounters were compared using negative binomial regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Compared with controls, trainees with MRI-confirmed hip and pelvic BSIs had significantly worse career and healthcare outcomes. BSI cases had significantly lower odds of graduating from AIT (OR = 0.27, 95% CI: 0.18\u20130.41) and lower odds of satisfactory completion of obligated service (OR = 0.62, 95% CI: 0.48\u20130.79) compared to controls. BSI cases had a higher risk of early discharge (HR = 1.44, 95% CI: 1.30\u20131.60). Female cases demonstrated higher attrition and lower graduation rates than males. Musculoskeletal healthcare utilization was 2.6 times higher among BSI cases during the first post-BCT year (RR = 2.61, 95% CI: 2.31\u20132.96) and remained elevated through year three.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Trainees who sustain hip or pelvic BSIs during BCT experience lasting negative impacts on military retention and healthcare utilization, despite successfully graduating from BCT. These injuries impose a disproportionate long-term burden, particularly among female trainees. Targeted prevention and comprehensive rehabilitation strategies are essential to mitigate their career and readiness impacts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1249\/mss.0000000000004138","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T20:11:16Z","timestamp":1788552676000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Long-Term Career and Healthcare Impacts of Hip\/Pelvic Bone Stress Injuries Sustained During Basic Combat Training: A Case-Control Study in Graduates"],"prefix":"10.1249","author":[{"given":"Garry F.","family":"Dredge","sequence":"first","affiliation":[{"name":"University of Kentucky, Lexington, KY;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel I.","family":"Rhon","sequence":"additional","affiliation":[{"name":"Uniformed Services University of the Health Sciences, Bethesda, MD;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abe R.","family":"Dummar","sequence":"additional","affiliation":[{"name":"U.S. Army Research Institute of Environmental Medicine, Natick, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian W.","family":"Noehren","sequence":"additional","affiliation":[{"name":"University of Kentucky, Lexington, KY;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna M.","family":"Hoch","sequence":"additional","affiliation":[{"name":"University of Kentucky, Lexington, KY;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas R.","family":"Heebner","sequence":"additional","affiliation":[{"name":"University of Kentucky, Lexington, KY;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,9,4]]},"container-title":["Medicine &amp; Science in Sports &amp; Exercise"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.1249\/MSS.0000000000004138","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T20:11:17Z","timestamp":1788552677000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1249\/MSS.0000000000004138"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,4]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1249\/mss.0000000000004138","relation":{},"ISSN":["0195-9131","1530-0315"],"issn-type":[{"value":"0195-9131","type":"print"},{"value":"1530-0315","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,4]]}}}