ACLR and military service: time to rethink?

Abstract

Anterior cruciate ligament (ACL) rupture is a common injury that affects young, active individuals, normally managed with reconstruction in this age group. Current UK Armed Forces policy precludes prospective applicants from joining with an anterior cruciate ligament reconstruction (ACLR). This isdue to the perceived risk of premature osteoarthritis (OA), graft rupture or clinical failure, all of which could make the service person medically non-deployable.The most recent evidence shows that an ACL rupture without associated significant meniscal or osteochondral defect has a similar likelihood of developing OA as to that of the uninjured knee after reconstruction at 20 years postoperatively.Applicants should be considered for service following an ACL rupture without significant concurrent meniscal or osteochondral defect who have undergone ACLR and 18 months of rehabilitation. We recommend these applicants to be graded P2 Medically Fully Deployable (MFD) as per the Joint Service Publication (JSP) guidance for service personnel who undergo ACLR.