Expert: MARK A. HOWELL - 4/27/2009

Question
Sir, my son received an appointment to the USAF Academy in March. We have just now discovered that he has a moderate tear of his medial meniscus after he accepted his appointment. He has contacted his Academy Liason Officer for protocol on informing the Academy and is waiting for his response.  My question can you or any of your contacts tell me if this is a life disqualification since he has yet to be enrolled in the Academy, and secondly, if not will he have to repeat the entire application process if deemed unable to enter this year.  He is asymptomatic for pain. Thank you for your time.

Answer
Steve,
Short answer is he should be OK to attend USAFA.

First of all let me say congratulations on receiving the appointment!  That's very difficult to obtain.

The following is a direct quote from the medical regulations for admission to USAFA.  "Physical findings of an unstable or internally deranged joint.  History of uncorrected anterior or posterior cruciate ligament injury and surgical correction of any knee ligaments if symptomatic or unstable."  These are reasons for disqualification.  Unfortunately, I have lots of experience with bad knees.

The 3 things in you favor are:  1.  You said it's moderate  2.  It's a tear and not a rupture  3.  You say it's symptomatic.

A  medial meniscus tear(torn cartilage)occurs when the knee joint is bent and the knee is then twisted.  This is common in football players.  It's also common for the meniscus tear to occur along with a torn ACL, so if his ACL is OK then that's a big relief.  As long as his knee doesn't "lock-up" he should be OK.  "Locking-up" occurs when a piece of the torn cartilage prevents the knee joint from working properly.

Not all meniscus tears require surgery.  Fortunately, almost any knee injury can be treated with ice packs, lots of rest, and immobilization.  This helps to decrease swelling and pain in the knee joint.  The average time to heal or return to sports is 4-6 weeks.  Of course that just an average.  Some patients take longer, others are quicker.

Since he won't have to report to the Academy for awhile yet, he should take this opportunity to stay off his knee as much as possible until then.

I was a commander at USAFA a few years ago, and I know he won't have any strenuous activities for a few weeks as the first few weeks are getting acclimated to the altitude and the school.  So he'll have a little bit more time to heal when there.

I wish him well and thank him for his willingness to serve in the Air Force.  (Just the fact that he chose the AF shows wisdom!) :-)
Colonel H