Clinical and Functional Outcomes of Anterior Cruciate Ligament Reconstruction With Autologous Hamstring Tendon in Patients Aged 50 Years or Older

Chun Jui Weng, Wen Ling Yeh, Kuo Yao Hsu, Chih hao Chiu, Shih Sheng Chang, Alvin Chao Yu Chen, Yi Sheng Chan*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

34 Scopus citations

Abstract

Purpose: To assess the clinical and functional outcomes, including the return to sports and the progression of arthritis, in patients aged 50 years or older after anterior cruciate ligament (ACL) reconstruction. Methods: A retrospective series of patients aged 50 years or older with ACL rupture who received ACL reconstruction surgery with autologous hamstring tendon was examined. Preoperative and postoperative functional outcomes were evaluated with the International Knee Documentation Committee (IKDC) subjective score, Lysholm score, and Tegner activity score. Associated injuries, postoperative complications, and the rate of return to preinjury sports were documented. A paired t test and the minimal clinically important difference (MCID) and patient acceptable symptom state (PASS) were used for statistical evaluation. Results: A total of 67 patients with a mean age of 56.6 years were enrolled. The mean follow-up time was 30.2 months. Clinical improvement in the IKDC score (from 41.4 preoperatively to 88.9 postoperatively), Lysholm score (from 49.8 to 86.1), and Tegner activity score (from 2.7 to 4.4) was noted. Regarding clinically relevant values of the MCID, all patients (100%) showed a ΔLysholm score exceeding 8.9; 66 of 67 patients (98.5%) revealed a ΔIKDC score exceeding 16.7; and 47 of 67 patients (70.1%) showed a ΔTegner activity score of more than 1. For the PASS, none of the patients had an IKDC score over 75.9 preoperatively whereas 60 patients (89.5%) had a score exceeding 75.9 postoperatively. Associated lesions included meniscal injuries (73.1%) and osteochondral lesions (89.6%). Of the patients, 36 (53.7%) returned to preinjury sports and 18 (22.9%) returned to sports with less intensity. No major complication, rerupture, or deterioration of arthritis was noted. Conclusions: Patients aged 50 years or older receiving ACL reconstruction achieved significant improvements in IKDC, Lysholm, and Tegner scores. All patients reached the MCID for the ΔLysholm score; 98.5%, for the ΔIKDC score; and 70.1%, for the ΔTegner activity score. None of the patients reached the PASS for the preoperative IKDC value, whereas 89.5% reached the PASS postoperatively. Among patients aged 50 years or older, 53.7% returned to preinjury sports and 26.9% returned to sports with lower intensity. Level of Evidence: Level IV, therapeutic case series.

Original languageEnglish
Pages (from-to)558-562
Number of pages5
JournalArthroscopy - Journal of Arthroscopic and Related Surgery
Volume36
Issue number2
DOIs
StatePublished - 02 2020

Bibliographical note

Publisher Copyright:
© 2019 Arthroscopy Association of North America

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