The role of anterior cruciate ligament reconstruction in the older patients, 55 years or above

Arbuthnot, J; Brink, Rodney B.

doi:10.1007/s00167-009-0864-3

Cited by 35 publications

(34 citation statements)

References 45 publications

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“…This is in line with Osti et al who reported comparable clinical outcomes in middleaged patients and in patients aged below 30 (Osti et al, 2011). Furthermore, this is also supported by Arbuthnot et al who reported that ACL reconstruction using autograft in patients above 55 years improves functional outcome scoring and permits a return to a reasonable level of activity, although not to pre-injury levels (Arbuthnot & Brink, 2010).…”

Section: Discussionsupporting

confidence: 86%

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Pre‐operative factors predicting good outcome in terms of health‐related quality of life after ACL reconstruction

Månsson

Kartus

Sernert

2012

Scandinavian Med Sci Sports

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The life situation of many patients changes after an anterior cruciate ligament (ACL) rupture and subsequent reconstruction, and this may affect their health-related quality of life in many ways. It is well known that the overall clinical results after ACL reconstruction are considered good, but pre-operative predictive factors for a good post-operative clinical outcome after ACL reconstruction have not been studied in as much detail. The purpose of this study was to identify pre-operative factors that predict a good post-operative outcome as measured by the Short Form 36 (SF-36) and Knee Osteoarthritis Outcome Score (KOOS) 3-6 years after ACL reconstruction. Seventy-three patients scheduled for ACL reconstruction were clinically examined pre-operatively. The SF-36 and KOOS questionnaires were sent by mail to these patients 3-6 years after reconstruction. Predictive factors for health-related quality of life were investigated using a stepwise regression analysis. In conclusion, pre-operative factors, such as pivot shift, knee function, and range of motion, may predict a good post-operative outcome and explain up to 25% in terms of health-related quality of life after ACL reconstruction. Furthermore, it appears that the patients' pre-injury and pre-operative Tegner activity levels are important predictors of post-operative health-related quality of life.

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Section: Discussionsupporting

confidence: 86%

“…Furthermore, this is also supported by Arbuthnot et al. who reported that ACL reconstruction using autograft in patients above 55 years improves functional outcome scoring and permits a return to a reasonable level of activity, although not to pre‐injury levels (Arbuthnot & Brink, ).…”

Section: Discussionmentioning

confidence: 56%

Pre‐operative factors predicting good outcome in terms of health‐related quality of life after ACL reconstruction

Månsson

Kartus

Sernert

2012

Scandinavian Med Sci Sports

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“…Abstracts of studies obtained during the search were reviewed in duplicate by 2 of the authors to determine appropriateness for inclusion in the study, with full-text review performed when questions existed as to whether the study should be included in analysis. There were 12 studies 1 - 7 , 12 , 17 , 23 , 24 , 29 that met the final criteria and were included in the final data analysis ( Figure 1 ). These studies had their reference lists reviewed for additional papers appropriate for inclusion, with no additional studies selected.…”

Section: Methodsmentioning

confidence: 99%

“…If arthritis is present in an ACL-deficient knee, it may be a relative contraindication to ACL reconstruction. 1 , 21 Older individuals have a greater likelihood of developing arthrofibrosis. 11 , 13 , 31 However, active patients are not satisfied with activity restraint.…”

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confidence: 99%

Results After Anterior Cruciate Ligament Reconstruction in Patients Older Than 40 Years

Mall¹,

Frank

Saltzman

et al. 2015

Sports Health: A Multidisciplinary Approach

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Context:Anterior cruciate ligament (ACL) reconstruction in older patients is a controversial topic among orthopaedic surgeons.Objective:To determine the outcomes, failure, and morbidity associated with ACL reconstruction in patients older than 40 years and to compare it with nonoperative treatment as well as results of ACL reconstruction in a younger patient population.Data Sources:A systematic review of the literature from 1970 to 2015 was conducted utilizing MEDLINE, CINAHL, and the Cochrane Central Register databases using PRISMA guidelines.Study Selection:Inclusion criteria were studies with longer than 2-year follow-up of primary ACL reconstruction and minimum age of patients older than 40 years, inclusive of any graft type or source and of any concomitant meniscal pathology.Study Design:Systematic review.Level of Evidence:Level 4.Data Extraction:Two independent reviewers collected demographic, preoperative, intraoperative, and postoperative data.Results:Twelve studies with a total of 452 patients were included. The mean patient age was 47.8 years (range, 40-66 years) with a mean follow-up of 53.3 months (minimum, 24 months). Lysholm scores improved from 53.9 to 90.5 in the 11 operative studies. The only nonoperative study reported a mean Lysholm score of 82 after rehabilitation. International Knee Documentation Committee (IKDC) scores of A or B were found in 81%. Tegner activity scores averaged 4.7 preinjury, fell to 2.9 preoperatively, and returned to 4.7 postoperatively. The reported failure rate was 2.3%. There were few complications, and failure rate was similar in younger patients.Conclusion:The data confirm that ACL reconstruction can be recommended to patients older than 40 years who wish to maintain an active lifestyle or have symptomatic instability with daily activities. Patient-based outcomes scores were better in the operative studies compared with the single nonoperative study in this patient population.

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“…Similar good results have been reported by other authors. 7 8 9 Studies that have compared outcomes of ACL reconstruction in patients younger and older than 40–50 years of age have demonstrated outcomes comparable in both the groups. 10 11 12 13 Cartilage degeneration, although present to a greater degree in the older cohort, was not associated with a poorer outcome at intermediate followup.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of the patellar tendon and hamstring graft anterior cruciate ligament reconstructions in patients aged above 50 years

Bali¹,

Nagraj²,

Kumar³

et al. 2015

IJOO

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Background:The treatment of anterior cruciate ligament (ACL) injury consists of arthroscopic ACL reconstruction with patellar tendon or hamstring graft. Satisfactory results have been reported so far in the younger age group. Dilemma arises regarding the suitability of ACL reconstruction in patients aged 50 years and above. This retrospective analyses the outcome of ACL reconstruction in patients aged 50 years and above.Materials and Methods:55 patients aged 50 years and above presented to our institution with symptomatic ACL tear and were managed with arthroscopic reconstruction with patellar tendon/hamstring graft. 22 patients underwent ACL reconstruction with bone- patellar tendon-bone graft and the remaining 33 with a hamstring graft. Evaluation of functional outcome was performed using International Knee Documentation Committee (IKDC) and Lysholm scoring in the preoperative period, at the end of 1 year and at the final followup. Radiographic evaluation was performed using the Kellgren–Lawrence grading system.Results:The mean preoperative IKDC score was 39.7 ± 3.3. At the end of 1-year following the operation, the mean IKDC score was 73.6 ± 4.9 and at the final followup was 67.8 ± 7.7. The mean preoperative Lysholm score was 40.4 ± 10.3. At the end of 1-year following the intervention, the mean Lysholm score was 89.7 ± 2.1 and at final followup was 85.3 ± 2.5. Overall, 14 out of 42 patients who underwent radiographic assessment showed progression of osteoarthritis changes at the final followup after the intervention.Conclusion:In our study, there was a statistically significant improvement in the IKDC and Lysholm scores following the intervention. There was a slight deterioration in the scores at the final followup but the overall rate of satisfaction was still high and most of the patients were able to do their routine chores and light exercises suitable for their age group. Around one-third of patients show progression of radiographic changes in the postoperative period and this requires long term evaluation.

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The role of anterior cruciate ligament reconstruction in the older patients, 55 years or above

Cited by 35 publications

References 45 publications

Pre‐operative factors predicting good outcome in terms of health‐related quality of life after ACL reconstruction

Pre‐operative factors predicting good outcome in terms of health‐related quality of life after ACL reconstruction

Results After Anterior Cruciate Ligament Reconstruction in Patients Older Than 40 Years

Outcomes of the patellar tendon and hamstring graft anterior cruciate ligament reconstructions in patients aged above 50 years

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