Tri-Service Musculoskeletal Injury Protocols Published


The Geneva Foundation (Geneva) today announced the release of 11 streamlined Tri-Service Post-Operative Rehabilitation Guidelines for hip, knee, foot, ankle, and shoulder injury rehabilitation in military healthcare. The work was supported by the Musculoskeletal Injury Rehabilitation Research for Operational Readiness (MIRROR) program at the Uniformed Services University of the Health Sciences.

In January 2020, Geneva, in partnership with the Broussard Foundation, brought together more than 50 military leaders, clinicians, scientists, and experts within the physical therapy, orthopedics, rehabilitation medicine, and pain management fields for the first ever Tri-Service Post-Operative Rehabilitation Protocol Consensus Meeting to advance musculoskeletal injury readiness. The protocols were developed and released for the U.S. Army, U.S. Navy, and U.S. Air Force in just under four months, marking a milestone in the MIRROR program.

MIRROR’s Chief of Research & Operations Dr. Brad Isaacson said, “The rapid turnaround of these important guidelines showcases the impact of the MIRROR program. Our amazing network of senior subject matter experts moved the needle for musculoskeletal care in such a short timeframe.”

The Tri-Service Post-Operative Rehabilitation Protocols, created with support from Geneva, USU and the Military Orthopaedics Tracking Injuries and Outcomes Network (MOTION), are identified as follows:


  • Achilles Tendon Repair Rehabilitation Guidelines
  • Ankle Reconstruction – Modified Brostrom Rehabilitation Guidelines
  • Anterior Cruciate Ligament Reconstruction (ACLR) Rehabilitation Guidelines
  • Arthroscopic Hip Rehabilitation Guidelines
  • Arthroscopic Knee Rehabilitation Guidelines
  • Arthroscopic Shoulder Rehabilitation Guidelines
  • Bicep Tenodesis Rehabilitation Guidelines
  • Meniscus Repair Rehabilitation Guidelines
  • Patellar Tendon Repair Rehabilitation Guidelines
  • Rotator Cuff Repair Rehabilitation Guidelines
  • Shoulder Instability Rehabilitation Guidelines

The Rehabilitation Protocols can be viewed at https://mirrorusuhs.org/mirror-activities/category/Rehabilitation+Protocols.

More than 800,000 U.S. service members are affected annually by musculoskeletal injuries (MSI) resulting in 25 million days of limited duty. Dr. Isaacson added, “Ensuring consistent treatment for our service members is what makes this milestone for the MIRROR program so significant. MSIs are the primary reason for medical discharge from serving in the U.S. military.”

Headquartered at the USU, the MIRROR program, supported by the Defense Health Agency (DHA), was established in 2019 to deliver high value research, education, and training, and provides infrastructure to rapidly execute clinically relevant MSI studies within the Military Health System (MHS). Geneva directs the MIRROR program by providing strategic leadership and program management, fiscal, data analysis, and regulatory support. MIRROR supports a broad scope of projects, including epidemiological investigations, multisite clinical trials, testing novel devices/treatment modalities, etc. which enhance the Department of Defense’s (DoD) efforts in addressing the negative impact that MSI has on the military. This collaboration provides the opportunity to achieve successful outcomes within the MHS.

About The Geneva Foundation

The Geneva Foundation is a 501(c)3 non-profit organization that advances military medicine through innovative scientific research, exceptional program management, and a dedication to U.S. service members and veterans, their families, and the global community. Geneva is proud to have over 25 years of experience in delivering full spectrum scientific, technical, and program management expertise in the areas of federal grants, federal contracts, industry sponsored clinical trials, and educational services. http://www.genevaUSA.org

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