Outcomes of anterior cruciate ligament reconstruction in patients older than 50 years of age

Background: Anterior cruciate ligament reconstruction (ACLR) has traditionally been reserved for young patients with functional instability. As the aging population continues to grow and embrace a more active lifestyle, it is important to determine if favorable outcomes of ACLR can be achieved in older adults. Methods: Patients greater than 50years of age undergoing ACLR between January 2001 and September 2006 were identified. Charts were retrospectively reviewed for clinical, pathologic, and radiographic findings. Prospective data was collected at follow-up, including Lysholm Knee Score, Tegner Activity Level Score, International Knee Documentation Committee (IKDC) Subjective Knee Form Score, and Knee Injury and Osteoarthritis Outcome Score (KOOS). Anteroposterior (AP) instability was assessed with use of a KT-2000 arthrometer (MEDmetric, San Diego, CA). Results: Forty-seven patients underwent ACLR with 32 (16 males and 16 females) available at a mean follow-up of 5.0years (range:2.2 to 9.0years). The mean age at the time of operation was 58.4 years (range:51 to 65 years). At time of final follow-up, the mean side-to-side difference measured by KT-2000 was 1.2 ± 1.3 mm (range:0 to 4.5 mm). Mean postoperative subjective IKDC score was 80.1 (range:33 to 100) and Lysholm score was 86.7 (range:45 to 95). There was no change in Tegner score from pre-injury (range:0 to 3) to postoperative (range:0 to 3). Twelve patients (38%) underwent subsequent knee surgery. All patients were satisfied with the final outcome of their ACLR surgery. Only patellofemoral Outerbridge cartilage grade was associated with worse outcome. Conclusion: ACLR provides symptomatic relief and restoration of function for patients greater than 50 years of age. ACLR should be considered in active older patients with subjective functional instability.