Anteroposterior Stability and Knee Strength after Anterior Cruciate Ligament Reconstruction in Patients Older than 50 Years Compared to Younger Patients
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Published:
Oct 15, 2021
Keywords:
older than fifty years younger patients anterior cruciate ligament reconstruction
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Abstract
Purpose: The treatment for anterior cruciate ligament injury in middle-aged people older than 50 years remains controversial. This retrospective study was conducted to test the hypothesis that clinical outcomes are similar in the two age groups for anterior cruciate ligament reconstruction.
Methods: A total of 41 patients were included. Twenty patients older than 50 years and 21 younger than 40 years. Patient data collected included preoperative and postoperative range of motion, visual analog scale, Lysholm Knee Scoring, International Knee Documentation Committee Knee Evaluation Form scores, anterior drawer test, Lachman test and pivot-shift test.
Results: There were no significant differences in postoperative range of motion, visual analog scale score, anterior drawer test, Lachman test and pivot-shift test. Lysholm score and International Knee Documentation Committee knee evaluation form score between the two groups were significantly better in the younger age than the older group.
Conclusions: Anterior cruciate ligament reconstruction in younger patient is more effective comparable to patients older than 50 years in the treatment of anterior cruciate ligament tears.
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References
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24. Ekdahl M, Wang JH, Ronga M, Fu FH. Graft healing in anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 2008; 16(10): 935-47.
25. Conteduca F, Caperna L, Ferretti A, Iorio R, Civitenga C, Ponzo A. Knee stability after anterior cruciate ligament reconstruction in patients older than forty years: comparison between different age groups. Int Orthop. 2013; 37(11): 2265-9.
2. Kim DK, Park G, Kuo L-T, Park WH. Patients older than 50 years had similar results of knee strength and anteroposterior stability after ACL reconstruction compared to younger patients. Knee Surg Sports Traumatol Arthrosc. 2019; 27: 230-8.
3. Iorio R, Iannotti F, Ponzo A, Proietti L, Redler A, Conteduca F, et al. Anterior cruciate ligament reconstruction in patients older than fifty years: a comparison with a younger age group. Int Orthop. 2018; 42(5): 1043-9.
4. Dahm DL, Wulf CA, Dajani KA, Dobbs RE, Levy BA, Stuart MA. Reconstruction of the anterior cruciate ligament in patients over 50 years. J Bone Joint Surg Br. 2008; 90(11): 1446-50.
5. Fu FH, Bennett CH, Lattermann C, Ma CB. Current trends in anterior cruciate ligament reconstruction. Part 1: biology and biomechanics of reconstruction. Am J Sports Med 1999; 27(6): 821-30.
6. Legnani C, Terzaghi C, Borgo E, Ventura A. Management of anterior cruciate ligament rupture in patients aged 40 years and older. J Orthop Traumatol. 2011; 12(4): 177-84.
7. Bohnsack M, Ruhmann O, Luck K, Wirth CJ. The influence of age on the outcome of anterior cruciate ligament reconstruction. Z Orthop Ihre Grenzgeb. 2002; 140(2): 194-8.
8. Osti L, Papalia R, Del Buono A, Leonardi F, Denaro V, Maffulli N. Surgery for ACL deficiency in patients over 50. Knee Surg Sports Traumatol Arthrosc. 2011; 19(3): 412-7.
9. Cinque ME, Chahla J, Moatshe G, DePhillipo NN, Kennedy NI, Godin JA, et al. Outcomes and complication rates after primary anterior cruciate ligament reconstruction are similar in younger and older patients. Orthop J Sports Med. 2017; 5(10): 1-6.
10. Buss DD, Min R, Skyhar M, Galinat B, Warren RF, Wickiewicz TL. Nonoperative treatment of acute anterior cruciate ligament injuries in a selected group of patients. Am J Sports Med. 1995; 23(2): 160-5.
11. Kim DK, Hwang JH, Park WH. Effects of 4 weeks preoperative exercise on knee extensor strength after anterior cruciate ligament reconstruction. J Phys Ther Sci. 2015; 27(9): 2693-6.
12. Blyth MJ, Gosal HS, Peake WM, Bartlett RJ. Anterior cruciate ligament reconstruction in patients over the age of 50 years: 2-8 year follow-up. Knee Surg Sports Traumatol Arthrosc. 2003; 11(4): 204-11.
13. Lysholm J, Gillquist J. Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale. Am J Sports Med. 1982; 10(3): 150-4.
14. Tegner Y, Lysholm J. Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res. 1985; (198): 43-9.
15. Chaory K, Poiraudeau S. Rating scores for ACL ligamentoplasty. Ann Readapt Med Phys. 2004; 47(6): 309-16.
16. Figueroa D, Figueroa F, Calvo R, Vaisman A, Espinoza G, Gili F. Anterior cruciate ligament reconstruction in patients over 50 years of age. Knee. 2014; 21(6): 1166-8.
17. Burks RT, Metcalf MH, Metcalf RW. Fifteen-year follow-up of arthroscopic partial meniscectomy. Arthroscopy. 1997; 13(6): 673-9.
18. Wolfson TS, Epstein DM, Day MS, Joshi BB, McGee A, Strauss EJ, et al. Outcomes of anterior cruciate ligament reconstruction in patients older than 50 years of age. Bull Hosp Jt Dis (2013). 2014; 72(4): 277-83.
19. Outerbridge RE. The etiology of chondromalacia patellae. J Bone Joint Surg Br. 1961; 43-B: 752-7.
20. Steadman JR, Briggs KK, Rodrigo JJ, Kocher MS, Gill TJ, Rodkey WG. Outcomes of microfracture for traumatic chondral defects of the knee: average 11-year follow-up. Arthroscopy. 2003; 19(5): 477-84.
21. Shelbourne KD, Stube KC. Anterior cruciate ligament (ACL)-deficient knee with degenerative arthrosis: treatment with an isolated autogenous patellar tendon ACL reconstruction. Knee Surg Sports Traumatol Arthrosc. 1997; 5(3): 150-6.
22. Andriacchi TP, Mundermann A, Smith RL, Alexander EJ, Dyrby CO, Koo S. A framework for the in vivo pathomechanics of osteoarthritis at the knee. Ann Biomed Eng. 2004; 32(3): 447-57.
23. Mall NA, Frank RM, Saltzman BM, Cole BJ, Bach BR Jr. Results after anterior cruciate ligament reconstruction in patients older than 40 years: how do they compare with younger patients? A systematic review and comparison with younger populations. Sports Health. 2016; 8(2): 177-81.
24. Ekdahl M, Wang JH, Ronga M, Fu FH. Graft healing in anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 2008; 16(10): 935-47.
25. Conteduca F, Caperna L, Ferretti A, Iorio R, Civitenga C, Ponzo A. Knee stability after anterior cruciate ligament reconstruction in patients older than forty years: comparison between different age groups. Int Orthop. 2013; 37(11): 2265-9.