Surgery for ACL deficiency in patients over 50

Osti, Leonardo; Papalia, Rocco; Buono, Angelo Del; Leonardi, Francesco; Denaro, Vincenzo; Maffulli, Nicola

doi:10.1007/s00167-010-1242-x

Cited by 60 publications

(112 citation statements)

References 31 publications

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“…Operative treatment documented favorable outcomes in this patient population with regard to knee stability and patient satisfaction, with results similar to those observed in a younger patient population [15, 19, 21, 23]. Among the four studies reporting on the difference in the outcomes between elderly and young patients, no increased risk of complication (stiffness, arthrofibrosis, infections) was noted in the middle-aged patients compared to the control group [15, 19, 21, 23].…”

Section: Discussionsupporting

confidence: 74%

“…Mostly level III studies were reported, either case–control [15, 20–23] or retrospective cohort [13, 24–28] studies. Five were case series (level IV) [14, 29–32].…”

Section: Resultsmentioning

confidence: 99%

“…Four retrospective case–control studies compared the outcomes of ACL reconstruction in subjects aged 40 years and older with those for a group of younger patients [15, 19, 21, 23]. …”

Section: Resultsmentioning

confidence: 99%

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Management of anterior cruciate ligament rupture in patients aged 40 years and older

Legnani

Terzaghi

Borgo

et al. 2011

J Orthopaed Traumatol

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The aim of anterior cruciate ligament (ACL) reconstruction is essentially to restore functional stability of the knee and to allow patients to return to their desired work and activities. While in the young and active population, surgery is often the best therapeutic option after an ACL tear, ACL reconstruction in middle-aged people is rather more controversial due to concerns about a higher complication rate. The purpose of our article is to establish, through a systematic review of the literature, useful decision-making criteria for the management of anterior cruciate ligament rupture in patients aged 40 years and older, guiding surgeons to the most appropriate therapeutic approach. Various reports have shown excellent results of ACL reconstruction in patients over the age of 40 in terms of subjective satisfaction, return to previous activity level, and reduced complication and failure rates. Some even document excellent outcomes in subjects of 50 years and older. Although there are limited high-level studies, data reported in the literature suggest that ACL reconstruction can be successful in appropriately selected, motivated older patients with symptomatic knee instability who want to return to participating in highly demanding sport and recreational activities. Deciding factors are based on occupation, sex, activity level of the subject, amount of time spent performing such highly demanding activities, and presence of associated knee lesions. Physiological age and activity level are more important than chronological age as deciding factors when considering ACL reconstruction.

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Section: Discussionsupporting

confidence: 74%

“…Mostly level III studies were reported, either case–control [15, 20–23] or retrospective cohort [13, 24–28] studies. Five were case series (level IV) [14, 29–32].…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Management of anterior cruciate ligament rupture in patients aged 40 years and older

Legnani

Terzaghi

Borgo

et al. 2011

J Orthopaed Traumatol

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“…Of the 19 studies, 2 studies 5,33 were rated as level of evidence II, 6 studies 6,9,33,39,51,63 qualified as level III, and 11 studies g were classified as level IV. Table 4 illustrates the mean AMS for each study and corresponding level of evidence rating provided by the 4 independent reviewers.…”

Section: Ams and Level Of Evidencementioning

confidence: 99%

ACL Reconstruction in Patients Aged 40 Years and Older

et al. 2013

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“…Historically, conservative measures have provided good results in most patient [1][2][3] , however the increasing understanding of the natural history of PCL insufficiency has induced many surgeons to recommend reconstruction or augmentation to prevent decline of the knee function in the short term, and the development of osteoarthritis of the patello-femoral joint and the medial compartment in the long term 4 , secondary to the damage to cartilage and meniscal tears [5][6][7][8][9] . Surgical reconstruction is usually recommended in symptomatic patients with grade III PCL tears who complain of pain and instability, and in those with multiple ligament injuries.…”

Section: Introductionmentioning

confidence: 99%

Acute augmentation for interstitial insufficiency of the posterior cruciate ligament. A two to five year clinical and radiographic study

Chan¹,

Kong²,

Buono

et al. 2016

MLTJ

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SummaryBackground: there is need to ascertain clinical and imaging outcomes after posterior cruciate ligament (PCL) augmentation. Methods: we performed a retrospective analysis of clinical, imaging and functional data on 21 physically active males who underwent arthroscopic trans-tibial augmentation of the PCL for symptomatic grade III PCL insufficiency. The average follow-up time was 50 months (24-60 months). The Lysholm knee score was administered to all the patients, ligament laxity was evaluated with the posterior drawer test, the KT-1000 arthrometer, and the anteromedial tibial step-off. Standing antero-posterior, lateral and Merchant's view radiographs were taken preoperatively and at annual follow-up. Results: post-operatively, ligament laxity and Lysholm knee scores were significantly improved than at baseline. Sixteen patients (73%) returned to pre-injury sport activity level, 3 patients (14%) returned to a lower level, 2 had to stop. We found radiographic degenerative changes in 5 of 22 affected knees (23%), with evidence of a statistically significant association between the occurrence of degenerative changes and the interval time from injury to surgery and duration of the follow up. Conclusions: arthroscopic transtibial single bundle autograft hamstring augmentation significantly improves the function of the knee, with an overall satisfactory outcome of 82% at 2-5 years from surgery.

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Surgery for ACL deficiency in patients over 50

Cited by 60 publications

References 31 publications

Management of anterior cruciate ligament rupture in patients aged 40 years and older

Management of anterior cruciate ligament rupture in patients aged 40 years and older

ACL Reconstruction in Patients Aged 40 Years and Older

Acute augmentation for interstitial insufficiency of the posterior cruciate ligament. A two to five year clinical and radiographic study

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