Prevalence and mechanisms of anterior cruciate ligament tears in military personnel: A cross-sectional study in Iran

Abstract

Background Anterior cruciate ligament (ACL) tear is common in military setting; such an injury increase institutional costs and workforce strain, however, few studies have investigated the mechanism and associated factors of ACL tear specifically in a military setting. The aim of this study was to investigate the prevalence and mechanisms of ACL tears in military personnel at a military referral hospital in Iran. Material and methods This cross-sectional study examined 402 military personnel who presented with knee complaints at a single referral Iranian military hospital. The ACL injury prevalence and mechanisms were assessed by physical examination, medical records, and magnetic resonance imaging (MRI) of the knee. Data were collected by an orthopedic resident. Results Of the total 402 patients, 285 were diagnosed with ACL tears; the prevalence was 70.9%. The most common mechanism leading to ACL tear was noncontact events. The knee changing direction-knee pivoting (54%) was the most frequent lower limb status, followed by a fall with the knee in valgus position (20.7%). The most commonly associated activity was military training (63.9%) and sports activities (32.6%). The incidence of ACL injuries was higher in soldiers compared with officers during military training, but higher in officers during sports exercises (P = 0.002). Common associated injuries involved the knee meniscus and cartilage. Conclusion The findings support those of previous studies, that in military personnel, the most common knee injury is damage to the ACL, most frequently through noncontact events, specifically knee pivoting, during military activities rather than sports and among soldiers. These findings help develop ACL injury prevention programs.