Skip to main content
Log in

Anterior cruciate ligament reconstruction in patients over the age of 50 years: 2- to 8-year follow-up

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

We present medium-term results in 30 prospectively followed patients aged over 50 years at the time of ACL reconstruction (31 procedures); mean follow-up time was 46 months (range 24–95). Mean Lysholm score improved significantly from 63 pre-operatively to 93 at final review Cincinnati score from 49 to 89. In IKDC score 25 knees (81%) were considered normal or nearly normal and 6 abnormal; there were no severely abnormal results. Mean Tegner activity scores improved from pre-operatively from 3.7 to 5.2 at review. Mean side-to-side difference measured by the KT-1000 at maximal manual pressure was 2.7 mm; two knees had. a measured difference greater than 5 mm. The mean torque ratio for isokinetic flexion strength was 102% and for extension strength 94%. Poor results as determined by the three scoring systems were associated mainly with advanced articular degenerative changes (Outerbridge grade 3 or 4) seen at the time of reconstruction. Despite this all patients reported improvement in stability and overall function of the knee. Degenerative change itself was associated with increased time to surgery from injury. This study demonstrates that the ACL can be reliably reconstructed in patients over the age of 50 years with good symptomatic relief, restoration of function and return to sporting activity.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Anderson C, Odensten M, Gillquist J (1991) Knee function after surgical or non-surgical treatment of acute rupture of the anterior cruciate ligament: a randomized study with a long-term follow-up period. Clin Orthop 264:255–263

    PubMed  Google Scholar 

  2. Bach BR Jr, Warren RF, Wickiewicz TL (1988) The pivot shift phenomenon: results and description of a modified clinical test for anterior cruciate ligament insufficiency. Am J Sports Med 16:571–576

    PubMed  Google Scholar 

  3. Bach BR Jr, Warren RF, Flynn WM, et al (1990) Arthrometric evaluation of knees that have a torn anterior cruciate ligament. J Bone Joint Surg Am 72:1299–1306

    PubMed  Google Scholar 

  4. Bach BR Jr, Jones GT, Sweet FA, et al (1994) Arthroscopically-assisted anterior cruciate ligament reconstruction using patellar tendon substitution. Two- to four-year follow-up results. Am J Sports Med 22:758–767

    PubMed  Google Scholar 

  5. Barber SD, Noyes FR, Mangine RE, et al (1990) Quantitative assessment of functional limitations in normal and anterior cruciate ligament-deficient knees. Clin Orthop 255:204–214

    PubMed  Google Scholar 

  6. Barber FA, Burton FE, McGuire DA, et al (1996) Is anterior cruciate ligament reconstruction age dependent? Arthroscopy 12:720–725

    Google Scholar 

  7. Bonamo JJ, Fay C, Firestone T (1990) The conservative treatment of the anterior cruciate deficient knee. Am J Sports Med 18:618–623

    CAS  PubMed  Google Scholar 

  8. Brandsson S, Kartus J, Larsson J, et al (2000) A comparison of results in middle-aged and young patients after anterior cruciate ligament reconstruction. Arthroscopy 16:178–182

    CAS  PubMed  Google Scholar 

  9. Buss DD, Warren RF, Wickiewicz TL, et al (1993) Arthroscopically assisted reconstruction of the anterior cruciate ligament with the use of autogenous patellar-ligament grafts. Results after twenty-four to forty-two months. J Bone Joint Surg Am 75:1346–1355

    CAS  PubMed  Google Scholar 

  10. Buss DD, Min R, Skyhar M, et al (1995) Nonoperative treatment of acute anterior cruciate ligament injuries in a selected group of patients. Am J Sports Med 23:160–165

    CAS  PubMed  Google Scholar 

  11. Ciccotti MG, Lombardo SJ, Nonweiler B, et al (1994) Non-operative treatment of ruptures of the anterior cruciate ligament in middle-aged patients. J Bone Joint Surg Am 76:1315–1321

    CAS  PubMed  Google Scholar 

  12. Clancy WG (1985) Intra-articular reconstruction of the anterior cruciate ligament. Orthop Clin North Am 16:181–189

    PubMed  Google Scholar 

  13. Daniel DM, Malcom LL, Losse G, et al (1985) Instrumented measurement of anterior laxity of the knee. J Bone Joint Surg Am 67:720–726

    CAS  PubMed  Google Scholar 

  14. Daniel DM, Stone ML, Sachs R, et al (1985) Instrumented measurement of instrumented knee laxity in patients with acute anterior cruciate ligament disruption. Am J Sports Med 13:401–407

    CAS  PubMed  Google Scholar 

  15. Daniel DM, Stone ML, Dobson BE, et al (1994) Fate of the ACL-injured patient. A prospective outcome study. Am J Sports Med 22:632–644

    CAS  PubMed  Google Scholar 

  16. Edwards KJ, Goral AB, Hay RM, et al (1991) Function restoration following anterior cruciate ligament reconstruction in active-duty military personnel. Mil Med 156:118–121

    CAS  PubMed  Google Scholar 

  17. Finsterbush A, Frankl U, Matan Y, et al (1990) Secondary damage to the knee after isolated injury of the anterior cruciate ligament. Am J Sports Med 18:475–479

    CAS  PubMed  Google Scholar 

  18. Galway HR, MacIntosh DL (1980) The lateral pivot shift: a symptom and sign of anterior cruciate ligament insufficiency. Clin Orthop 147:45–50

    PubMed  Google Scholar 

  19. Harner CD, Irrgang JJ, Dearwater PJ, et al (1992) Loss of motion after anterior cruciate ligament reconstruction. Am J Sports Med 20:449–506

    Google Scholar 

  20. Hefti F, Muller W, Jakob RP, et al (1993) Evaluation of knee ligament injuries with the IKDC form. Knee Surg Sports Traumatol Arthrosc 1:226–234

    CAS  PubMed  Google Scholar 

  21. Heier KA, Mack DR, Mosely JR, et al (1997) An analysis of anterior cruciate ligament reconstruction in middle-aged patients. Am J Sports Med 25:527–532

    PubMed  Google Scholar 

  22. Lysholm J, Gillquist J (1982) Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale. Am J Sports Med 10:150–154

    CAS  PubMed  Google Scholar 

  23. Menard D (1996) The ageing athlete. In: Harries M, Williams C, Stanish WD, Micheli LJ (eds) Oxford textbook of sports medicine. Oxford University Press, Oxford, pp 596–620

  24. Noyes FR, Barber SD (1991) The effect of an extra-articular procedure on allograft reconstructions for chronic ruptures of the anterior cruciate ligament. J Bone Joint Surg Am 73:882–892

    CAS  PubMed  Google Scholar 

  25. Noyes FR, Barber-Westin SD (1997) Anterior cruciate ligament reconstruction with autogenous patellar tendon graft in patients with articular cartilage damage. Am J Sports Med 25:626–634

    CAS  PubMed  Google Scholar 

  26. Noyes FR, McGinniss GH (1985) Controversy about treatment of the knee with anterior cruciate laxity. Clin Orthop 198:61–76

    PubMed  Google Scholar 

  27. Noyes FR, Matthews DS, Mooar PA, et al (1983) The symptomatic anterior cruciate-deficient knee. II. The results of rehabilitation, activity modification and counseling on functional disability. J Bone Joint Surg Am 65:163–174

    CAS  PubMed  Google Scholar 

  28. Noyes FR, Mooar PA, Matthews DS, et al (1983) The symptomatic anterior cruciate-deficient knee. I. The long-term functional disability in athletically active individuals. J Bone Joint Surg Am 65:154–162

    CAS  PubMed  Google Scholar 

  29. Noyes FR, Barber SD, Mangine RE (1990) Bone-patellar ligament bone and fascia lata allografts for reconstruction of the anterior cruciate ligament. J Bone Joint Surg Am 72:1125–1136

    CAS  PubMed  Google Scholar 

  30. Outerbridge RE (1961) The etiology of chondromalacia patellae. J Bone Joint Surg Br 43:752–757

    Google Scholar 

  31. Plancher KD, Steadman JR, Briggs KK, et al (1998) Reconstruction of the anterior cruciate ligament in patients who are at least forty years old. J Bone Joint Surg Am 80:184–197

    Article  CAS  PubMed  Google Scholar 

  32. Sapega AA (1990) Muscle performance evaluation in orthopaedic practice. J Bone Joint Surg Am 72:1562–1574

    CAS  PubMed  Google Scholar 

  33. Shelbourne KD, Wilckens JH (1993) Intraarticular anterior cruciate ligament reconstruction in the symptomatic arthritic knee. Am J Sports Med 21:685–689

    CAS  PubMed  Google Scholar 

  34. Shelbourne KD, Whitaker HJ, McCarroll JR, et al (1990) Anterior cruciate ligament injury: evaluation of intra-articular reconstruction of acute tears without repair. Am J Sports Med 18:484–489

    CAS  PubMed  Google Scholar 

  35. Sommerlath K, Lysholm J, Gillquist J (1991) The long-term course after treatment of acute anterior cruciate ligament ruptures. A 9 to 16 year follow-up. Am J Sports Med 19:156–162

    CAS  PubMed  Google Scholar 

  36. Tegner Y, Lysholm J (1985) Rating systems in the evaluation of knee ligament injuries. Clin Orthop 198:43–49

    PubMed  Google Scholar 

  37. Van Huss WD (1984) Physical activity and ageing. In: Strauss RH (ed) Sports medicine and physiology. Saunders, Philadelphia, pp 373–385

  38. Webb JM, Corry IS, Clingeleffer AJ, et al (1998) Endoscopic reconstruction for isolated anterior cruciate ligament rupture. J Bone Joint Surg Br 80:288–294

    CAS  PubMed  Google Scholar 

  39. Woo SL-Y, Hollis JM, Adams DJ, et al (1991) Tensile properties of the human femur-anterior cruciate ligament-tibia complex. The effects of specimen age and orientation. Am J Sports Med 19:217–225

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to R. John Bartlett.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Blyth, M.J.G., Gosal, H.S., Peake, W.M. et al. Anterior cruciate ligament reconstruction in patients over the age of 50 years: 2- to 8-year follow-up. Knee Surg Sports Traumatol Arthrosc 11, 204–211 (2003). https://doi.org/10.1007/s00167-003-0368-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-003-0368-5

Keywords

Navigation