Weng Chun-Jui, Yang Cheng-Pang, Yeh Wen-Ling, Hsu Kuo-Yao, Chang Shih-Sheng, Chiu Chih-Hao, Chen Alvin Chao-Yu, Chan Yi-Sheng
Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Taoyuan.
Comprehensive Sports Medicine Center, Chang Gung Memorial Hospital, Taoyuan.
Orthop J Sports Med. 2022 May 12;10(5):23259671221094788. doi: 10.1177/23259671221094788. eCollection 2022 May.
Few studies have compared the outcomes of anterior cruciate ligament (ACL) reconstruction between older patients and younger patients.
To evaluate the clinical and functional outcomes of ACL reconstruction with autologous hamstring tendon in patients >50 years and <30 years. It was hypothesized that the outcomes would be comparable between these age groups.
Cohort study; Level of evidence, 3.
Patients >50 years (older group) or <30 years (younger group) who underwent ACL reconstruction surgery with autologous hamstring tendon between 2012 and 2015 at the authors' hospital were retrospectively enrolled in this study. All patients had a minimum of 2 years of follow-up. Intraoperative findings, including cartilage and meniscal injury, were recorded, and clinical and functional outcomes were evaluated using the International Knee Documentation Committee (IKDC), Lysholm, and Tegner activity scores. We used the paired-samples test for statistical analysis between the 2 age groups.
A total of 67 patients and 459 patients were included in the older and younger groups, respectively. Both groups achieved significant preoperative to postoperative improvement in IKDC (older group, from 41.4 to 88.9; younger group, from 49 to 91.2), Lysholm (older group, from 49.8 to 86.1; younger group, from 50.2 to 91.8), and Tegner (older group, from 2.7 to 4.4; younger group, from 4.6 to 6.9) ( < .05 for all) scores. The change in Tegner score from preinjury to postoperatively was not statistically significant in the older group (from 4.5 to 4.4; = .471), although it was significant in the younger group (from 7.5 to 6.9; < .05). No between-group differences were noted in preoperative or postoperative IKDC or Lysholm scores. Both age groups reached a high rate of return to sports activity, and no major complications or ACL retears were noted in either group.
Comparable results after ACL reconstruction were achieved in patients >50 years compared with patients <30 years, with a high rate of return to sports activity and a low rate of complications at the 2-year follow-up. The younger group returned to a higher Tegner score, while the older group did not.
很少有研究比较老年患者和年轻患者前交叉韧带（ACL）重建的结果。
评估年龄大于50岁和小于30岁的患者自体腘绳肌腱ACL重建的临床和功能结果。假设这些年龄组之间的结果具有可比性。
队列研究；证据等级，3级。
回顾性纳入2012年至2015年在作者所在医院接受自体腘绳肌腱ACL重建手术的年龄大于50岁（老年组）或小于30岁（年轻组）的患者。所有患者至少随访2年。记录术中发现，包括软骨和半月板损伤，并使用国际膝关节文献委员会（IKDC）、Lysholm和Tegner活动评分评估临床和功能结果。我们使用配对样本检验对两个年龄组进行统计分析。
老年组和年轻组分别纳入67例和459例患者。两组患者术前至术后IKDC评分（老年组，从41.4提高到88.9；年轻组，从49提高到91.2）、Lysholm评分（老年组，从49.8提高到86.1；年轻组，从50.2提高到91.8）和Tegner评分（老年组，从２.７提高到4.4；年轻组，从4.6提高到6.9）均有显著改善（均P＜0.05）。老年组从伤前到术后Tegner评分的变化无统计学意义（从4.5到4.4；P = 0.471），而年轻组有显著变化（从7.5到6.9；P＜0.05）。术前或术后IKDC或Lysholm评分在两组之间无差异。两个年龄组恢复运动活动的比例都很高，两组均未出现重大并发症或ACL再撕裂。
与小于30岁的患者相比，大于50岁的患者ACL重建后结果具有可比性，在2年随访时运动恢复率高且并发症发生率低。年轻组恢复到更高的Tegner评分，而老年组则没有。
