FIGURE 1.

The “iceberg” of orthopedic injuries (adapted from Owens and Cameron).⁶⁸ The severe orthopedic traumatic injuries at the “tip” (e.g., amputation) receive a large share of attention from the media, researchers, and funding sources. Orthopedic injuries at the “base” receive less attention but cause a larger burden of injury and disease on the military and its health system. This is due in part to the surgeries to correct the injuries (e.g., joint replacement), which often induce trauma to soft tissue and bone and result in severe postoperative pain, prolonged opioid use, and delayed functional recovery.