title: An analysis of anterior cruciate ligament reconstruction in middle-aged patients.
abstract: The purpose of this study was to evaluate the results and complications of anterior cruciate ligament surgery in middle-aged patients. Forty-five consecutive patients over 40 years old (average age, 44.6 years) who had arthroscopically assisted anterior cruciate ligament reconstructions with midthird patellar tendon autografts were evaluated. The patients returned for interviews, physical examinations, radiographs, Biodex dynamometer strength testing, and KT-1000 arthrometer testing at an average of 37 months after their surgeries (range, 24 to 96 months). The mean Lysholm and Gillquist score was 91, which corresponds to symptoms only with vigorous activity. The overall scores from the International Knee Documentation Committee form were 29 (64%) normal or nearly normal and 2 (4%) severely abnormal. Side-to-side differences as determined by the KT-1000 arthrometer were < or = 3 mm in 31 of 40 patients (78%), between 3 and 5 mm in 4 patients (10%), and > 5 mm in 5 patients at 30 pounds of anterior displacement. Seventy-six percent of the patients (N = 34) returned to their preoperative activity levels. Three patients required repeat arthroscopic surgery for persistent knee pain and two patients had graft ruptures. This study shows that when middle-aged patients undergo surgery, their results can be successful and satisfying to a degree similar to those of younger patients.
authors.affiliation: Baylor College of Medicine, Department of Orthopedics, Houston, Texas 77030, USA.
authors.forename: K A
authors.initials: KA
authors.lastname: Heier
authors.forename: D R
authors.initials: DR
authors.lastname: Mack
authors.forename: J B
authors.initials: JB
authors.lastname: Moseley
authors.forename: R
authors.initials: R
authors.lastname: Paine
authors.forename: J R
authors.initials: JR
authors.lastname: Bocell
mesh_terms: D000328:Adult; D000367:Age Factors; D016118:Anterior Cruciate Ligament / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D018771:Arthralgia / Q000209:etiology / Q000601:surgery; D001182:Arthroscopy / Q000009:adverse effects; D001265:Athletic Injuries / Q000601:surgery; D004724:Endoscopy / Q000009:adverse effects; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007407:Interviews as Topic; D007593:Joint Instability / Q000601:surgery; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction; D017847:Patellar Ligament / Q000637:transplantation; D010808:Physical Examination; D011183:Postoperative Complications; D011859:Radiography; D016059:Range of Motion, Articular; D012086:Reoperation; D012189:Retrospective Studies; D012421:Rupture; D014182:Transplantation, Autologous; D016896:Treatment Outcome