title: Anterior cruciate ligament reconstruction and service in the British Army.
abstract: BACKGROUND
  In 2005, British Army recruiting policy was revised to permit applicants with a history of anterior cruciate ligament reconstruction (ACLR) to be accepted for an initial period of engagement.
  
  
  OBJECTIVE
  To determine whether personnel with an ACLR history are more likely to be medically discharged due to further injuries and complications than those without.
  
  
  METHODS
  A retrospective study of personnel commissioned or enlisted into the British Army between January 2006 and July 2009. ACLR cases were identified from personnel and medical records and were age and sex matched to randomly selected controls. Reasons for discharge were identified.
  
  
  RESULTS
  A total of 69 cases and 140 controls were included. A significant increase in risk of medical discharge was found in those with ACLR (incidence risk ratio was 3.04; 95% confidence interval 1.24-7.45). Sixty-one per cent of cases experienced complications linked to their previous surgery.
  
  
  CONCLUSIONS
  The current British Army policy on recruitment of those with a history of ACLR should be reviewed in terms of fitness for service and risk of foreseeable harm in these individuals.
authors.affiliation: Army Medical Directorate Support Unit, Former Army Staff College, Slim Road, Camberley GU15 4NP, UK.
authors.forename: J V
authors.initials: JV
authors.lastname: Halford
authors.affiliation: Institute of Occupational and Environmental Medicine, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
authors.forename: K B H
authors.initials: KB
authors.lastname: Lam
authors.affiliation: HQ Army Recruiting and Training Division, Trenchard Lines, Pewsey SN9 6BE, UK.
authors.forename: S E F
authors.initials: SE
authors.lastname: Folkes
authors.affiliation: Institute of Occupational and Environmental Medicine, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK, s.sadhra@bham.ac.uk.
authors.forename: S
authors.initials: S
authors.lastname: Sadhra
mesh_terms: D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D059549:Anterior Cruciate Ligament Reconstruction / Q000009:adverse effects*; D004651:Employment; D005260:Female; D006801:Humans; D007717:Knee / Q000601:surgery; D007718:Knee Injuries / Q000150:complications / Q000601:surgery*; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D008889:Military Personnel; D057766:Policy; D011183:Postoperative Complications / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D012306:Risk; D006113:United Kingdom / Q000453:epidemiology; D014938:Work Capacity Evaluation; D055815:Young Adult
keywords: Anterior cruciate ligament reconstruction; fitness in the armed services; military; re-injury.