Metalwork removal in potential army recruits. Evidence-based changes to entry criteria.

Civilian practice and the literature do not support the routine removal of metalwork from the asymptomatic patient. A significant risk of complication exists. The MoD and Army Medical Services are expected to conduct themselves in line with current National Health Service guidelines and standards of care. The literature is clear that removal is not indicated unless sound clinical reasons exist. There is no comparable group to that of the recruit with retained metal, but evidence suggests that the rigors of basic training can be accepted without risk to the individual. If a problem arose then removal could be indicated at that time. No studies or papers in support of this policy were found. No evidence was found to support the current British Army policy, which is now being altered.