2021
DOI: 10.1016/j.otsr.2021.103039
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Anterior cruciate ligament reconstruction in the over-50s. A prospective comparative study between surgical and functional treatment

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Cited by 15 publications
(13 citation statements)
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“…These studies all indicated that significant improvement was observed in postoperative stability and function. In this study, sideto-side arthrometer difference-related data measured in patients over the age of 50 were comparable with that in other studies (Table 6) (2,(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)20,(41)(42)(43). In this study, ACL achieved excellent or good postoperative IKDC scores in 93.75% of patients, which is similar to what has been reported by other studies (8,12).…”
Section: Discussionsupporting
confidence: 91%
“…These studies all indicated that significant improvement was observed in postoperative stability and function. In this study, sideto-side arthrometer difference-related data measured in patients over the age of 50 were comparable with that in other studies (Table 6) (2,(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)20,(41)(42)(43). In this study, ACL achieved excellent or good postoperative IKDC scores in 93.75% of patients, which is similar to what has been reported by other studies (8,12).…”
Section: Discussionsupporting
confidence: 91%
“…40 Additionally, given the patient's age, activity level, and satisfactory function in everyday activities, it was decided not to pursue revision surgery, consistent with the fact that older patients typically have subjectively acceptable results with an ACL-deficient knee. 41 It was noted that the VAS (D1.7), SANE (D51.7), and Lysholm (D41.1) scores all significantly improved postoperatively in all timelines. Our cohort demonstrated similar SANE scores to the internally braced cohort in the study described by Bodendorfer et al 24 and Kitchen et al 35 as well as studies describing traditional ACLR.…”
Section: Discussionmentioning
confidence: 87%
“…Although these older ACL‐deficient patients are still at risk for meniscal injuries if an ACLR is not performed within 1‐year of injury, this risk is less than that for younger cohorts [35]. This suggests a lower threshold for selecting nonoperative management in patients aged ≥ 40, however the evidence supporting this is limited; one study has shown no significant increase in osteoarthritis progression compared to surgically managed patients [43], and three studies have demonstrated significant improvements in PROMs with high levels of patient satisfaction (83% [8]), but at significantly lower levels than those treated surgically [8, 13, 43]. Although these studies demonstrate acceptable outcomes after non‐surgical management of ACL tears in middle‐aged patients, the paucity of comparative evidence makes the wide‐spread adoption of evidence‐based surgical indications and recommendations for this patient population difficult.…”
Section: Discussionmentioning
confidence: 99%
“…Despite a lack of formal clinical practise guidelines on the management of ACL injuries in patients older than 40, there exists a trend towards increased utilization of ACL reconstruction (ACLR) in this patient population [6, 24]. Although literature published in 1994 suggests acceptable results may be achieved with non‐operative treatment of ACL injuries in middle‐aged patients, advancements in surgical techniques and rehabilitation protocols may have contributed to a trend favouring surgical management[8, 13]. While several studies have demonstrated improvements in patient‐reported outcome measures (PROMs) and knee laxity testing, outcomes after ACLR in patients aged ≥ 40 years, little is known about the clinical significance of these results [9, 19, 36–38, 41].…”
Section: Introductionmentioning
confidence: 99%