Sylvia Stephen M, Perrone Gabriel S, Stone Jonathan A, Miltenberg Benjamin, Nezwek Teron A, Zhang Yilun, Golenbock Samuel W, Richmond John C, Salzler Matthew J
Tufts Medical Center, Boston, Massachusetts, U.S.A..
Tufts Medical Center, Boston, Massachusetts, U.S.A.
Arthroscopy. 2022 May;38(5):1537-1543. doi: 10.1016/j.arthro.2021.09.024. Epub 2021 Oct 1.
To evaluate patient satisfaction, retear rates, and patient-reported outcomes (PROs) in patients aged 40 and older undergoing allograft anterior cruciate ligament reconstruction (ACLR). The secondary goal was to compare these parameters between groups of patients with intact versus failed grafts, and to evaluate these in relation to a historically reported International Knee Documentation Committee (IKDC) patient-acceptable symptoms state (PASS) score.
Records of patients aged 40 and older who underwent ACLR between 2005 and 2016 at a single institution with a minimum 2-year follow-up were retrospectively reviewed. Patient-reported satisfaction, outcome scores, and failure rates were analyzed. The rate of achieving a previously defined IKDC PASS score based on younger cohorts was reported, and an updated PASS threshold for older patients was calculated.
201 patients were included with a mean age of 48.6 years (range: 40-68) and mean follow-up of 6.2 years (range: 2.8-11.2). 182 (90.5%) patients reported satisfaction following surgery. 16 (8.0%) patients experienced failure of their ACLR, 10 of which underwent revision ACLR. The median IKDC score in the intact ACLR group was 86.2, compared to 66.7 in the failure group (P < .001). In total, 134 (72.4%) patients in the intact group achieved the historical PASS score of 75.9 on IKDC compared to only 4 (25%) in the failure group (χ = 15.396, P < .001). An updated IKDC PASS threshold for older cohorts was calculated to be 66.7.
Patients aged 40 and older who underwent allograft ACLR had an 8.0% failure rate at a mean follow-up of 6 years. Graft failure in patients aged 40 and older was associated with worse PROs. The majority of patients achieved the historically reported IKDC PASS threshold. Additionally, an updated age-appropriate IKDC PASS score of 66.7 was calculated to aid in future ACLR studies assessing older patients.
Level IV.
评估年龄在40岁及以上接受同种异体前交叉韧带重建（ACLR）患者的满意度、再撕裂率和患者报告结局（PROs）。次要目标是比较移植完好与失败患者组之间的这些参数，并根据历史报道的国际膝关节文献委员会（IKDC）患者可接受症状状态（PASS）评分对这些参数进行评估。
回顾性分析2005年至2016年在单一机构接受ACLR且年龄在40岁及以上、至少随访2年患者的记录。分析患者报告的满意度、结局评分和失败率。报告基于较年轻队列达到先前定义的IKDC PASS评分的比例，并计算老年患者的更新PASS阈值。
纳入201例患者，平均年龄48.6岁（范围：40 - 68岁），平均随访6.2年（范围：2.8 - 11.2年）。182例（90.5%）患者术后报告满意。16例（8.0%）患者ACLR失败，其中10例接受了翻修ACLR。完整ACLR组的IKDC评分中位数为86.2，而失败组为66.7（P < 0.001）。完整组中共有134例（72.4%）患者在IKDC上达到了75.9的历史PASS评分，而失败组中只有4例（25%）达到（χ = 15.396，P < 0.001）。计算得出老年队列的更新IKDC PASS阈值为66.7。
年龄在40岁及以上接受同种异体ACLR的患者在平均6年的随访中失败率为8.0%。40岁及以上患者的移植失败与更差的PROs相关。大多数患者达到了历史报道的IKDC PASS阈值。此外，计算得出更新的适合年龄的IKDC PASS评分为66.7，以帮助未来评估老年患者的ACLR研究。
IV级。
