Wierer Guido, Runer Armin, Hoser Christian, Herbst Elmar, Gföller Peter, Fink Christian
Department of Traumatology and Sports Injuries, Paracelsus Medical University Salzburg, Muellner Hauptstrasse 48, 5020, Salzburg, Austria.
Gelenkpunkt - Center for Sports and Joint Surgery, Olympiastraße 39, 6020, Innsbruck, Austria.
Knee Surg Sports Traumatol Arthrosc. 2017 May;25(5):1528-1534. doi: 10.1007/s00167-016-4363-z. Epub 2016 Oct 24.
The purpose of this study is to compare the clinical outcome of ACL reconstructions in patients older than 40 years of age to younger subjects. It has been hypothesized that patients older than 40 years of age achieve comparable clinical outcomes following acute ACL reconstruction using a hamstring tendon autograft than younger patients.
Patients with an isolated ACL tear without any concomitant injuries and subsequent ACL reconstruction within 48 h from injury were included in this prospective study. According to patients' age, subjects were assigned to two groups: (A) 18-40 years and (B) 40-60 years. Functional outcomes, pain, post-operative radiographs and return to sports were recorded and analysed. The follow-up period was 24 months.
A total of 59 patients were included in the study. Group A consisted of 39 patients (14 women, 25 men; median 27 years), group B of 20 patients (12 women, 8 men; median 45 years) respectively. At final follow-up, the Lysholm score showed no significant difference between group A (median 90; range 68-100) and group B (median 94.5; range 63-100) (n.s.). The final Tegner score showed a significant difference between group A (median 6; range 2-9) and group B (median 5.5; range 3-8) (p < 0.05). The mean VAS pain score was 1.3 (range 0-6) in group A and 1 (range 0-7) in group B, respectively (n.s.). Both groups returned to their pre-injury activity level and did not significantly change their activity in respect of pivoting sports and sports frequency at final follow-up (n.s.). According to the IKDC score, all except one of the patients in group A and all patients in group B had a normal or nearly normal final outcome (n.s.).
Patients older than 40 years of age achieve comparable clinical outcomes following acute ACL reconstruction using a hamstring tendon autograft than younger patients.
Cohort study, Level III.
本研究旨在比较40岁以上患者与年轻患者前交叉韧带（ACL）重建的临床结果。研究假设是，40岁以上患者在使用自体腘绳肌腱进行急性ACL重建后可获得与年轻患者相当的临床结果。
本前瞻性研究纳入了单纯ACL撕裂且无任何合并伤，并在受伤后48小时内进行了后续ACL重建的患者。根据患者年龄，将受试者分为两组：（A）18 - 40岁和（B）40 - 60岁。记录并分析功能结果、疼痛、术后X线片以及恢复运动情况。随访期为24个月。
本研究共纳入59例患者。A组39例患者（14例女性，25例男性；中位年龄27岁），B组20例患者（12例女性，8例男性；中位年龄45岁）。在末次随访时，Lysholm评分显示A组（中位值90；范围68 - 100）和B组（中位值94.5；范围63 - 100）之间无显著差异（无统计学意义）。最终的Tegner评分显示A组（中位值6；范围2 - 9）和B组（中位值5.5；范围3 - 8）之间存在显著差异（p < 0.05）。A组的平均视觉模拟评分（VAS）疼痛评分为1.3（范围0 - 6），B组为1（范围0 - 7），（无统计学意义）。两组均恢复到受伤前的活动水平，在末次随访时，其旋转运动和运动频率方面的活动情况均无显著变化（无统计学意义）。根据国际膝关节文献委员会（IKDC）评分，A组除1例患者外，B组所有患者最终结果均为正常或接近正常（无统计学意义）。
4０岁以上患者在使用自体腘绳肌腱进行急性ACL重建后可获得与年轻患者相当的临床结果。
队列研究，III级。
