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Erschienen in:

27.04.2024 | Original Article

Impact of age on clinical outcomes in anterior cruciate ligament reconstruction

verfasst von: Michelle Rogger, Oday Al-Dadah

Erschienen in: European Journal of Orthopaedic Surgery & Traumatology | Ausgabe 5/2024

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Abstract

Background

Anterior cruciate ligament reconstruction (ACLR) is a common procedure for symptomatic ACL injuries. Age is often factored into clinical decision making and can influence the choice of conservative management over surgical intervention. The aim of this study was to investigate the effect of chronological age on the clinical outcome following ACLR.

Method

Six validated patient-reported outcome measures (PROM) were used to collect pre-operative and post-operative scores from patients with ACL rupture undergoing ACLR. Data were stratified pertaining to the patient’s age at the time of surgery to compare the Younger Group (under 40 years) with the Older Group (over 40 years).

Results

A total of 45 patients were included in this study. Pre-operatively the Younger Group (n = 32) had significantly better Lysholm (p = 0.016), Tegner (p = 0.001), Knee Injury and Osteoarthritis Outcome Score (KOOS) Activities of Daily Living (ADL) sub-score (p = 0.003) and International Knee Documentation Committee (IKDC) score (p = 0.014) as compared to the Older Group (n = 13). Post-operatively, there was no significant difference (p > 0.05) between the two groups as all the PROM scores were comparable except for the Tegner score (p = 0.02), where younger patients had higher activity levels. Significant inverse correlations were only found between age and Tegner score (rho = − 0.58, p < 0.001) and KOOS Sport and Recreation sub-score (rho = − 0.33, p = 0.038).

Conclusion

ACLR is a clinically successful treatment strategy for patients of all ages. Thus, age should not be used in isolation to determine patient suitability.
Literatur
1.
Zurück zum Zitat Abram SGF, Price AJ, Judge A, Beard DJ (2020) Anterior cruciate ligament (ACL) reconstruction and meniscal repair rates have both increased in the past 20 years in England: hospital statistics from 1997 to 2017. Br J Sports Med 54(5):286–291CrossRefPubMed Abram SGF, Price AJ, Judge A, Beard DJ (2020) Anterior cruciate ligament (ACL) reconstruction and meniscal repair rates have both increased in the past 20 years in England: hospital statistics from 1997 to 2017. Br J Sports Med 54(5):286–291CrossRefPubMed
2.
Zurück zum Zitat Cinque ME, Chahla J, Moatshe G, DePhillipo NN, Kennedy NI, Godin JA et al (2017) Outcomes and complication rates after primary anterior cruciate ligament reconstruction are similar in younger and older patients. Orthop J Sports Med 5(10):2325967117729659CrossRefPubMedPubMedCentral Cinque ME, Chahla J, Moatshe G, DePhillipo NN, Kennedy NI, Godin JA et al (2017) Outcomes and complication rates after primary anterior cruciate ligament reconstruction are similar in younger and older patients. Orthop J Sports Med 5(10):2325967117729659CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat Kim DK, Park G, Kuo LT, 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):230–238CrossRefPubMed Kim DK, Park G, Kuo LT, 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):230–238CrossRefPubMed
4.
Zurück zum Zitat Kim KT, Kim HJ, Lee HI, Park YJ, Kang DG, Yoo JI et al (2018) A comparison of results after anterior cruciate ligament reconstruction in over 40 and under 40 years of age: a meta- analysis. Knee Surg Relat Res 30(2):95–106CrossRefPubMedPubMedCentral Kim KT, Kim HJ, Lee HI, Park YJ, Kang DG, Yoo JI et al (2018) A comparison of results after anterior cruciate ligament reconstruction in over 40 and under 40 years of age: a meta- analysis. Knee Surg Relat Res 30(2):95–106CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat Brown CA, McAdams TR, Harris AH, 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):2181–2190CrossRefPubMed Brown CA, McAdams TR, Harris AH, 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):2181–2190CrossRefPubMed
6.
Zurück zum Zitat Corona K, Ronga M, Morris BJ, Tamini J, Zappala G, Cherubino M 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):1932–1945CrossRefPubMed Corona K, Ronga M, Morris BJ, Tamini J, Zappala G, Cherubino M 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):1932–1945CrossRefPubMed
7.
Zurück zum Zitat Corona K, Cerciello S, Vasso M et al (2022) Age over 50 does not predict results in anterior cruciate ligament reconstruction. Orthop Rev 14(5):37310CrossRef Corona K, Cerciello S, Vasso M et al (2022) Age over 50 does not predict results in anterior cruciate ligament reconstruction. Orthop Rev 14(5):37310CrossRef
8.
Zurück zum Zitat Magnitskaya N, Mouton C, Gokeler A, Nuehrenboerger C, Pape D, Seil R (2020) Younger age and hamstring tendon graft are associated with higher IKDC 2000 and KOOS scores during the first year after ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 28(3):823–832CrossRefPubMed Magnitskaya N, Mouton C, Gokeler A, Nuehrenboerger C, Pape D, Seil R (2020) Younger age and hamstring tendon graft are associated with higher IKDC 2000 and KOOS scores during the first year after ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 28(3):823–832CrossRefPubMed
9.
Zurück zum Zitat Cristiani R, Mikkelsen C, Edman G, Forssblad M, Engstrom B, Stalman A (2020) Age, gender, quadriceps strength and hop test performance are the most important factors affecting the achievement of a patient-acceptable symptom state after ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 28(2):369–380CrossRefPubMed Cristiani R, Mikkelsen C, Edman G, Forssblad M, Engstrom B, Stalman A (2020) Age, gender, quadriceps strength and hop test performance are the most important factors affecting the achievement of a patient-acceptable symptom state after ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 28(2):369–380CrossRefPubMed
10.
Zurück zum Zitat Weng C-J, Yang C-P, Yeh W-L, Hsu K-Y, Chang S-S, Chiu C et al (2022) Outcomes of anterior cruciate ligament reconstruction in patients older than 50 years and younger than 30 years. Orthop J Sports Med 10(5):232596712210947CrossRef Weng C-J, Yang C-P, Yeh W-L, Hsu K-Y, Chang S-S, Chiu C et al (2022) Outcomes of anterior cruciate ligament reconstruction in patients older than 50 years and younger than 30 years. Orthop J Sports Med 10(5):232596712210947CrossRef
11.
12.
Zurück zum Zitat Roos EM, Lohmander LS (2003) The knee injury and osteoarthritis outcome score (KOOS): from joint injury to osteoarthritis. Health Qual Life Outcomes 1:64CrossRefPubMedPubMedCentral Roos EM, Lohmander LS (2003) The knee injury and osteoarthritis outcome score (KOOS): from joint injury to osteoarthritis. Health Qual Life Outcomes 1:64CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat Irrgang JJ, Anderson AF (2002) Development and validation of health-related quality of life measures for the knee. Clin Orthop Relat Res 402:95–109CrossRef Irrgang JJ, Anderson AF (2002) Development and validation of health-related quality of life measures for the knee. Clin Orthop Relat Res 402:95–109CrossRef
14.
Zurück zum Zitat Irrgang JJ, Anderson AF, Boland AL, Harner CD, Kurosaka M, Neyret P et al (2001) Development and validation of the international knee documentation committee subjective knee form. Am J Sports Med 29(5):600–613CrossRefPubMed Irrgang JJ, Anderson AF, Boland AL, Harner CD, Kurosaka M, Neyret P et al (2001) Development and validation of the international knee documentation committee subjective knee form. Am J Sports Med 29(5):600–613CrossRefPubMed
15.
Zurück zum Zitat Tegner Y, Lysholm J (1985) Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res 198:43–49CrossRef Tegner Y, Lysholm J (1985) Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res 198:43–49CrossRef
16.
Zurück zum Zitat Ware J Jr, Kosinski M, Keller SD (1996) A 12-item short-form health survey: construction of scales and preliminary tests of reliability and validity. Med Care 34(3):220–233CrossRefPubMed Ware J Jr, Kosinski M, Keller SD (1996) A 12-item short-form health survey: construction of scales and preliminary tests of reliability and validity. Med Care 34(3):220–233CrossRefPubMed
18.
Zurück zum Zitat EuroQol Group (1990) EuroQol–a new facility for the measurement of health-related quality of life. Health Policy 16(3):199–208CrossRef EuroQol Group (1990) EuroQol–a new facility for the measurement of health-related quality of life. Health Policy 16(3):199–208CrossRef
19.
Zurück zum Zitat Greiner W, Weijnen T, Nieuwenhuizen M, Oppe S, Badia X, Busschbach J et al (2003) A single European currency for EQ-5D health states. Results from a six-country study. Eur J Health Econ 4(3):222–231CrossRefPubMed Greiner W, Weijnen T, Nieuwenhuizen M, Oppe S, Badia X, Busschbach J et al (2003) A single European currency for EQ-5D health states. Results from a six-country study. Eur J Health Econ 4(3):222–231CrossRefPubMed
Metadaten
Titel
Impact of age on clinical outcomes in anterior cruciate ligament reconstruction
verfasst von
Michelle Rogger
Oday Al-Dadah
Publikationsdatum
27.04.2024
Verlag
Springer Paris
Erschienen in
European Journal of Orthopaedic Surgery & Traumatology / Ausgabe 5/2024
Print ISSN: 1633-8065
Elektronische ISSN: 1432-1068
DOI
https://doi.org/10.1007/s00590-024-03923-9

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