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Acute ACL reconstruction in patients over 40 years of age

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose of this study is to compare the clinical outcome of ACL reconstructions in patients older than 40 years of age to younger subjects. It has been hypothesized that patients older than 40 years of age achieve comparable clinical outcomes following acute ACL reconstruction using a hamstring tendon autograft than younger patients.

Methods

Patients with an isolated ACL tear without any concomitant injuries and subsequent ACL reconstruction within 48 h from injury were included in this prospective study. According to patients’ age, subjects were assigned to two groups: (A) 18–40 years and (B) 40–60 years. Functional outcomes, pain, post-operative radiographs and return to sports were recorded and analysed. The follow-up period was 24 months.

Results

A total of 59 patients were included in the study. Group A consisted of 39 patients (14 women, 25 men; median 27 years), group B of 20 patients (12 women, 8 men; median 45 years) respectively. At final follow-up, the Lysholm score showed no significant difference between group A (median 90; range 68–100) and group B (median 94.5; range 63–100) (n.s.). The final Tegner score showed a significant difference between group A (median 6; range 2–9) and group B (median 5.5; range 3–8) (p < 0.05). The mean VAS pain score was 1.3 (range 0–6) in group A and 1 (range 0–7) in group B, respectively (n.s.). Both groups returned to their pre-injury activity level and did not significantly change their activity in respect of pivoting sports and sports frequency at final follow-up (n.s.). According to the IKDC score, all except one of the patients in group A and all patients in group B had a normal or nearly normal final outcome (n.s.).

Conclusion

Patients older than 40 years of age achieve comparable clinical outcomes following acute ACL reconstruction using a hamstring tendon autograft than younger patients.

Level of evidence

Cohort study, Level III.

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Author information

Authors and Affiliations

  1. Department of Traumatology and Sports Injuries, Paracelsus Medical University Salzburg, Muellner Hauptstrasse 48, 5020, Salzburg, Austria

    Guido Wierer

  2. Gelenkpunkt - Center for Sports and Joint Surgery, Olympiastraße 39, 6020, Innsbruck, Austria

    Armin Runer, Christian Hoser, Peter Gföller & Christian Fink

  3. Department of Orthopaedic Sports Medicine, Klinikum rechts der Isar, TU Munich, Ismaninger Str. 22, 81675, Munich, Germany

    Elmar Herbst

  4. Research Unit for OSMI, UMIT/ISAG, Eduard-Wallnöfer-Zentrum 1, 6060, Hall in Tirol, Austria

    Christian Fink

Authors
  1. Guido Wierer
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  2. Armin Runer
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  3. Christian Hoser
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  4. Elmar Herbst
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  5. Peter Gföller
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  6. Christian Fink
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Corresponding author

Correspondence to Peter Gföller.

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Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Funding:

Research was supported by a research grant from OSMI (Research unit for orthopedic sports medicine and injury prevention), Private university UMIT Hall Austria. The authors report the following potential conflict of interest or source of funding: Christian Fink receives support from Karl Storz and Medacta.

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Informed consent was obtained from all individual participants included in the study.

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Wierer, G., Runer, A., Hoser, C. et al. Acute ACL reconstruction in patients over 40 years of age. Knee Surg Sports Traumatol Arthrosc 25, 1528–1534 (2017). https://doi.org/10.1007/s00167-016-4363-z

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  • DOI: https://doi.org/10.1007/s00167-016-4363-z

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