Outcomes of Anterior Cruciate Ligament Reconstruction in Patients Older Than 50 Years and Younger Than 30 Years

Chun-Jui Weng; Cheng-Pang Yang; Wen-Ling Yeh; Kuo-Yao Hsu; Shih-Sheng Chang; Chih-Hao Chiu; Alvin Chao-Yu Chen; Yi-Sheng Chan

doi:10.1177/23259671221094788

Outcomes of Anterior Cruciate Ligament Reconstruction in Patients Older Than 50 Years and Younger Than 30 Years

Orthop J Sports Med. 2022 May 12;10(5):23259671221094788. doi: 10.1177/23259671221094788. eCollection 2022 May.

Authors

Chun-Jui Weng^{1

2

3}, Cheng-Pang Yang^{1

2

3}, Wen-Ling Yeh^{1

2

3}, Kuo-Yao Hsu^{1

2

3}, Shih-Sheng Chang^{1

2

3}, Chih-Hao Chiu^{1

2

3}, Alvin Chao-Yu Chen^{1

2

3}, Yi-Sheng Chan^{1

2

3}

Affiliations

¹ Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Taoyuan.
² Comprehensive Sports Medicine Center, Chang Gung Memorial Hospital, Taoyuan.
³ Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou.

Abstract

Background: Few studies have compared the outcomes of anterior cruciate ligament (ACL) reconstruction between older patients and younger patients.

Purpose: To evaluate the clinical and functional outcomes of ACL reconstruction with autologous hamstring tendon in patients >50 years and <30 years. It was hypothesized that the outcomes would be comparable between these age groups.

Study design: Cohort study; Level of evidence, 3.

Methods: Patients >50 years (older group) or <30 years (younger group) who underwent ACL reconstruction surgery with autologous hamstring tendon between 2012 and 2015 at the authors' hospital were retrospectively enrolled in this study. All patients had a minimum of 2 years of follow-up. Intraoperative findings, including cartilage and meniscal injury, were recorded, and clinical and functional outcomes were evaluated using the International Knee Documentation Committee (IKDC), Lysholm, and Tegner activity scores. We used the paired-samples t test for statistical analysis between the 2 age groups.

Results: A total of 67 patients and 459 patients were included in the older and younger groups, respectively. Both groups achieved significant preoperative to postoperative improvement in IKDC (older group, from 41.4 to 88.9; younger group, from 49 to 91.2), Lysholm (older group, from 49.8 to 86.1; younger group, from 50.2 to 91.8), and Tegner (older group, from 2.7 to 4.4; younger group, from 4.6 to 6.9) (P < .05 for all) scores. The change in Tegner score from preinjury to postoperatively was not statistically significant in the older group (from 4.5 to 4.4; P = .471), although it was significant in the younger group (from 7.5 to 6.9; P < .05). No between-group differences were noted in preoperative or postoperative IKDC or Lysholm scores. Both age groups reached a high rate of return to sports activity, and no major complications or ACL retears were noted in either group.

Conclusion: Comparable results after ACL reconstruction were achieved in patients >50 years compared with patients <30 years, with a high rate of return to sports activity and a low rate of complications at the 2-year follow-up. The younger group returned to a higher Tegner score, while the older group did not.

Keywords: ACL; ACL reconstruction; anterior cruciate ligament; older patients.