Guido Wierer1, Armin Runer2, Christian Hoser2, Elmar Herbst3, Peter Gföller4, Christian Fink2,5. 1. Department of Traumatology and Sports Injuries, Paracelsus Medical University Salzburg, Muellner Hauptstrasse 48, 5020, Salzburg, Austria. 2. Gelenkpunkt - Center for Sports and Joint Surgery, Olympiastraße 39, 6020, Innsbruck, Austria. 3. Department of Orthopaedic Sports Medicine, Klinikum rechts der Isar, TU Munich, Ismaninger Str. 22, 81675, Munich, Germany. 4. Gelenkpunkt - Center for Sports and Joint Surgery, Olympiastraße 39, 6020, Innsbruck, Austria. p.gfoeller@gelenkpunkt.com. 5. Research Unit for OSMI, UMIT/ISAG, Eduard-Wallnöfer-Zentrum 1, 6060, Hall in Tirol, Austria.
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.
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.
Entities:
Keywords:
ACL; Acute anterior cruciate ligament reconstruction; Hamstring graft; Middle age; Over 40 years
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