Return to military duty after undergoing anterior cruciate ligament reconstruction: a retrospective cross-sectional...

Anterior cruciate ligament reconstruction (ACL reconstruction) and the subsequent return to military duty are important concerns for military personnel. This study aimed to evaluate the outcomes of ACL reconstruction and the rate of and factors influencing return to duty among military personnel.

A retrospective cross-sectional study of military personnel undergoing ACL reconstruction between 2010 and 2020, with at least 2 years of follow-up. Demographic data, injury and surgery details, activity at injury, Lachman test, Lysholm score, complications and return to military duty were recorded.

We included 408 military personnel. Injuries mostly occurred during sports (76.5%), mainly football. Autologous hamstring tendon grafts were used in 79.2%. Meniscal injury was present in 54.9%, treated with repair or partial meniscectomy. Complications were infrequent, with 0.7% infection or graft re-rupture. Postoperative knee stability improved significantly, with 84.1% showing no anterior tibial translation. Over 90% achieved good or excellent Lysholm scores. Return to duty was achieved in 89.2%, with the majority returning to previous military duties; 8.8% had occupational reassignment due to physical limitations, and 2% were medically discharged. Most patients had a normal body mass index (BMI); return rates were lower in patients with BMI <18.5 or ≥30.

ACL reconstruction provides favourable functional and stability outcomes, resulting in high return-to-duty rates in military personnel. Extremes of BMI adversely impact return to duty, highlighting the need for tailored perioperative and rehabilitation strategies to optimise recovery and military readiness.