Document Title: Heier-AJSM-Jul97.shtml
Article Title: An Analysis of Anterior Cruciate Ligament Reconstruction in Middle-Aged Patients
Authors: Keith A. Heier MD, David R. Mack MD, J. Bruce Moseley MD, Russell Paine RPT, and James R. Bocell, MD
Publication: American Journal of Sports Medicine
Date: July/August 1997
Volume 25, Number 4, pages 527–532
Keywords: Over-40 age group, middle age, ACL reconstruction, autografting.

(Reference-denoting numbers appear in the same font and point size as the document text. As with all Knee Library documents, this article is provided in full-text form, complete with all figures and tables.)

Comments: This article makes it clear that ACL reconstruction is well worthwhile in middle-aged people. Heier et al. found that these patients had results that were no less impressive than younger ACL-reconstruction patients.

ABSTRACT

The purpose of this study was to evaluate the results and complications of anterior cruciate ligament surgery in middle-aged patients. Forty-five consecutive patients over 40 years old (average age, 44.6 years) who had arthroscopically assisted anterior cruciate ligament reconstructions with midthird patellar tendon au- tografts were evaluated. The patients returned for interviews, physical examinations, radiographs, Biodex dynamometer strength testing, and KT-1 000 arthrometer testing at an average of 37 months after their surgeries (range, 24 to 96 months). The mean Lysholm and Gillquist score was 91, which corresponds to symptoms only with vigorous activity. The overall scores from the International Knee Documentation Committee form were 29 (64%) normal or nearly normal and 2 (4%) severely abnormal. Side-to-side differences as determined by the KT-1 000 arthrometer were less than or equal to 3 mm in 31 of 40 patients (78%), between 3 and 5 mm in 4 patients (10%), and >5 mm in 5 patients at 30 pounds of anterior displacement. Seventy-six percent of the patients (N = 34) returned to their preoperative activity levels. Three patients required repeat arthroscopic surgery for persistent knee pain and two patients had graft ruptures. This study shows that when middle-aged patients undergo surgery, their results can be successful and satisfying to a degree similar to those of younger patients.

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