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

Abstract

We compared two groups of patients who had undergone anterior cruciate ligament (ACL) reconstruction. The groups were similar in regard to sex distribution, index injury, absence of meniscal or chondral lesions, surgical technique, and postoperative rehabilitation programs, but different in age. In the study group the mean age was 42.6 years, while in the control group the mean age was 20 years. The clinical results were assessed at a mean of 29 months after surgery using the Lysholm score, International Knee Documentation Committee form, Tegner activity level, and the KT-1000 arthrometer test. No significant differences were reported. Standard X-ray studies showed no variation between the two groups in the postoperative period. Intra-articular ACL reconstruction using a bone-patellar tendon-bone graft can be recommended in selected patients over 40 years of age as an alternative to conservative treatment.

High rate of return to activity after ACL reconstruction in patients over 40 years of age: a systematic review

“…The use of BPTB autografts in middle-aged patients showed similar midterm results and complication rates to those in younger patients 30. BPTB allografts demonstrated a quicker return to sporting activities as compared with BPTB autografts, which was accompanied with an increased laxity and higher incidence of failure in the allograft group 6…”

Evidence based medicine in clinical practice: how to advise patients on the influence of age on the outcome of surgical anterior cruciate ligament reconstruction: a review of the literature

“…Set B was therefore complete, containing a total of 39 papers. On the basis of a full text review, four papers 12-15 satisfied the final inclusion criteria and were accepted into set C. Three of these [13][14][15] were available in Medline, two 13 15 in Embase, and none in the Cochrane Library. One paper 12 was identified only by means of the search of reference lists.…”

“…Of these four studies, three [13][14][15] were full papers and one 12 was a "mini-paper" of a single page. All four specifically evaluated whether or not age is an influencing factor in the outcome of anterior cruciate ligament reconstruction surgery.…”

ACL Reconstruction in Patients Aged 40 Years and Older

“…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.…”