Tags

Type your tag names separated by a space and hit enter

Single- and double-bundle anterior cruciate ligament reconstruction in patients aged over 50 years.
Arthroscopy. 2012 Nov; 28(11):1702-9.A

Abstract

PURPOSE

The purpose of our study was to retrospectively evaluate the outcomes after anterior cruciate ligament (ACL) reconstruction with hamstring in patients aged 50 years or older. In addition, we present, for the first time, the outcomes of a subgroup of middle-aged patients treated with double-bundle (DB) reconstruction.

METHODS

Fifty patients aged 50 years or older underwent primary ACL reconstruction with hamstring. Inclusion criteria were primary ACL reconstruction in active patients. Exclusion criteria were multiligamentous injuries and a contralateral ACL-deficient knee. The mean age at surgery was 54.4 years (range, 50 to 65 years). The mean period from the initial injury to surgery was 32.6 months (range, 3 to 125 months). Of the patients, 36 underwent single-bundle (SB) ACL reconstruction and 14 underwent DB reconstruction. Patients were assessed preoperatively with physical examination (including range of motion, pivot-shift test, and instrumented knee laxity measurement), the Lysholm score, the International Knee Documentation Committee scoring system, and the Tegner activity scale. Standard radiographs were taken, and degenerative changes were graded according to the Ahlbäck radiologic classification of arthritis.

RESULTS

Patients were evaluated at a mean of 4.4 years (range, 2 to 7 years) after surgery. A significant improvement in knee function and symptoms was reported in most patients, with increased Lysholm, International Knee Documentation Committee, and Tegner scores (P < .001). The outcomes of clinical assessment and instrumented laxity testing were clearly improved when compared with preoperative status (P < .001). The level of osteoarthritis did not statistically increase at follow-up. No statistically significant difference could be observed between the SB and DB groups (P = not significant).

CONCLUSIONS

Operative treatment showed favorable outcomes in most of the ACL-reconstructed patients with regard to knee stability, osteoarthritis progression, and patient satisfaction in a cohort of subjects aged 50 years or older. Our subgroup of patients undergoing DB ACL reconstruction reported average satisfactory outcomes, which did not significantly differ from the SB group.

LEVEL OF EVIDENCE

Level IV, therapeutic case series.

Authors+Show Affiliations

Minimally Invasive Articular Surgery Unit, Istituto Ortopedico G. Pini, Milan, Italy. alberto.ventura@doctoral.itNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

22951371

Citation

Ventura, Alberto, et al. "Single- and Double-bundle Anterior Cruciate Ligament Reconstruction in Patients Aged Over 50 Years." Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association, vol. 28, no. 11, 2012, pp. 1702-9.
Ventura A, Legnani C, Terzaghi C, et al. Single- and double-bundle anterior cruciate ligament reconstruction in patients aged over 50 years. Arthroscopy. 2012;28(11):1702-9.
Ventura, A., Legnani, C., Terzaghi, C., & Borgo, E. (2012). Single- and double-bundle anterior cruciate ligament reconstruction in patients aged over 50 years. Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association, 28(11), 1702-9. https://doi.org/10.1016/j.arthro.2012.04.146
Ventura A, et al. Single- and Double-bundle Anterior Cruciate Ligament Reconstruction in Patients Aged Over 50 Years. Arthroscopy. 2012;28(11):1702-9. PubMed PMID: 22951371.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Single- and double-bundle anterior cruciate ligament reconstruction in patients aged over 50 years. AU - Ventura,Alberto, AU - Legnani,Claudio, AU - Terzaghi,Clara, AU - Borgo,Enrico, Y1 - 2012/08/27/ PY - 2011/06/23/received PY - 2012/04/14/revised PY - 2012/04/16/accepted PY - 2012/9/7/entrez PY - 2012/9/7/pubmed PY - 2013/5/2/medline SP - 1702 EP - 9 JF - Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association JO - Arthroscopy VL - 28 IS - 11 N2 - PURPOSE: The purpose of our study was to retrospectively evaluate the outcomes after anterior cruciate ligament (ACL) reconstruction with hamstring in patients aged 50 years or older. In addition, we present, for the first time, the outcomes of a subgroup of middle-aged patients treated with double-bundle (DB) reconstruction. METHODS: Fifty patients aged 50 years or older underwent primary ACL reconstruction with hamstring. Inclusion criteria were primary ACL reconstruction in active patients. Exclusion criteria were multiligamentous injuries and a contralateral ACL-deficient knee. The mean age at surgery was 54.4 years (range, 50 to 65 years). The mean period from the initial injury to surgery was 32.6 months (range, 3 to 125 months). Of the patients, 36 underwent single-bundle (SB) ACL reconstruction and 14 underwent DB reconstruction. Patients were assessed preoperatively with physical examination (including range of motion, pivot-shift test, and instrumented knee laxity measurement), the Lysholm score, the International Knee Documentation Committee scoring system, and the Tegner activity scale. Standard radiographs were taken, and degenerative changes were graded according to the Ahlbäck radiologic classification of arthritis. RESULTS: Patients were evaluated at a mean of 4.4 years (range, 2 to 7 years) after surgery. A significant improvement in knee function and symptoms was reported in most patients, with increased Lysholm, International Knee Documentation Committee, and Tegner scores (P < .001). The outcomes of clinical assessment and instrumented laxity testing were clearly improved when compared with preoperative status (P < .001). The level of osteoarthritis did not statistically increase at follow-up. No statistically significant difference could be observed between the SB and DB groups (P = not significant). CONCLUSIONS: Operative treatment showed favorable outcomes in most of the ACL-reconstructed patients with regard to knee stability, osteoarthritis progression, and patient satisfaction in a cohort of subjects aged 50 years or older. Our subgroup of patients undergoing DB ACL reconstruction reported average satisfactory outcomes, which did not significantly differ from the SB group. LEVEL OF EVIDENCE: Level IV, therapeutic case series. SN - 1526-3231 UR - https://www.unboundmedicine.com/medline/citation/22951371/Single__and_double_bundle_anterior_cruciate_ligament_reconstruction_in_patients_aged_over_50_years_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0749-8063(12)00432-X DB - PRIME DP - Unbound Medicine ER -