Anterior Cruciate Ligament Reconstruction Using Bone–Patellar Tendon–Bone Allograft in Patients Aged 50 and Older Leads to Improved Activity Levels and Acceptable Patient-Reported Outcomes

Abstract

Purpose To evaluate patient-reported outcomes in patients aged 50 years and older undergoing anterior cruciate ligament reconstruction (ACLR) using bone–patellar tendon–bone (BPTB) allograft with minimum 2-year follow-up. Methods A retrospective review was performed on a consecutive series of patients aged 50 and older who underwent ACLR using BPTB allograft by a single surgeon with minimum 2-year follow-up. Postoperative International Knee Documentation Committee (IKDC), Lysholm, and Physical Component Summary of the 12-item Short-Form Health Survey were used to assess outcomes, as well as preoperative and postoperative Tegner activity scores, which were compared using a paired sample t test. Results Fifty patients met inclusion criteria, with a mean age of 55.3 ± 4.4 years and mean follow-up of 4.8 ± 1.9 years. Tegner activity scores improved from a mean preoperative score of 3.26 to a mean postoperative score of 5.25 ( P < .001). The mean postoperative scores for Lysholm, IKDC, and Physical Component Summary were 87.3, 81.1, and 54.3, respectively. In total, 36 (72%) patients achieved a patient acceptable symptom state score for IKDC and 37 (74%) patients achieved a minimal clinically important difference for Tegner activity score. Thirty-eight (76%) patients reported good-to-excellent results, 6 (12%) patients reported fair results, and 6 (12%) patients reported poor results. Conclusions ACLR with BPTB allograft in patients aged 50 and older leads to good patient-reported outcomes with significantly increased postoperative activity status at a minimum 2-year follow-up. Level of Evidence Level IV, therapeutic case series.

Patients older than 55 years regain sporting and recreational activities after arthroscopic anterior cruciate ligament reconstruction

“…et al did present a similar result in their retrospective study after ACL reconstruction in a group of 69 patients but with a mean age of 33.4 years [27]. Sylvia et al recently reported that in patients over 50, the Tegner Activity Level was 5.3 after a 2 year follow-up [35]. Hence, we were able to conirm these results.…”

Anterior Cruciate Ligament Reconstruction Improves Functional Scores and Quality of Life in Patients Older Than 50 Years of Age

“…Studies are conducted using different graft types like hamstring tendon autograft, quadriceps tendon autograft, or bone–patellar tendon–bone autograft at patients older than 50 years of age have shown improved functional knee scores and high rates of return to sportive activitie. 40 , 41 , 42 Corona et al. 43 showed comparable results with younger patients at a large systematic review.…”

Good clinical outcomes of anterior cruciate ligament reconstruction in patients over 60 years of age

“…Several studies have evaluated the benefit of ACLR in middle-aged patients and found outcomes comparable to those in younger patients [6,11,25,26,29,37]. Furthermore, some well-documented researches have demonstrated excellent clinical results following ACLR in selected and motivated patients older than 50 years [7,9,17,22,23,27,35,36]. In addition, few studies have reported that ACLR in active patients over 60 years without OA could restore knee stability and allow patients to return to preinjury activity levels [1,18,31,33].…”