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Graft choice or drilling technique does not influence outcomes of ACL reconstruction in patients over forty-five

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate whether graft-type and tunnel location in ACL reconstruction impact patient-reported outcomes in individuals over the age of 45.

Methods

From 2015 to 2018, patients over 45 years old undergoing primary ACL reconstruction without multi-ligamentous injuries were enrolled in an institutional registry. Baseline International Knee Documentation Committee (IKDC) subjective scores, Knee Injury and Osteoarthritis Outcome Scores (KOOS), Marx Activity Scale, and patient characteristics were collected. Follow-up occurred at a minimum of two years to obtain patient-reported outcomes.

Results

Of the 51 patients who qualified for the study, 44 (86.3%) patients were available at a minimum of two years after surgery date (range 24–60 months). Average age at time of surgery of the available patients was 51.6 ± 4.87 (range 45–66). Between femoral tunnel drilling methods, there were no differences in the proportion of patients achieving clinically significant improvement or post-operative outcome scores. While patients who received patellar tendon autografts were more likely to achieve clinically significant improvement in the KOOS sports subscale, there were no other differences in outcomes measures between graft types. Two patients had a retear of their graft, and an additional five patients complained of subjective instability.

Conclusions

In patients over the age of 45, neither the method used to create the femoral tunnel nor the graft type used in ACL reconstruction caused a significant difference in post-operative PROMs with a minimum of two years of follow-up.

Level of Evidence

Therapeutic IV, Case Series.

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Funding

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript. The authors have no financial or proprietary interests in any material discussed in this article.

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Authors and Affiliations

  1. Department of Orthopaedics and Sports Medicine, University of Cincinnati Medical Center, Ohio 231 Albert Sabin Way Cincinnati, Cincinnati, OH, 45267-0212, USA

    Nihar S. Shah, Blake M. Bacevich, Rachel M. Boxer, Ramsey S. Sabbagh, Kimberly A. Hasselfeld, Christopher J. Utz, Barton R. Branam, Angelo J. Colosimo & Brian M. Grawe

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  1. Nihar S. Shah
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  2. Blake M. Bacevich
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  3. Rachel M. Boxer
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  4. Ramsey S. Sabbagh
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  6. Christopher J. Utz
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Contributions

NSS performed data analysis, drafted this manuscript, and provided final approval. BMB performed data collection, revised this manuscript, and provided final approval. RMB revised this manuscript and provided final approval. RSS performed data collection, revised this manuscript, and provided final approval. KAH performed data collection, revised this manuscript, and provided final approval. CJU substantially contributed to conception and design, revised the manuscript, and provided final approval. BRB substantially contributed to conception and design, revised the manuscript, and provided final approval. AJC substantially contributed to conception and design, revised the manuscript, and provided final approval. BMG designed this project, revised the manuscript, assisted with drafting, and provided final approval.

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Correspondence to Nihar S. Shah.

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Shah, N.S., Bacevich, B.M., Boxer, R.M. et al. Graft choice or drilling technique does not influence outcomes of ACL reconstruction in patients over forty-five. Eur J Orthop Surg Traumatol 32, 1609–1616 (2022). https://doi.org/10.1007/s00590-021-03139-1

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  • DOI: https://doi.org/10.1007/s00590-021-03139-1

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