Outcomes of Anterior Cruciate Ligament Reconstruction in Patients Older Than 50 Years and Younger Than 30 Years

Abstract

Background: Few studies have compared the outcomes of anterior cruciate ligament (ACL) reconstruction between older patients and younger patients. Purpose: To evaluate the clinical and functional outcomes of ACL reconstruction with autologous hamstring tendon in patients >50 years and <30 years. It was hypothesized that the outcomes would be comparable between these age groups. Study Design: Cohort study; Level of evidence, 3. Methods: Patients >50 years (older group) or <30 years (younger group) who underwent ACL reconstruction surgery with autologous hamstring tendon between 2012 and 2015 at the authors’ hospital were retrospectively enrolled in this study. All patients had a minimum of 2 years of follow-up. Intraoperative findings, including cartilage and meniscal injury, were recorded, and clinical and functional outcomes were evaluated using the International Knee Documentation Committee (IKDC), Lysholm, and Tegner activity scores. We used the paired-samples t test for statistical analysis between the 2 age groups. Results: A total of 67 patients and 459 patients were included in the older and younger groups, respectively. Both groups achieved significant preoperative to postoperative improvement in IKDC (older group, from 41.4 to 88.9; younger group, from 49 to 91.2), Lysholm (older group, from 49.8 to 86.1; younger group, from 50.2 to 91.8), and Tegner (older group, from 2.7 to 4.4; younger group, from 4.6 to 6.9) ( P < .05 for all) scores. The change in Tegner score from preinjury to postoperatively was not statistically significant in the older group (from 4.5 to 4.4; P = .471), although it was significant in the younger group (from 7.5 to 6.9; P < .05). No between-group differences were noted in preoperative or postoperative IKDC or Lysholm scores. Both age groups reached a high rate of return to sports activity, and no major complications or ACL retears were noted in either group. Conclusion: Comparable results after ACL reconstruction were achieved in patients >50 years compared with patients <30 years, with a high rate of return to sports activity and a low rate of complications at the 2-year follow-up. The younger group returned to a higher Tegner score, while the older group did not.

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

“…Weng et al. 44 stated patients aged older than 50 years showed similar results with patients aged younger than 30 years and showed low complication rates as well at their cohort study.…”

Revision Rates After Primary Allograft ACL Reconstruction by Allograft Tissue Type in Older Patients

“…The low revision rate found in the study patients may be attributed in part to the fact that older athletes typically participate in less intense sports and have overall lower activity level compared to high school or collegiate-aged patients. 40,41 Furthermore, older patients may not return to sports as early as their younger counterparts. 4 The processing of allograft tissue with the goal of reducing the risk of disease transmission and increasing the availability of allograft tissue has been extensively studied, and irradiation has been shown to have an important effect on graft failure.…”

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].…”