Arthroscopy. 2020 Feb;36(2):563-565. doi: 10.1016/j.arthro.2019.10.038.
Evidence suggests that anterior cruciate ligament reconstruction in patients older than 50 years of age has similar outcomes when compared with younger patients. However, poorer results are associated with advanced degenerative intra-articular chondral changes. The caveat here is that these conclusions are mainly based on retrospective level IV case series. The question is whether functionally unstable patients 50 years and older, whether active or not, benefit from surgical reconstruction and the answer is clearly yes. It provides restoration of function and should be considered in active older patients with subjective instability who have not responded to nonoperative treatment.
有证据表明,对于 50 岁以上的患者,前交叉韧带重建的效果与年轻患者相似。然而,与晚期退行性关节内软骨变化相关的结果较差。需要注意的是,这些结论主要基于回顾性 IV 级病例系列研究。问题是,50 岁及以上的功能不稳定患者,无论是否活跃,是否从手术重建中获益,答案显然是肯定的。它可以恢复功能,对于活跃的老年患者,尤其是那些对非手术治疗没有反应的患者,应考虑进行手术治疗。