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Erschienen in: Sport Sciences for Health 4/2021

04.05.2021 | Original Article

Good functional outcomes in patient’s age > 40 years after anterior cruciate ligament reconstruction with hamstring tendon graft: a retrospective study

verfasst von: Ravi Gupta, Anil Kapoor, Akash Singhal, Bharath Mali Patil, Manharjot Malhi, Gladson David Masih

Erschienen in: Sport Sciences for Health | Ausgabe 4/2021

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Abstract

Background

Many surgeons are still hesitant to do arthroscopic anterior cruciate ligament reconstruction (ACL) in patients above 40 years old.

Purpose

The effect of ACL reconstruction on functional outcomes in patients above 40 years of age.

Materials and methods

Patients of age > 40 years who underwent ACL reconstruction were enrolled in the study. Functional outcomes (Lysholm, WOMAC score, and Tegner activity scale), pain (VAS score), and knee stability (KT-1000) were assessed at final follow-up and compared with pre-operative scores. All patients were followed up for a minimum of 2 years.

Results

A total of 112 patients were included in the study. Eighty-eight were males and 24 were females. The mean age at the time of surgery was 44.8 ± 5.6 years (40–63 years). The mean Lysholm score was improved from 64.1 ± 11.7 to 87.2 ± 5.9 (p = 0.0001). Similarly, the WOMAC score was also improved from 8.8 ± 6.9 to 2.3 ± 1.9 (p = 0.0001). The mean side-to-side difference (KT-1000) also improved from 6.65 ± 2.25 mm to 2.32 ± 1.45 mm (p = 0.0001). More than 70% of the patients had excellent or good outcomes. Median pre-injury Tegner activity scale was 5 (3–8) and the median post-ACLR Tegner activity scale was 5 (3–7; p = 1).

Conclusion

ACL reconstruction in patients > 40 years of age results in good functional outcomes and knee stability.
Literatur
2.
Zurück zum Zitat Gupta R, Kapoor A, DavidMasih G (2020) Prevalence of concomitant knee injuries associated with anterior cruciate ligament tear in kabaddi and football players. J Clinic Orthop Trauma 23:160–165 Gupta R, Kapoor A, DavidMasih G (2020) Prevalence of concomitant knee injuries associated with anterior cruciate ligament tear in kabaddi and football players. J Clinic Orthop Trauma 23:160–165
3.
Zurück zum Zitat Buss DD, Min R, Skyhar M, Galinat B, Warren RF, Wickiewicz TL (1995) Nonoperative treatment of acute anterior cruciate ligament injuries in a selected group of patients. Am J Sports Med 23(2):160–165CrossRef Buss DD, Min R, Skyhar M, Galinat B, Warren RF, Wickiewicz TL (1995) Nonoperative treatment of acute anterior cruciate ligament injuries in a selected group of patients. Am J Sports Med 23(2):160–165CrossRef
4.
Zurück zum Zitat Heier KA, Mack DR, Moseley JB, Paine R, Bocell JR (1997) An analysis of anterior cruciate ligament reconstruction in middle-aged patients. Am J Sports Med 25(4):527–532CrossRef Heier KA, Mack DR, Moseley JB, Paine R, Bocell JR (1997) An analysis of anterior cruciate ligament reconstruction in middle-aged patients. Am J Sports Med 25(4):527–532CrossRef
5.
Zurück zum Zitat Brandsson S, Kartus J, Larsson J, Eriksson BI, Karlsson J (2000) A comparison of results in middle-aged and young patients after anterior cruciate ligament reconstruction. Arthroscopy 16(2):178–182CrossRef Brandsson S, Kartus J, Larsson J, Eriksson BI, Karlsson J (2000) A comparison of results in middle-aged and young patients after anterior cruciate ligament reconstruction. Arthroscopy 16(2):178–182CrossRef
6.
Zurück zum Zitat Gee AO, Kinsella S, Huffman GR, Sennett BJ, Tjoumakaris FP (2013) Anterior cruciate ligament reconstruction in patients aged> 40 years: a case-control study. Physician sportsmed 41(1):30–34CrossRef Gee AO, Kinsella S, Huffman GR, Sennett BJ, Tjoumakaris FP (2013) Anterior cruciate ligament reconstruction in patients aged> 40 years: a case-control study. Physician sportsmed 41(1):30–34CrossRef
7.
Zurück zum Zitat Brown CA, McAdams TR, Harris AHS, Maffulli N, Safran MR (2013) ACL reconstruction in patients aged 40 years and older: a systematic review and introduction of a new methodology score for ACL studies. Am J Sports Med 41(9):2181–2190CrossRef Brown CA, McAdams TR, Harris AHS, Maffulli N, Safran MR (2013) ACL reconstruction in patients aged 40 years and older: a systematic review and introduction of a new methodology score for ACL studies. Am J Sports Med 41(9):2181–2190CrossRef
8.
Zurück zum Zitat Tay KS, Tan AHC (2018) Clinical outcomes, return to sports, and patient satisfaction after anterior cruciate ligament reconstruction in young and middle-aged patients in an asian population: a 2-year follow-up study. Arthroscopy 34(4):1054–1059CrossRef Tay KS, Tan AHC (2018) Clinical outcomes, return to sports, and patient satisfaction after anterior cruciate ligament reconstruction in young and middle-aged patients in an asian population: a 2-year follow-up study. Arthroscopy 34(4):1054–1059CrossRef
9.
Zurück zum Zitat Corona K, Ronga M, Morris B et al (2020) Comparable clinical and functional outcomes after anterior cruciate ligament reconstruction over and under 40 years of age. Knee Surg Sports Traumatol Arthrosc 28(6):1932–1945CrossRef Corona K, Ronga M, Morris B et al (2020) Comparable clinical and functional outcomes after anterior cruciate ligament reconstruction over and under 40 years of age. Knee Surg Sports Traumatol Arthrosc 28(6):1932–1945CrossRef
10.
Zurück zum Zitat Shea KG, Carey JL (2015) Management of anterior cruciate ligament injuries: evidence-based guideline. J Am Acad Orthop Surg 23(5):e1–e5CrossRef Shea KG, Carey JL (2015) Management of anterior cruciate ligament injuries: evidence-based guideline. J Am Acad Orthop Surg 23(5):e1–e5CrossRef
11.
Zurück zum Zitat Gupta RK, Aggarwal S, Aggarwal V, Garg SK, Kumar S (2010) Preserved insertions of the semitendinosus and gracilis tendons (STG) in ACL reconstruction: a new surgical technique with preliminary results. Curr Orthop Pract 21(4):409–414CrossRef Gupta RK, Aggarwal S, Aggarwal V, Garg SK, Kumar S (2010) Preserved insertions of the semitendinosus and gracilis tendons (STG) in ACL reconstruction: a new surgical technique with preliminary results. Curr Orthop Pract 21(4):409–414CrossRef
12.
Zurück zum Zitat Antosh IJ, Svoboda SJ, Peck KY, Garcia ESJ, Cameron KL (2018) Change in KOOS and WOMAC scores in a young athletic population with and without anterior cruciate ligament injury. Am J Sports Med 46(7):1606–1616CrossRef Antosh IJ, Svoboda SJ, Peck KY, Garcia ESJ, Cameron KL (2018) Change in KOOS and WOMAC scores in a young athletic population with and without anterior cruciate ligament injury. Am J Sports Med 46(7):1606–1616CrossRef
13.
Zurück zum Zitat Bohnsack M, Rühmann O, Lück K, Wirth C (2002) The influence of age on the outcome of anterior cruciate ligament reconstruction. Z Orthop Ihre Grenzgeb 140(2):194–198CrossRef Bohnsack M, Rühmann O, Lück K, Wirth C (2002) The influence of age on the outcome of anterior cruciate ligament reconstruction. Z Orthop Ihre Grenzgeb 140(2):194–198CrossRef
14.
Zurück zum Zitat Fabio C, Ludovico C, Andrea F, Raffaele I, Carolina C, Antonio P (2013) Knee stability after anterior cruciate ligament reconstruction in patients older than forty years: comparison between different age groups. Int orthop 37(11):2265–2269CrossRef Fabio C, Ludovico C, Andrea F, Raffaele I, Carolina C, Antonio P (2013) Knee stability after anterior cruciate ligament reconstruction in patients older than forty years: comparison between different age groups. Int orthop 37(11):2265–2269CrossRef
15.
Zurück zum Zitat Desai N, Björnsson H, Samuelsson K, Karlsson J, Forssblad M (2014) Outcomes after ACL reconstruction with focus on older patients: results from The Swedish National Anterior Cruciate Ligament Register. Knee Surg Sports Traumatol Arthrosc 22(2):379–386CrossRef Desai N, Björnsson H, Samuelsson K, Karlsson J, Forssblad M (2014) Outcomes after ACL reconstruction with focus on older patients: results from The Swedish National Anterior Cruciate Ligament Register. Knee Surg Sports Traumatol Arthrosc 22(2):379–386CrossRef
16.
Zurück zum Zitat Kim DK, Park G, Kuo L-T, Park WH (2019) 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 27(1):230–238CrossRef Kim DK, Park G, Kuo L-T, Park WH (2019) 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 27(1):230–238CrossRef
17.
Zurück zum Zitat Damborg F, Nissen N, Kuur E (2002) Reconstruction of the anterior cruciate ligament in patients over 40 years of age. Ugeskr Laeger 164(9):1217–1220PubMed Damborg F, Nissen N, Kuur E (2002) Reconstruction of the anterior cruciate ligament in patients over 40 years of age. Ugeskr Laeger 164(9):1217–1220PubMed
18.
Zurück zum Zitat Legnani C, Terzaghi C, Borgo E, Ventura A (2011) Management of anterior cruciate ligament rupture in patients aged 40 years and older. J Orthop Traumatol 12(4):177–184CrossRef Legnani C, Terzaghi C, Borgo E, Ventura A (2011) Management of anterior cruciate ligament rupture in patients aged 40 years and older. J Orthop Traumatol 12(4):177–184CrossRef
19.
Zurück zum Zitat Noyes FR, Barber-Westin SD (1997) Anterior cruciate ligament reconstruction with autogenous patellar tendon graft in patients with articular cartilage damage. Am J Sports Med 25(5):626–634CrossRef Noyes FR, Barber-Westin SD (1997) Anterior cruciate ligament reconstruction with autogenous patellar tendon graft in patients with articular cartilage damage. Am J Sports Med 25(5):626–634CrossRef
20.
Zurück zum Zitat Shelbourne KD, Wilckens JH (1993) Intraarticular anterior cruciate ligament reconstruction in the symptomatic arthritic knee. Am J Sports Med 21(5):685–689CrossRef Shelbourne KD, Wilckens JH (1993) Intraarticular anterior cruciate ligament reconstruction in the symptomatic arthritic knee. Am J Sports Med 21(5):685–689CrossRef
21.
Zurück zum Zitat Hjermundrud V, Bjune TK, Risberg MA, Engebretsen L, Årøen A (2010) Full-thickness cartilage lesion do not affect knee function in patients with ACL injury. Knee Surg Sports Traumatol Arthrosc 18(3):298–303CrossRef Hjermundrud V, Bjune TK, Risberg MA, Engebretsen L, Årøen A (2010) Full-thickness cartilage lesion do not affect knee function in patients with ACL injury. Knee Surg Sports Traumatol Arthrosc 18(3):298–303CrossRef
22.
Zurück zum Zitat Blyth MJ, Gosal HS, Peake WM, Bartlett RJ (2003) Anterior cruciate ligament reconstruction in patients over the age of 50 years: 2-to 8-year follow-up. Knee Surg Sports Traumatol Arthrosc 11(4):204–211CrossRef Blyth MJ, Gosal HS, Peake WM, Bartlett RJ (2003) Anterior cruciate ligament reconstruction in patients over the age of 50 years: 2-to 8-year follow-up. Knee Surg Sports Traumatol Arthrosc 11(4):204–211CrossRef
23.
Zurück zum Zitat Dahm D, Wulf C, Dajani K, Dobbs R, Levy B, Stuart M (2008) Reconstruction of the anterior cruciate ligament in patients over 50 years. JBJS 90(11):1446–1450 Dahm D, Wulf C, Dajani K, Dobbs R, Levy B, Stuart M (2008) Reconstruction of the anterior cruciate ligament in patients over 50 years. JBJS 90(11):1446–1450
24.
Zurück zum Zitat Trojani C, Sané J-C, Coste J-S, Boileau P (2009) Four-strand hamstring tendon autograft for ACL reconstruction in patients aged 50 years or older. Orthop Traumatol Surg Res 95(1):22–27CrossRef Trojani C, Sané J-C, Coste J-S, Boileau P (2009) Four-strand hamstring tendon autograft for ACL reconstruction in patients aged 50 years or older. Orthop Traumatol Surg Res 95(1):22–27CrossRef
25.
Zurück zum Zitat Iorio R, Iannotti F, Ponzo A et al (2018) Anterior cruciate ligament reconstruction in patients older than fifty years: a comparison with a younger age group. Int Orthop 42(5):1043–1049CrossRef Iorio R, Iannotti F, Ponzo A et al (2018) Anterior cruciate ligament reconstruction in patients older than fifty years: a comparison with a younger age group. Int Orthop 42(5):1043–1049CrossRef
26.
Zurück zum Zitat Weng C-J, Yeh W-L, Hsu K-Y et al (2020) Clinical and functional outcomes of anterior cruciate ligament reconstruction with autologous hamstring tendon in patients aged 50 years or older. Arthroscopy 36(2):558–562CrossRef Weng C-J, Yeh W-L, Hsu K-Y et al (2020) Clinical and functional outcomes of anterior cruciate ligament reconstruction with autologous hamstring tendon in patients aged 50 years or older. Arthroscopy 36(2):558–562CrossRef
27.
Zurück zum Zitat Costa GG, Grassi A, Perelli S et al (2019) Age over 50 years is not a contraindication for anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 27(11):3679–3691CrossRef Costa GG, Grassi A, Perelli S et al (2019) Age over 50 years is not a contraindication for anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 27(11):3679–3691CrossRef
28.
Zurück zum Zitat Panisset J-C, Gonzalez J-F, de Lavigne C et al (2019) ACL reconstruction in over-50 year-olds: comparative study between prospective series of over-50 year-old and under-40 year-old patients. Orthop Traumatol Surg Res 105(8):S259–S265CrossRef Panisset J-C, Gonzalez J-F, de Lavigne C et al (2019) ACL reconstruction in over-50 year-olds: comparative study between prospective series of over-50 year-old and under-40 year-old patients. Orthop Traumatol Surg Res 105(8):S259–S265CrossRef
29.
Zurück zum Zitat Vaishya R, Dhiman RS, Vaish A (2014) Anterior cruciate ligament reconstruction in a 75 years old man: a case report with review of literature. Chin J Traumatol 17(2):121–124PubMed Vaishya R, Dhiman RS, Vaish A (2014) Anterior cruciate ligament reconstruction in a 75 years old man: a case report with review of literature. Chin J Traumatol 17(2):121–124PubMed
30.
Zurück zum Zitat Toanen C, Demey G, Ntagiopoulos PG, Ferrua P, Dejour D (2017) Is there any benefit in anterior cruciate ligament reconstruction in patients older than 60 years? Am J Sports Med 45(4):832–837CrossRef Toanen C, Demey G, Ntagiopoulos PG, Ferrua P, Dejour D (2017) Is there any benefit in anterior cruciate ligament reconstruction in patients older than 60 years? Am J Sports Med 45(4):832–837CrossRef
31.
Zurück zum Zitat Ciccotti MG, Lombardo SJ, Nonweiler B, Pink M (1994) Non-operative treatment of ruptures of the anterior cruciate ligament in middle-aged patients. Results after long-term follow-up. JBJS 76(9):1315–1321CrossRef Ciccotti MG, Lombardo SJ, Nonweiler B, Pink M (1994) Non-operative treatment of ruptures of the anterior cruciate ligament in middle-aged patients. Results after long-term follow-up. JBJS 76(9):1315–1321CrossRef
32.
Zurück zum Zitat Mall NA, Frank RM, Saltzman BM, Cole BJ, Bach BR Jr (2016) 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 8(2):177–181CrossRef Mall NA, Frank RM, Saltzman BM, Cole BJ, Bach BR Jr (2016) 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 8(2):177–181CrossRef
33.
Zurück zum Zitat Wierer G, Runer A, Hoser C, Herbst E, Gföller P, Fink C (2017) Acute ACL reconstruction in patients over 40 years of age. Knee Surg Sports Traumatol Arthrosc 25(5):1528–1534CrossRef Wierer G, Runer A, Hoser C, Herbst E, Gföller P, Fink C (2017) Acute ACL reconstruction in patients over 40 years of age. Knee Surg Sports Traumatol Arthrosc 25(5):1528–1534CrossRef
34.
Zurück zum Zitat Karpinski K, Mueller-Rath R, Niemeyer P, Angele P, Petersen W (2019) Subgroups of patients with osteoarthritis and medial meniscus tear or crystal arthropathy benefit from arthroscopic treatment. Knee Surg Sports Traumatol Arthrosc 27(3):782–796CrossRef Karpinski K, Mueller-Rath R, Niemeyer P, Angele P, Petersen W (2019) Subgroups of patients with osteoarthritis and medial meniscus tear or crystal arthropathy benefit from arthroscopic treatment. Knee Surg Sports Traumatol Arthrosc 27(3):782–796CrossRef
35.
Zurück zum Zitat Fitzgerald GK, Axe MJ, Snyder-Mackler L (2000) A decision-making scheme for returning patients to high-level activity with nonoperative treatment after anterior cruciate ligament rupture. Knee Surg Sports Traumatol Arthrosc 8(2):76–82CrossRef Fitzgerald GK, Axe MJ, Snyder-Mackler L (2000) A decision-making scheme for returning patients to high-level activity with nonoperative treatment after anterior cruciate ligament rupture. Knee Surg Sports Traumatol Arthrosc 8(2):76–82CrossRef
36.
Zurück zum Zitat Louboutin H, Debarge R, Richou J et al (2009) Osteoarthritis in patients with anterior cruciate ligament rupture: a review of risk factors. Knee 16(4):239–244CrossRef Louboutin H, Debarge R, Richou J et al (2009) Osteoarthritis in patients with anterior cruciate ligament rupture: a review of risk factors. Knee 16(4):239–244CrossRef
37.
Zurück zum Zitat Tsoukas D, Fotopoulos V, Basdekis G, Makridis KG (2016) No difference in osteoarthritis after surgical and non-surgical treatment of ACL-injured knees after 10 years. Knee Surg Sports Traumatol Arthrosc 24(9):2953–2959CrossRef Tsoukas D, Fotopoulos V, Basdekis G, Makridis KG (2016) No difference in osteoarthritis after surgical and non-surgical treatment of ACL-injured knees after 10 years. Knee Surg Sports Traumatol Arthrosc 24(9):2953–2959CrossRef
38.
Zurück zum Zitat Paschos NK (2017) Anterior cruciate ligament reconstruction and knee osteoarthritis. World J Orthop 8(3):212CrossRef Paschos NK (2017) Anterior cruciate ligament reconstruction and knee osteoarthritis. World J Orthop 8(3):212CrossRef
Metadaten
Titel
Good functional outcomes in patient’s age > 40 years after anterior cruciate ligament reconstruction with hamstring tendon graft: a retrospective study
verfasst von
Ravi Gupta
Anil Kapoor
Akash Singhal
Bharath Mali Patil
Manharjot Malhi
Gladson David Masih
Publikationsdatum
04.05.2021
Verlag
Springer Milan
Erschienen in
Sport Sciences for Health / Ausgabe 4/2021
Print ISSN: 1824-7490
Elektronische ISSN: 1825-1234
DOI
https://doi.org/10.1007/s11332-021-00754-7

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