title: Autologous hamstring anterior cruciate ligament reconstruction in patients older than 40.
abstract: The primary objective in this retrospective review was to assess the patient-specific outcomes and clinical utility of anterior cruciate ligament (ACL) reconstruction using the autologous quadruple-band hamstring technique in patients older than 40. Study results agree with the recent literature and demonstrate the effectiveness of an alternative to the bone-patellar tendon-bone (BPB) technique-an alternative with potentially decreased postoperative morbidity. Results also support the recent conclusion that age alone should not be a limiting factor in whether ACL reconstruction should be performed. We found that appropriately selected patients may experience significant improvements in stability, function, and pain after ACL reconstruction with the quadruple-band hamstring autograft technique. For outcomes after ACL reconstruction, there seems to be no significant difference between the sexes or between patients with and without associated injuries in this population. This study also supports use of the autologous hamstring technique as a viable option for older patients-with results similar to those of the BPB technique. The autologous hamstring technique was associated with excellent patient satisfaction and excellent functional outcome with limited postoperative morbidity. This technique may become the preferred approach for the older athlete, given its limited morbidity and equivalent clinical stability.
authors.affiliation: Department of Orthopaedics and Rehabilitation, Walter Reed Army Medical Center, Washington, DC, USA.
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Javernick
authors.forename: Benjamin K
authors.initials: BK
authors.lastname: Potter
authors.forename: Andrew
authors.initials: A
authors.lastname: Mack
authors.forename: Kenneth B
authors.initials: KB
authors.lastname: Dekay
authors.forename: Kevin P
authors.initials: KP
authors.lastname: Murphy
mesh_terms: D000328:Adult; D000367:Age Factors; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012737:Sex Factors; D013710:Tendons / Q000637:transplantation*; D014182:Transplantation, Autologous; D016896:Treatment Outcome