In this episode, we’re going to continue our discussion with Dr. Matt Provencher and focus on ACL tears in the military, then wrap up with a discussion on returning tactical athletes to full duty.

 Our conversation picks back up with an article from the February issue of OJSM this tear titled “Failure Rates After Anterior Cruciate Ligament Repair With Suture Tape Augmentation in an Active-Duty Military Population.” This level 2 case series reported a significantly high failure rate of 26% in patients who underwent repair of proximal ACL avulsions augmented with a suture tape internal brace. The authors identified several risk factors for failure, including age younger than 17 or older than 35, elite level of competition, greater time from injury to surgery and active tobacco use.

We finish up today with a discussion of ACL rehabilitation in the military population. The last article we reference is titled “The Warrior Athlete Part 2 – Return to Duty in the US Military: Advancing ACL Rehabilitation in the Tactical Athlete.” Matt Provencher and colleagues report that ACL injuries in the warfighter population is a complex decision-making matrix that begins with proper pre-habilitation, discussion of graft choice and surgical technique, and lastly the coordination of a well-defined and patient specific post-op rehab plan complete with a multifaceted return to duty assessment.