ARCUS Kliniken, Rastatterstr 17-19, 75179, Pforzheim, Germany.
Center for Orthopaedics, Trauma Surgery and Rehabilitation Medicine, University Medicine, Greifswald, Germany.
Knee Surg Sports Traumatol Arthrosc. 2023 Feb;31(2):632-640. doi: 10.1007/s00167-022-07116-x. Epub 2022 Aug 21.
(1) To compare sporting and recreational activity levels before and at a minimum 6 year follow-up, and (2) to assess the clinical and functional outcomes after anterior cruciate ligament (ACL) reconstruction in patients older than 55 years.
A retrospective evaluation of prospectively collected data of 150 patients with a mean age of 64 ± 4.5 (57-74) years was evaluated 8.6 ± 1.4 (6-11) years after primary ACL reconstruction using hamstring autograft. All patients were assessed using the International Knee Documentation Committee scoring system (IKDC), Knee injury and Osteoarthritis Outcome Score (KOOS), Tegner activity level, and visual analog scale (VAS) for pain. The level of recreational activities was assessed using a sport-specific questionnaire. All patients were categorized according to Isolated and Combined ACL injury groups.
The data of 125 patients were analyzed at the last follow-up. While 25 patients were lost to follow-up, 117 of 125 patients were active before their injury in at least one sports discipline compared to 121 of 125 patients after ACL reconstruction. One hundred and two (82%) patients had returned to their recreational activities at the final follow-up. The mean IKDC subjective score increased from 49.5 ± 23.2 (11.5-100) to 76.2 ± 14.8 (33.3-100) (p < 0.0001). The mean KOOS sport increased significantly from 36 ± 36.2 (0-100) to 74.1 ± 25.5 (0-100) (p < 0.0001). The mean VAS score improved from 6.0 ± 2.6 (0-10) to 1.0 ± 1.4 (0-6) (p < 0.0001). There was no significant difference in the median Tegner activity level (preoperative 5 (2-8) vs. follow-up 5 (2-8) (n.s). There was no significant difference in the number of sports disciplines and duration when comparing pre-injury and mid-term follow-up activity after ACL reconstruction. High-impact activities experienced a significant decline, while a significant increase in participation in low-impact activities was recorded.
The majority of patients with symptomatic instability regained their pre-injury recreational activity level with excellent clinical and functional outcomes after arthroscopic ACL reconstruction. Nevertheless, a change from high-to low-impact activities has been observed.
Level IV.
（1）比较运动和娱乐活动水平在术前和至少 6 年随访时的变化，（2）评估 55 岁以上患者前交叉韧带（ACL）重建后的临床和功能结果。
回顾性分析 150 例平均年龄 64±4.5（57-74）岁的前瞻性收集数据，所有患者均采用腘绳肌腱自体移植物进行初次 ACL 重建。使用国际膝关节文献委员会评分系统（IKDC）、膝关节损伤和骨关节炎结果评分（KOOS）、Tegner 活动水平和视觉模拟评分（VAS）评估疼痛，对 8.6±1.4（6-11）年后的患者进行评估。使用特定于运动的问卷评估娱乐活动水平。所有患者均根据孤立性和合并性 ACL 损伤组进行分类。
在最后一次随访时，对 125 例患者的数据进行了分析。25 例患者失访，125 例患者中有 117 例在受伤前至少参加过一项运动项目，而 125 例 ACL 重建后有 121 例参加过运动项目。102（82%）例患者在最终随访时已恢复娱乐活动。IKDC 主观评分平均从 49.5±23.2（11.5-100）增加到 76.2±14.8（33.3-100）（p<0.0001）。KOOS 运动平均显著从 36±36.2（0-100）增加到 74.1±25.5（0-100）（p<0.0001）。VAS 评分从 6.0±2.6（0-10）改善至 1.0±1.4（0-6）（p<0.0001）。术前中位数 Tegner 活动水平（5（2-8）与随访时（5（2-8）无显著差异（n.s）。ACL 重建后，比较术前和中期随访的活动时，运动项目数量和持续时间无显著差异。高冲击活动显著减少，而低冲击活动的参与显著增加。
大多数有症状不稳定的患者在接受关节镜 ACL 重建后，临床和功能结果均恢复到术前的娱乐活动水平。然而，已经观察到从高冲击活动到低冲击活动的转变。
IV 级。
