Department of Sports Medicine Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, South Korea.
Department of Orthopaedic Surgery and Sports Medicine Center, Chang Gung Memorial Hospital, No. 6 West Sec, Chia-Pu Road, Putz City, Chiayi, 613, Taiwan.
Knee Surg Sports Traumatol Arthrosc. 2019 Jan;27(1):230-238. doi: 10.1007/s00167-018-5342-3. Epub 2019 Jan 2.
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).
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.
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].
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.
Retrospective cohort study, III.
评估 50 岁以上行前交叉韧带（ACL）重建术患者的膝关节力量、韧带稳定性和功能结果，并与年轻患者组（<40 岁）进行比较。
回顾性研究了 40 名 50 岁以上和 50 名<40 岁的 ACL 重建患者。评估等速伸肌和屈肌肌力。以 60°/s 和 180°/s 的速度测量峰值扭矩。将每个速度下的最高峰值扭矩与未受伤侧进行比较。还评估了患者的膝关节前后（AP）松弛度和功能结果，通过 Lysholm 和国际膝关节文献委员会（IKDC）评分进行测量。所有测试均在基线和术后 1 年进行评估。
两组在基线时具有可比性。两组在术后 1 年时所有参数均有显著改善，包括等速肌力、AP 松弛度和功能评分（均 p<0.05）。与年轻患者相比，老年患者的伸肌和屈肌力量、AP 松弛度和 Lysholm 评分相似（无统计学意义）。然而，年轻患者的 IKDC 评分优于老年患者[中位数 81.1；95%置信区间（CI）88.7-95.3 比中位数 75.6；95%CI 70.1-79.3，p=0.007]。
尽管 IKDC 评分较低，但 ACL 重建的老年患者的膝关节力量和韧带松弛度与年轻患者相当。建议对 50 岁以上 ACL 功能不全的患者进行 ACL 重建，尤其是对功能需求较高的患者。
回顾性队列研究，III 级。
