Knee Surg Relat Res.  2019 Dec;31(4):e13. 10.1186/s43019-019-0015-1.

The mechanism and cause of anterior cruciate ligament tear in the Korean military environment

  • 1Department of Orthopaedic surgery, Armed Forces Capital Hospital, 81, Saemaeul-ro 177beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea.
  • 2Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea.
  • 3Department of Orthopaedic Surgery, Hallym Sacred Heart Hospital, Hallym University College of Medicine, 22, Gwanpyeong-ro 170beon-gil, Dongan-gu, Anyang-si, Gyeonggi-do, Republic of Korea.
  • 4Department of Orthopaedic Surgery, Gil Hospital, Gachon University of Medicine and Science, 21, Namdong-daero 774beon-gil, Namdong-gu, Incheon, Republic of Korea.


Anterior cruciate ligament (ACL) injury is very common but few studies have analyzed the injury mechanism and cause of ACL tear in a specific environment such as a military institution. The purpose of this study was to analyze the injury mechanism and cause of ACL injury in the military environment. Additionally, this study could provide outcomes that may aid future studies on prevention of ACL injury in military personnel.
This study retrospectively analyzed 168 patients who sustained ACL tear while in military service and underwent ACL reconstruction surgery in a military hospital. Analysis of the injury mechanism and the cause was evaluated by analyzing the medical records. Knee magnetic resonance imaging analysis was also conducted for further evaluation of associated injury.
The majority of ACL injuries in the military environment occurred through non-contact injury. Changing direction (46.4%) was the most common lower-leg position, followed by landing with the knee in a valgus position (26.8%). The activity undertaken at the time of injury was exercise in 76.2% of cases and military training/daily activities in 23.8% of cases. The incidence of ACL injury was higher in the soldier compared to the officer group during exercise (P = 0.017). Soccer was the most common activity at the time of injury (54.1%), followed by military training/daily activities, futsal, and basketball. The most common injury time was between 30 and 60 min after the start of exercise. Commonly associated injury sites were the medial meniscus and the medial collateral ligament.
The main mechanism of ACL injury occurring in the military environment was non-contact injury, especially on changing the direction of the lower leg. Soccer was the most frequent activity at the time of the injury. These findings suggested that preventive strategies against ACL injury in the military environment could effectively reduce the incidence of ACL injury.


Anterior cruciate ligament; Injury mechanism; Injury cause; Military environment; Injury prevention program

MeSH Terms

Anterior Cruciate Ligament*
Collateral Ligaments
Hospitals, Military
Magnetic Resonance Imaging
Medical Records
Menisci, Tibial
Military Personnel*
Retrospective Studies
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