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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 KuoEmail author
  • Won Hah ParkEmail author
KNEE

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 Muscle strength measurement Knee laxity Older patients 

Abbreviations

ACL

Anterior cruciate ligament

AP

Anteroposterior

IKDC

International Knee Documentation Committee

MMT

Maximal manual test

n.s.

Non-significant

Post-op

Postoperative

Notes

Author contributions

DKK and WHP were responsible for the study concept and design. DKK and GP conducted this study and collected data. DKK and L-TK participated in the analysis and interpretation of the data. DKK, GP, and L-TK drafted the manuscript. L-TK and WHP critically revised the manuscript for important intellectual content. All authors read and approved the final manuscript.

Funding

None.

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

167_2018_5342_MOESM1_ESM.docx (15 kb)
Supplementary material 1 (DOCX 15 KB)

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Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2019

Authors and Affiliations

  1. 1.Department of Sports Medicine CenterSamsung Medical Center, Sungkyunkwan University School of MedicineSeoulSouth Korea
  2. 2.Department of Orthopaedic Surgery and Sports Medicine CenterChang Gung Memorial HospitalPutz CityTaiwan

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