Corona Katia, Cerciello Simone, Vasso Michele, Toro Giuseppe, D'Ambrosi Riccardo, Pola Enrico, Ciolli Gianluca, Mercurio Michele, Schiavone Panni Alfredo
Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, Campobasso, Italy, University of Molise.
Department of Orthopaedics, A. Gemelli University Hospital Foundation IRCCS, Catholic University, Rome, Italy, Catholic University.
Orthop Rev (Pavia). 2022 Jul 27;14(2):37310. doi: 10.52965/001c.37310. eCollection 2022.
Grown in the worldwide population of over 50 of age individuals who remain in good health and continue to engage in sports has led to an increase of anterior cruciate ligament (ACL) tears in this aged population. ACL reconstruction was reserved for young and active athletes, but seems to produce good outcomes also in over 50s.
To compare the patient-reported functional scores, arthrometric outcomes, and complications of primary ACL reconstruction between older (>50 years) and younger (<50 years) patients.
A systematic review was performed on Pubmed, Scopus, Google Scholar and Cochrane library regarding studies that compared the clinical outcomes of ACLR between patients aged > 50 years and those aged < 50 years. The outcomes evaluated were knee functional outcomes, antero-posterior laxity and complications rate.
This study included 5 retrospective cohort studies with a total of 645 patients (357 in the older 50 group and 288 in the younger group). All included studies reported significant improvements in clinical outcomes in both groups after ACL reconstruction. No significant differences were noted in terms of International Knee Documentation Committee (IKDC), Lysholm, Tegner scores and anteroposterior instability between the two groups (p = n.s.). Over 50 cohort seem to have an increased risk for complication rate when compared with the younger cohort (p= 0.0005).
ACL reconstruction in patients older than 50 years is a safe procedure with good results that are comparable to those of younger patients.
Systematic review and meta-analysis; Level of evidence, 3.
全球50岁以上保持健康且继续从事运动的人群数量不断增长，导致该年龄段前交叉韧带（ACL）撕裂的病例有所增加。ACL重建术以往多用于年轻且活跃的运动员，但在50岁以上人群中似乎也能产生良好的效果。
比较年龄较大（>50岁）和年龄较小（<50岁）患者在初次ACL重建术后患者报告的功能评分、关节测量结果及并发症情况。
在PubMed、Scopus、谷歌学术和考克兰图书馆上进行了一项系统综述，纳入比较年龄>50岁和<50岁患者ACL重建临床结果的研究。评估的结果包括膝关节功能结果、前后向松弛度和并发症发生率。
本研究纳入了5项回顾性队列研究，共645例患者（50岁以上组357例，较年轻组288例）。所有纳入研究均报告两组在ACL重建术后临床结果均有显著改善。两组在国际膝关节文献委员会（IKDC）、Lysholm、Tegner评分及前后向不稳定方面无显著差异（p=无统计学意义）。与较年轻队列相比，50岁以上队列的并发症发生率似乎更高（p=0.0005）。
50岁以上患者的ACL重建是一种安全的手术，效果良好，与较年轻患者相当。
系统综述和荟萃分析；证据等级，3级。
