ACL reconstruction: officer application

Fidge

Crow
Hi all,

I've recently made an application for a reserves officer, which was rejected due to an ACL reconstruction I had 5 years ago. Just to clarify a few points; knee is strong, stable, with no problems. The points above have been clarified by a consultant and GP. I've sent a letter to the medical centre with medical evidence for a second appeal.

Basically has anyone been through a similar process/ predicament as myself and could they offer any advice to resolve the situation.

Any help would be greatly welcomed.
Cheers
 
Been through the exact same thing, I basically had to get referred to a specialist orthopaedic surgeon in the army, or something, to be assessed in addition to the normal medical. For AOSB I was allowed to attend it all, but before RMAS I had to have seen the specialist. I honestly think there is a bit of luck about it, as I know others who have been rejected repeatedly, and others who never had any of it picked up at all. Others still who had friends who were regarded as important who got them seen originally by a specialist which saved them more time... Just get all the evidence you need, and get your CSM to fight your corner. I told them I'd been rowing and playing rugby etc all the time and had no issues. Definitely feel that helped. It is a ballache and can take months though, so be prepared for the appeal process being shit!
 

Fidge

Crow
Cheers defensivewoof,
I couldn't believe it when it was rejected. Thought it was a joke considering I asked a shit load of people about it before I applied. I've given them recent times for triathlons amongst other things. How did you manage to get a referral? If I can do that it'll enable me to prove the knee is strong.
Ta
 
Truly I'm not sure, I just harassed people on and on, and eventually a medical was booked. So I thought it was all sorted then, but then the doctor there said I had to see a specialist. The specific evidence/documents I had in my file may have helped. I had a letter from the consulting surgeon, if that's the guy that actually chopped me up, plus the physio after I finished the rehab, as well as a letter from my GP. I imagine the GP one was the least valuable, although I suppose the most recent and up to date on the status of my knee. Just get all you can I reckon! 5 years is longer than it needs to be clear for, I think the official thing says it requires 18 months including rehab being completed before a medical will be considered. So you should be eligible on that basis!
 

Fidge

Crow
Cheers for all your help fella. I'll put a plan into action and at least I know I'm not flogging a dead horse.
 

Fidge

Crow
Hi all,

I recently submitted my second appeal and was rejected due the JSP 950; paragraph 4K.49 on knee ligaments. I've got one more chance at appeal. Has anyone got any last pieces of advice?? Ive done the following; letter from my GP, medical notes on recovery, medical notes linking to my current job in the police, evidence of physical fitness and letter from my surgeon stating I was fit enough for my role in the police. Other background info you may require, i had an ACL reconstruction 5 years ago and have no problems with the knee.

Cheers.
 
Are you submitting anything new, or just 'having a go' on the assumption that you have nothing to lose and may sneak through where the other two appeals didn't?
This is the section on the JSP you are up against (in case you haven't already found it)

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. Candidates with previous reconstruction of
the anterior cruciate ligament (ACL) or posterior cruciate 26 ligament are normally to be graded L8. However, some candidates who have had ACL reconstruction may be acceptable for entry providing the joint is stable, there
is no evidence of osteoarthritis and function is normal. Such cases should all be assessed in the first instance by a Service specialist in orthopaedics27


26 This is a very much rarer injury than ACL rupture and there is at present a paucity of post-operative
outcome evidence.
27 ACL repair. Director Manning (Army) has published a policy (D/DM(A)/353 dated 16 Dec 05)
allowing some candidates who have had ACL reconstruction to enlist. Reference should be made to
guidelines published by single-Service Occupational Physicians responsible for the selection of recruits.

and I can't find a copy of D/DM(A)/353
 

Gorgonopsid

Old-Salt
Are you submitting anything new, or just 'having a go' on the assumption that you have nothing to lose and may sneak through where the other two appeals didn't?
This is the section on the JSP you are up against (in case you haven't already found it)




and I can't find a copy of D/DM(A)/353

Having an interest in this myself, I found this malingering in the attachments: https://www.arrse.co.uk/community/attachments/ortho_acl-1-doc.70350/

Highlights
RECRUITMENT


2.In order to be considered for enlistment or commissioning a candidate must meet the following criteria:


a.Only a single ACLR per knee is allowed.

b.Eighteen months must have elapsed since the reconstruction.

c.The reconstruction must have been carried out within 3 years of the injury.

d.The operative technique must have been either bone-patellar tendonorhamstring grafting.

e.A return to a high level of physical activity must have been achieved, demonstrated by a 3 month exercise diary.


If the above criteria have been met the case must be referred with the operating notes to a serving orthopaedic surgeon who carries out ACLR.They will access the applicant to confirm that there is no other significant knee pathology, they haveundergone an appropriate procedure and made a satisfactory recovery.





ORTHOPAEDIC ASSESSMENT
3.The following must be demonstrated:


a. Pain free at all required levels of physical activity.

b. Full range of movement.

c. Absence of effusion and crepitus.

d. Absence of joint line and tibial tuberosity tenderness.

e. Anterior draw test and Lachman’s test are negative or less than one.

f. The Duck walk can be performed satisfactorily.

g. The operative notes record adequate residual meniscal tissue.



4. Applicants who meet these criteria may be graded P2L2 MFD on entry. On completion of training the Service Medical is to record formal assessment of the knees. The appropriate JMES grading should include the medical marker L2.
 
Having had this op, and then done a further 17 years service, I wouldn't recommend it, joining that is. I can barely walk now, and not without the aid of a leg brace.


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Fidge

Crow
I think I'm going to speak to my consultant and get some further clarification on what operation I had; for instances whether it was a full or partial rupture. I'll also gain some further medical evidence from himself and address the points highlighted in the JSP.
 

Gorgonopsid

Old-Salt
I think I'm going to speak to my consultant and get some further clarification on what operation I had; for instances whether it was a full or partial rupture. I'll also gain some further medical evidence from himself and address the points highlighted in the JSP.
I think that's the wisest way forward, having the full surgical notes and perhaps getting a scan done under the consultants care along with a write up by him touching on all the points above,would go a long way further than the GPs usual fairly non commital note.

One point there is that it can only be btb patellar or hamstring, which are long used and well understood grafts, there are other graft types such as allograft (from a corpse) and synthetic both of which have serious problems with either strength or fragmentation and then there is funky experimental stuff.
 
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DocSavage

Swinger
Gents
Sorry to rain on the parade but the regulations have just changed. As of November 2015 NO candidate who has had ACL rupture or repair/ reconstruction will be considered fit for service. The rules used to allow people to join under limited criteria as listed above (quote from JSP 950) but the reconstructed entrants did not do as well over time and sustained higher drop out rates.

As of now if you have had ACl reconstruction you will not be allowed to join and appeals will not be successful via the medical chain.

You can send as much info as you like from a civpop surgeon but it is all irrelevant I'm afraid.

I suspect someone will at some point find a link to the updated JSP 950
 

Gorgonopsid

Old-Salt
Gents
Sorry to rain on the parade but the regulations have just changed. As of November 2015 NO candidate who has had ACL rupture or repair/ reconstruction will be considered fit for service. The rules used to allow people to join under limited criteria as listed above (quote from JSP 950) but the reconstructed entrants did not do as well over time and sustained higher drop out rates.

As of now if you have had ACl reconstruction you will not be allowed to join and appeals will not be successful via the medical chain.

You can send as much info as you like from a civpop surgeon but it is all irrelevant I'm afraid.

I suspect someone will at some point find a link to the updated JSP 950
Doc disappointing as that is, thanks for posting the info, and regardless of that decision I've no regrets having the surgery.

I'm 3 months from the op and I've got most of my strength back, knee that actually doesn't buckle, though also a sore patellar tendon, the surgeon and physios keep telling me I'm recovering exceptionally well, and none of that would have happened if hadn't chanced across the old JSP950 giving me the inspiration to have a crack.
 
Doc disappointing as that is, thanks for posting the info, and regardless of that decision I've no regrets having the surgery.

I'm 3 months from the op and I've got most of my strength back, knee that actually doesn't buckle, though also a sore patellar tendon, the surgeon and physios keep telling me I'm recovering exceptionally well, and none of that would have happened if hadn't chanced across the old JSP950 giving me the inspiration to have a crack.
Cracking positive attitude which will serve you well in whatever you decide to pursue next.
 

P-Ride

Old-Salt
Ah, I am interested in going into Officer Reserves and have a ruptured ACL, which I did 3 years ago this month.

Sounds like I'd have been out on the old rules, as it's 3 years (even if I get the operation tomorrow!)

Moreover, and at least as consolation, I am automatically barred from any kind of Officer Reserve roles, whatsoever, due to the fact I ruptured my ACL - regardless of whatever treatment I would have had afterwards?

Thanks
 

P-Ride

Old-Salt
To clarify, if I don't have the reconstruction, I am still ineligible? I do a wide variety of sports without one, for what it's worth..
 

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