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[OASC]

OASC Bulletin 24

In this bulletin, we would like to highlight the current policy regarding anterior cruciate ligament reconstruction.

The forces involved in rupturing an anterior cruciate ligament are such that other damage to the knee, such as tears of a meniscus or damage to the knee joint surfaces, are common. If left untreated the ACL deficient knee is likely to suffer further damage resulting in premature osteoarthritis. While the surgical reconstruction of the ACL has progressed considerably over the years the reconstructed ligament is not able to mimic exactly the function of a normal knee, the knee therefore remains at greater risk of further injury and arthritis. In the words of a specialist knee surgeon “following reconstruction, the knee is not normal and never will be”.

The tri-service policy regarding anterior cruciate ligament reconstruction is quite straight forward and has not changed since 2006:

3.12.47 Knee ligaments. Candidates with any degree of instability of the collateral or cruciate ligaments of the knee joint or previous surgical repair of a cruciate ligament are graded L8 (ie unfit for Service). extract from Joint Service Publication (JSP) 346

There is reference in the JSP to assessment by a Service specialist in orthopaedics for selected candidates who have had an ACL reconstruction, however this relates to an Army study into the robustness of ACL reconstructions during Army training. The RAF is not, and has not, been involved with this study. In short, it is considered that an ACL reconstruction will probably perform perfectly adequately under normal circumstances in civilian life; however, the rigours of military service places the reconstruction and the knee joint under extra stress with the risk of further damage or premature osteoarthritis.

For more information regarding any of these areas highlighted, please contact your AFCO and they will be able to give you more detailed information regarding specific cases.

Please note that, although OASC will endeavour to answer generic questions that arise, we will not be engaging or commenting on individual cases. In those cases, the individual is advised to contact their nearest AFCO who will be able to deal with any queries. All information published is for information only.

Information regarding a career in the RAF can be found at http://www.raf.mod.uk/careers