Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Feb;16(1):57-65.
doi: 10.4055/cios22344. Epub 2023 Sep 1.

A Comparison of Results in Older, Middle-aged, and Younger Patients after Primary Anterior Cruciate Ligament Reconstruction: Minimum 10-Year Follow-up

Kyoung Ho Yoon  1 , Se Min Lee  2 , Jae Young Park  3 , Hee Sung Lee  2 , Sung Hyun Hwang  1
Affiliations

A Comparison of Results in Older, Middle-aged, and Younger Patients after Primary Anterior Cruciate Ligament Reconstruction: Minimum 10-Year Follow-up

Kyoung Ho Yoon et al. Clin Orthop Surg. 2024 Feb.

Abstract

Background: Anterior cruciate ligament (ACL) reconstruction is commonly performed to prevent decreased knee function and restore stability in middle-aged and even older patients. However, few studies have compared the long-term clinical outcomes of ACL reconstruction between older, younger, and middle-aged patients. The purpose of this study was to compare the long-term clinical outcomes of ACL reconstruction in older patients with those in younger and middle-aged patients.

Methods: A total of 352 patients who underwent primary ACL reconstruction between January 2003 and March 2008 were retrospectively reviewed and classified into three groups (group A: 246 [age, 20-29 years], group B: 72 [age, 40-49 years], group C: 34 [age, 50-65 years]). The mean follow-up period was 14.2 ± 1.6 years. Clinical outcomes were evaluated and compared between groups.

Results: The differences in the range of motion, clinical scores, and stability tests were not statistically significant among the three groups. The difference in the graft failure rate among the three groups was significant (group A: 16 [6.5%], group B: 7 [9.7%], group C: 6 [17.6%]; p = 0.040). In particular, when compared between the two groups, there was a significant difference between group A and group C (p = 0.036). The 10-year survival rates were 93.5%, 90.3%, and 82.4% for groups A, B, and C, respectively (p = 0.048).

Conclusions: Although graft failure rates were higher in older patients than younger and middle-aged patients, clinical outcomes of ACL reconstruction in older patients were comparable to those of younger and middle-aged patients in terms of the range of motion, clinical scores, and stability tests at a minimum follow-up of 10 years.

Keywords: Age; Anterior cruciate ligament; Anterior cruciate ligament reconstruction; Knee; Survival rate.

PubMed Disclaimer

Conflict of interest statement

CONFLICT OF INTEREST: No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1. Flowchart of patient enrollment.
Fig. 2
Fig. 2. Measurement of anterior tibial translation on a stress radiograph. Black arrow indicates anterior tibial translation.
Fig. 3
Fig. 3. Kaplan-Meier survival estimates of anterior cruciate ligament (ACL) graft failure at the 10-year follow-up were 93.5%, 90.3%, and 82.4%. The log-rank test (Mantel-Cox, 95% confidence interval) showed significant difference among the groups (p = 0.048).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Buss DD, Warren RF, Wickiewicz TL, Galinat BJ, Panariello R. Arthroscopically assisted reconstruction of the anterior cruciate ligament with use of autogenous patellar-ligament grafts: results after twenty-four to forty-two months. J Bone Joint Surg Am. 1993;75(9):1346–1355. - PubMed
    1. Iorio R, Iannotti F, Ponzo A, et al. Anterior cruciate ligament reconstruction in patients older than fifty years: a comparison with a younger age group. Int Orthop. 2018;42(5):1043–1049. - PubMed
    1. Barber FA, Aziz-Jacobo J, Oro FB. Anterior cruciate ligament reconstruction using patellar tendon allograft: an age-dependent outcome evaluation. Arthroscopy. 2010;26(4):488–493. - PubMed
    1. Seng K, Appleby D, Lubowitz JH. Operative versus nonoperative treatment of anterior cruciate ligament rupture in patients aged 40 years or older: an expected-value decision analysis. Arthroscopy. 2008;24(8):914–920. - PubMed
    1. Shelbourne KD, Stube KC. Anterior cruciate ligament (ACL)-deficient knee with degenerative arthrosis: treatment with an isolated autogenous patellar tendon ACL reconstruction. Knee Surg Sports Traumatol Arthrosc. 1997;5(3):150–156. - PubMed