Document Title: Kuechle-AJARS-Oct02.shtml
Article Title: Allograft Anterior Cruciate Ligament Reconstruction in Patients Over 40 Years of Age
Authors: David K. Kuechle, M.D., Sara E. Pearson, Ph.D., William R. Beach, M.D., Eric L. Freeman, M.D., David F. Pawlowski, M.Ed., A.T.C., Terry L. Whipple, M.D., Richard B. Caspari†, M.D., and John F. Meyers, M.D.
Publication: Arthroscopy, The Journal of Arthroscopy and Related Surgery
Date: October 2002
Volume 18, Number 8, pages 845–853
Keywords: Over-40 age group, middle age, ACL reconstruction, allografting.

(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 shows that ACL reconstruction is well worthwhile in middle-aged people (defined as being over 40 years old). Allografting brings a satisfactory success rate here. Any over-40 person whose doctor still advises that ACL reconstruction be avoided merely because of age would do well to cite both this study and the November 2000 AJARS study by Noyes and Barber-Westin.

Purpose: The study goal was to determine the results of allograft anterior cruciate ligament (ACL) reconstruction in patients over 40 years old at a minimum of 24 months follow-up (mean, 59.7 months; range, 24 to 110 months).

Type of Study: Retrospective review.

Methods: The records of 57 consecutive patients (mean age at surgery, 45.0 years; range, 40.2 to 60.8 years) were reviewed retrospectively. Nine patients who had undergone either prior ACL reconstruction, extra-articular reinforcement of the intra-articular procedure, or subsequent upper tibial osteotomy were eliminated. One patient was lost to follow-up. Of the remaining 47 patients (48 knees), 29 (62%) were men, and 18 (38%) were women. Twenty-eight of the 47 study patients (60%) were available for clinical interview consisting of physical examination, radiographs, and functional testing. Twenty-seven of these patients also underwent KT-1000 measurement, and 26 underwent Biodex evaluation. The remaining 19 patients were interviewed by telephone.

Results: At follow-up, Lachman, anterior drawer, and pivot shift tests were 0 or 1 in 27 (96%) of 28 patients. Differences between the index and contralateral legs as measured by KT-1000 at 20 lb of force were 0 to 2 mm in 22 of 27 patients (81%) and 3 to 5.5 mm in 5 patients (19%). None had a side-to-side difference greater than 5.5 mm. Based on the International Knee Documentation Committee activity classification system, 26 (55%) of 47 patients achieved the same or higher grade of activity postoperatively as they had preinjury.

Conclusions: Results of ACL reconstruction in patients over 40 compare favorably with those observed in younger patients. Age should not be a limiting factor in choosing surgical reconstruction to treat functional instability in the ACL-deficient patient.

To access the full text of this article, please click here.
There is no charge for viewing articles. However, a password is required.
If you do not already have a password, please e-mail Michael Frind at frind@execulink.com for one.
Prior to requesting a password, please make certain you have read the Site Terms of Use pertaining to this site.

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

Copyright October 2002 by Arthroscopy, The Journal of Arthroscopic and Related Surgery, Arthroscopy Association of North America. For details regarding copyright as it applies to this page, please visit the page entitled Site Terms of Use and Aspects of Copyright on this site.

This website was created for the benefit of the world's largest knee-injury community, Bob's ACL WWWBoard (also known as the Kneeboard), accessible to everyone at http://factotem.org.

Documents posted on this site serve merely as a virtual library, and are intended solely for purposes of making access to high-quality peer-reviewed medical-journal articles convenient for all users of the Kneeboard. Knee-injury patients are hereby encouraged to discuss this material with their respective medical teams.

Site Terms of Use and Aspects of Copyright

Printing Hints and Tips