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Patients older than 55 years regain sporting and recreational activities after arthroscopic anterior cruciate ligament reconstruction

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

Abstract

Purpose

(1) To compare sporting and recreational activity levels before and at a minimum 6 year follow-up, and (2) to assess the clinical and functional outcomes after anterior cruciate ligament (ACL) reconstruction in patients older than 55 years.

Methods

A retrospective evaluation of prospectively collected data of 150 patients with a mean age of 64 ± 4.5 (57–74) years was evaluated 8.6 ± 1.4 (6–11) years after primary ACL reconstruction using hamstring autograft. All patients were assessed using the International Knee Documentation Committee scoring system (IKDC), Knee injury and Osteoarthritis Outcome Score (KOOS), Tegner activity level, and visual analog scale (VAS) for pain. The level of recreational activities was assessed using a sport-specific questionnaire. All patients were categorized according to Isolated and Combined ACL injury groups.

Results

The data of 125 patients were analyzed at the last follow-up. While 25 patients were lost to follow-up, 117 of 125 patients were active before their injury in at least one sports discipline compared to 121 of 125 patients after ACL reconstruction. One hundred and two (82%) patients had returned to their recreational activities at the final follow-up. The mean IKDC subjective score increased from 49.5 ± 23.2 (11.5–100) to 76.2 ± 14.8 (33.3–100) (p < 0.0001). The mean KOOS sport increased significantly from 36 ± 36.2 (0–100) to 74.1 ± 25.5 (0–100) (p < 0.0001). The mean VAS score improved from 6.0 ± 2.6 (0–10) to 1.0 ± 1.4 (0–6) (p < 0.0001). There was no significant difference in the median Tegner activity level (preoperative 5 (2–8) vs. follow-up 5 (2–8) (n.s). There was no significant difference in the number of sports disciplines and duration when comparing pre-injury and mid-term follow-up activity after ACL reconstruction. High-impact activities experienced a significant decline, while a significant increase in participation in low-impact activities was recorded.

Conclusion

The majority of patients with symptomatic instability regained their pre-injury recreational activity level with excellent clinical and functional outcomes after arthroscopic ACL reconstruction. Nevertheless, a change from high-to low-impact activities has been observed.

Level of evidence

Level IV.

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Authors and Affiliations

  1. ARCUS Kliniken, Rastatterstr 17-19, 75179, Pforzheim, Germany

    Philips Ogunleye, Hannah Jäger, Felix Zimmermann, Peter Balcarek, Christian Sobau, Andree Ellermann & Alexander Zimmerer

  2. Center for Orthopaedics, Trauma Surgery and Rehabilitation Medicine, University Medicine, Greifswald, Germany

    Alexander Zimmerer

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  1. Philips Ogunleye
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Contributions

PO and HJ carried out data collection. AZ and FZ participated in the design of the study and performed the statistical analysis. PB, CS and AE conceived the study, and helped to draft the manuscript. All authors read and approved the manuscript.

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Correspondence to Alexander Zimmerer.

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F-2020-117, Ethics Committee Landesärztekammer Baden-Würtemberg, Germany.

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Ogunleye, P., Jäger, H., Zimmermann, F. et al. Patients older than 55 years regain sporting and recreational activities after arthroscopic anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 31, 632–640 (2023). https://doi.org/10.1007/s00167-022-07116-x

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