Complex Knee Problems in a Young, Active Duty Military Population. Part I: ACL Reconstruction, Allograft OATs, and Treatment of Meniscal Injuries

The treatment of young, active duty military personnel is challenging because of the need to sustain a high level of physical activity throughout their career, often despite complex injuries sustained in training and wartime environments. The young “warrior-athlete” patients must maintain strict physical fitness requirements, similar to elite athletes, often with limited time for recovery. The combination of high physical demands and expectations following severe knee injuries makes the surgical decision-making process difficult, but has also led to significant clinical experience and expertise in many areas of orthopaedic surgery. The following set of articles is part I of II in a series of comprehensive reviews, clinical approaches, and descriptions of surgical techniques from members of the Society of Military Orthopaedic Surgeons (SOMOS). The authors have drawn from their own experience dealing with these often challenging problems and present review articles on anterior cruciate ligament (ACL) graft choices and the treatment of meniscal injuries, as well as surgical technique reviews for ACL reconstruction and allograft osteochondral articular transplants (OATs).

The first article by Drs. Ryu and Provencher details the special considerations for ACL graft selection in young, active patients. Dr. Provencher et al then outline a step-by-step description of the special considerations involved in bone-patellar tendon-bone autograft ACL reconstruction as it pertains to high-demand populations.

Dr. Owens et al provide a succinct review of the diagnostic and management principles for the young, active patient with a meniscal tear. Drs. Fitzpatrick and Tokish present a technique article highlighting the most important aspects of osteochondral allograft transplantation.

We hope that the readers of The Journal of Knee Surgery find part I of this special focus edition educational and useful in their own practices.