An Analysis of Anterior Cruciate Ligament Reconstruction in Middle-Aged Patients

Abstract

The purpose of this study was to evaluate the results and complications of anterior cruciate ligament surgery in middle-aged patients. Forty-five consecutive pa tients over 40 years old (average age, 44.6 years) who had arthroscopically assisted anterior cruciate liga ment reconstructions with midthird patellar tendon au tografts were evaluated. The patients returned for in terviews, physical examinations, radiographs, Biodex dynamometer strength testing, and KT-1000 arthrom eter testing at an average of 37 months after their surgeries (range, 24 to 96 months). The mean Lysholm and Gillquist score was 91, which corresponds to symptoms only with vigorous activity. The overall scores from the International Knee Documentation Committee form were 29 (64%) normal or nearly nor mal and 2 (4%) severely abnormal. Side-to-side differ ences as determined by the KT-1 000 arthrometer were ≤3 mm in 31 of 40 patients (78%), between 3 and 5 mm in 4 patients (10%), and >5 mm in 5 patients at 30 pounds of anterior displacement. Seventy-six percent of the patients (N = 34) returned to their preoperative activity levels. Three patients required repeat arthro scopic surgery for persistent knee pain and two pa tients had graft ruptures. This study shows that when middle-aged patients undergo surgery, their results can be successful and satisfying to a degree similar to those of younger patients.

Intra-articular ACL reconstruction in the over-40-year-old patient

“…Recently several authors [1, 3,6,9,11] found similar results in motivated patients over 40 years old to those in younger patients. Barber et al [3] compared two groups of patients, under and over 40 years old, and concluded that the outcomes were the same.…”

“…Older patients were treated by guided rehabilitation and were strongly urged to modify their physical activities [4,7]. Some extra-articular procedures were performed in selected cases [14], but the long-term results were poor.Recently several authors [1, 3,6,9,11] found similar results in motivated patients over 40 years old to those in younger patients. Barber et al [3] compared two groups of patients, under and over 40 years old, and concluded that the outcomes were the same.…”

Anterior Cruciate Ligament Reconstruction Improves Activity-Induced Pain in Comparison With Pain at Rest in Middle-Aged Patients With Significant Cartilage Degeneration

“…2,5,13 However, many authors have demonstrated that the outcomes of ACL reconstruction in middle-aged or elderly patients were satisfactory, some of them comparable with those of younger patients. [1][2][3]5,8,11,13,17 Given the results, age does not appear to affect the outcome of ACL reconstruction. Rather, the status of articular cartilage might be a more important predictor of outcomes.…”

Results of Revision Anterior Cruciate Ligament Surgery

“…19,25,40 The KT-1000 arthrometer and functional testing were performed by a certified athletic trainer/physical therapist who was not involved with surgical treatment, and 30 lb of force was selected to compare side-to-side measurements. 13 were allowed to warm up, and the hop was graded as a mean of 3 attempts. It has been shown that the singlelegged hop is associated not only with functional outcome in the ACL-reconstructed knee but also with isokinetic quadriceps peak torque at 180 and 300 deg/s.…”