OpenLB
Open Library of Bioscience
Advanced Search
Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
Jan, 2019;27 (1): 230-238.

Patients older than 50 years had similar results of knee strength and anteroposterior stability after ACL reconstruction compared to younger patients.

Do Kyung Kim, Geon Park, Liang-Tseng Kuo, Won Hah Park
Author Information
  1. Do Kyung Kim: Department of Sports Medicine Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, South Korea.
  2. Geon Park: Department of Sports Medicine Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, South Korea.
  3. Liang-Tseng Kuo: Department of Orthopaedic Surgery and Sports Medicine Center, Chang Gung Memorial Hospital, No. 6 West Sec, Chia-Pu Road, Putz City, Chiayi, 613, Taiwan. light71829@gmail.com. ORCID
  4. Won Hah Park: Department of Sports Medicine Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, South Korea. pk90007@naver.com.
PMID: 30600340 DOI: 10.1007/s00167-018-5342-3

Abstract

PURPOSE: To evaluate knee strength, ligament stability, and functional outcomes in patients older than 50 years who underwent anterior cruciate ligament (ACL) reconstruction, and to compare these results with those obtained from a younger patient group (< 40 years).
METHODS: Forty patients older than 50 years and 50 patients younger than 40 years who underwent ACL reconstruction were retrospectively studied. Isokinetic extensor and flexor muscle strength were evaluated. The peak torque was determined at speeds of 60°/s and 180°/s. The highest peak torque at each velocity was compared with that on the uninjured side. patients were also evaluated for knee anteroposterior (AP) laxity and functional outcomes, which were measured by the Lysholm and International Knee Documentation Committee (IKDC) scores. All tests were evaluated at baseline and 1 year postoperatively.
RESULTS: The groups were comparable at the baseline. Both groups had significant improvements in all parameters, including isokinetic muscle strength, AP laxity, and functional scores, at 1 year postoperatively (all p < 0.05). Compared with younger patients, older patients had similar results for extensor and flexor strength, AP laxity, and Lysholm score (n.s.). However, younger patients had better IKDC scores than did older patients [median 81.1; 95% confidence interval (CI) 95% CI 78.9-88.7 vs. median 75.6; 95% CI 70.1-79.3, p = 0.007].
CONCLUSIONS: Though with lower IKDC scores, older patients with ACL reconstruction had comparable results of knee strength and ligament laxity to younger patients. ACL reconstruction is recommended for treating patients older than 50 years with ACL insufficiency, especially for those with high functional demand.
LEVEL OF EVIDENCE: Retrospective cohort study, III.

Keywords

Anterior cruciate ligament reconstruction Knee laxity Muscle strength measurement Older patients

References

  1. Am J Sports Med. 1999 Nov-Dec;27(6):821-30 [PMID: 10569374]
  2. Am J Sports Med. 2001 May-Jun;29(3):272-9 [PMID: 11394593]
  3. J Orthop Res. 2003 Mar;21(2):231-7 [PMID: 12568953]
  4. Knee Surg Sports Traumatol Arthrosc. 2003 Jul;11(4):204-11 [PMID: 12761610]
  5. Ann Readapt Med Phys. 2004 Aug;47(6):309-16 [PMID: 15297121]
  6. Arthroscopy. 2007 Jan;23(1):21-8, 28.e1-3 [PMID: 17210423]
  7. Clin Sports Med. 2008 Jul;27(3):405-24, vii-ix [PMID: 18503875]
  8. Arthroscopy. 2008 Aug;24(8):914-20 [PMID: 18657740]
  9. J Bone Joint Surg Br. 2008 Nov;90(11):1446-50 [PMID: 18978263]
  10. Clin J Sport Med. 2009 Jan;19(1):3-8 [PMID: 19124976]
  11. Arthroscopy. 2010 Apr;26(4):488-93 [PMID: 20362827]
  12. Knee Surg Sports Traumatol Arthrosc. 2011 Mar;19(3):412-7 [PMID: 20734026]
  13. J Sport Rehabil. 2013 Feb 18;22(1): [PMID: 22951307]
  14. Knee Surg Sports Traumatol Arthrosc. 2013 Sep;21(9):2011-8 [PMID: 23238924]
  15. Int Orthop. 2013 Nov;37(11):2265-9 [PMID: 23995333]
  16. J Orthop Sports Phys Ther. 2015 Dec;45(12):1017-25 [PMID: 26471854]
  17. J Phys Ther Sci. 2015 Sep;27(9):2693-6 [PMID: 26504270]
  18. Sports Health. 2016 Mar-Apr;8(2):177-81 [PMID: 26674619]
  19. Am J Sports Med. 2017 Mar;45(4):832-837 [PMID: 28056178]
  20. Orthop J Sports Med. 2017 Oct 02;5(10):2325967117729659 [PMID: 29051896]
  21. Int Orthop. 2018 May;42(5):1043-1049 [PMID: 29532113]
  22. Knee Surg Relat Res. 2018 Jun 1;30(2):95-106 [PMID: 29843196]
  23. Sci Rep. 2018 Jun 15;8(1):9186 [PMID: 29907841]
  24. Clin Orthop Relat Res. 1985 Sep;(198):43-9 [PMID: 4028566]
  25. Am J Sports Med. 1982 May-Jun;10(3):150-4 [PMID: 6896798]
  26. Am J Sports Med. 1995 Mar-Apr;23(2):160-5 [PMID: 7778699]

MeSH Term

Adult
Age Factors
Aging
Anterior Cruciate Ligament
Anterior Cruciate Ligament Injuries
Anterior Cruciate Ligament Reconstruction
Humans
Joint Instability
Knee
Knee Injuries
Knee Joint
Lysholm Knee Score
Male
Middle Aged
Muscle Strength
Muscle, Skeletal
Recovery of Function
Retrospective Studies
Torque
Treatment Outcome
Comparative Study Journal Article
Article has an altmetric score of 1

Word Cloud

Created with Highcharts 10.0.0patientsstrengtholderACLreconstructionyoungerlaxitykneeligamentfunctional50 yearsresultsscoresevaluatedAPIKDC95%CIstabilityoutcomesunderwentcruciateextensorflexormusclepeaktorquecomparedPatientsanteroposteriorLysholmKneebaseline1 yearpostoperativelygroupscomparablesimilarPURPOSE:evaluateanteriorcompareobtainedpatientgroup< 40 yearsMETHODS:Forty5040 yearsretrospectivelystudiedIsokineticdeterminedspeeds60°/s180°/shighestvelocityuninjuredsidealsomeasuredInternationalDocumentationCommitteetestsRESULTS:significantimprovementsparametersincludingisokineticp < 005ComparedscorensHoweverbetter[median811confidenceinterval789-887vsmedian756701-793p = 0007]CONCLUSIONS:ThoughlowerrecommendedtreatinginsufficiencyespeciallyhighdemandLEVELOFEVIDENCE:RetrospectivecohortstudyIIIAnteriorMusclemeasurementOlder

Similar Articles

Cited By