As active-duty personnel and veterans feel the damaging effects of arthritis stemming from their service, advocates are pushing Congress to dedicate more money for research on potential ways to treat and prevent the disease.
Veterans are more likely to develop arthritis than civilians, according to an October 2018 study. Other studies indicate that osteoarthritis is the second-leading cause of military discharge, behind combat wounds.
“A lot of the progress to be made with arthritis is about prevention,” said Dr. Colin Edgerton, a former Army rheumatologist and current chair of the American College of Rheumatology’s Committee on Rheumatological Care.
“It’s about stopping those injuries before they occur so that that person is not looking at early joint replacement surgery and disability at a point in life where they otherwise would not have had that,” he said.
During his time in the military, Edgerton was primarily responsible for treating soldiers with musculoskeletal disorders. As part of his job, he had to judge whether soldiers with arthritis or similar degenerative issues needed to be medically discharged or not.
“I was acutely aware of the impact that had on readiness and on the individual’s lives,” he said.
Arthritis encompasses over 100 diseases, including mechanical (or degenerative) and inflammatory ones, the latter of which involves immune-system disorders like lupus or rheumatoid arthritis, according to Edgerton.
Service members who suffer knee injuries while deployed are at an increased risk of developing arthritis, he said. One recent study found that one in five military members with a knee injury developed radiographic arthritis before age 30.
This can be “a real career-ender for a soldier” and lead to mobility issues earlier in their lives than expected, Edgerton said.
“That veteran then will be looking at a knee replacement in their early 40s versus a peer in the civilian world that may not have been subjected to a mechanical injury getting a knee replacement in their 60s or 70s,” he said.
The Congressionally Directed Medical Research Programs budget for fiscal-year 2019 does not specifically identify arthritis as a subject area of concern. Edgerton and the ACR want arthritis to be listed as a “line item,” meaning it would be designated as a research subject worthy of increased focus and given more funding.
“If there was a dedicated line in that research budget for arthritis, that would go a long way toward establishing kind of a sustainable focus on arthritis, since it is such a high-impact disease in the military population,” he said.
For perspective, the CDMRP allocated $130 million for breast cancer research in 2019.
Arthritis was listed in the Army’s 2018 Medical Research and Material Command medical research program as an area of interest. However, arthritis research only received slightly more than $6 million in funding.
The congressional Arthritis Caucus did issue a dear colleague letter asking that arthritis be made a line item in the 2019 CDMRP, but to no avail.
Edgerton is hoping 2020 is finally the year Congress makes arthritis research the priority he and his organization believe it should be.
“Just three years ago we kind of recognized that this is something that needed to be done and each year we ... get more support,” he said. “So we hope this is the year that we actually get it done.”