Purpose

To evaluate return to sport and clinical outcomes with at least 2 years followup after arthroscopic reconstruction ACL in population over 50 years-old. Methods: eighty-one patients aged 50 years or older underwent isolated, primary ACL reconstruction with hamstring autograft between 2014 and 2016. In all patients, a period of conservative treatment had failed (minimum 6 months), and they complained of functional instability and/or limitation during daily activity. Patients were assessed preoperatively and at the latest follow-up with a physical examination, return to sports activity, the Lysholm score, the International Knee Documentation Committee scoring system, the Knee injury and Osteoarthritis Outcome Score, and the Tegner activity scale. Data regarding complications and revision surgeries were collected at 2-year follow-up.

Results

At the last follow-up, significant improvement in outcome scores from pre- to postoperative assessments was found. The mean overall IKDC score increased from a preoperative mean of 54.4–82.9 (p < 0.001). Mean preoperative Lysholm score increased from a preoperative mean of 67.4–90.4 (p < 0.001). The mean overall KOOS score increased from a preoperative mean (p < 0.001). Median preoperative Tegner score was 5 (range 2–8) and median postoperative score was 5 (range 1–7). 86% of patients returned to the sport, 51% to their preinjury sports level. Tegner score, before accident, was the only positive influencing factor a return to pre-injury level of the sport.

Conclusion

Arthroscopic reconstruction ACL in patients over 50 years-old resulted in excellent functional outcomes, with most patients returning to sport and at the same level they had before the injury.

Level of evidence

Level IV.

中文翻译：

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关节镜检查前十字韧带重建术是治疗50岁以上患者膝关节不稳的可靠选择。

目的

为了评估50岁以上人群在关节镜重建ACL后至少2年随访的运动和临床结局。方法：2014年至2016年间，对81位50岁或50岁以上的患者进行了自体ACL绳肌原位重建，所有患者均经历了一段保守治疗失败（至少6个月），他们抱怨功能不稳定和/或日常活动中的限制。对患者进行术前评估，并在最近的一次随访中进行身体检查，恢复运动能力，Lysholm评分，国际膝关节文献委员会评分系统，膝关节损伤和骨关节炎结果评分以及Tegner活动量表。在2年的随访中收集了有关并发症和翻修手术的数据。

结果

在最后一次随访中，发现从术前评估到术后评估结果得分均有显着改善。IKDC的总体平均评分较术前的54.4–82.9有所提高（p  <0.001）。术前平均Lysholm评分从术前平均67.4–90.4升高（p  <0.001）。平均总KOOS评分高于术前平均值（p  <0.001）。术前Tegner评分中位数为5（范围2-8），术后中位数为5（范围1-7）。86％的患者恢复了这项运动，而其受伤前的运动水平达到了51％。事故发生前，Tegner得分是唯一恢复运动至受伤前水平的积极因素。

结论

关节镜重建ACL在50岁以上的患者中产生了出色的功能预后，大多数患者恢复运动并且恢复到受伤前的水平。

证据水平

第四级。