Double-bundle anterior cruciate ligament reconstruction in patients aged 60 years and older

IF 1.5 Q3 ORTHOPEDICS Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology Pub Date : 2024-01-01 DOI:10.1016/j.asmart.2023.11.003

Kentaro Miyamoto , Kazutoshi Kurokouchi , Shinya Ishizuka , Shigeo Takahashi , Takashi Tsukahara , Ryosuke Kawai , Tadahiro Sakai , Hiroki Oba , Takefumi Sakaguchi , Shiro Imagama

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Abstract

Background

This study aimed to examine the clinical outcomes of double-bundle (DB) anterior cruciate ligament (ACL) reconstruction in patients aged ≥60 years.

Methods

Anatomical DB-ACL reconstruction using hamstring tendon autografts was performed in 13 patients aged ≥60 years at our institution between June 2012 and May 2018. The patients included seven men and six women, and the mean age at surgery was 65.0 years (range, 60–73 years). The mean time from injury to surgery was 80.5 months (range, 1–480 months), and the mean follow-up time was 26.2 months (range, 24–42 months). All patients were assessed based on physical examination findings, clinical scores, Kellgren–Lawrence grades preoperatively and at the final postoperative follow-up, intraoperative meniscal or chondral lesions, and perioperative complications. Status of returning to sports for all patients was assessed at the final follow-up.

Results

The mean side-to-side differences by arthrometer improved from 4.3 mm (range, 2–8 mm) to 0.9 mm (range, 0–2 mm), and the positive pivot-shift test decreased from 100% to 8%. The mean extensor muscle strength was 93.3% (range, 74–116%) postoperatively. The mean Lysholm score improved from 71.1 (range, 27-85) to 95.2 (range, 89-100). Ten of the 13 patients (77%) returned to their pre-injury level of sports performance, and one patient (8%) returned to sports with less intensity. Intraoperatively, meniscal tears were observed in 10 patients (77%), and chondral lesions >grade 2 were observed in 11 (85%). One patient developed perioperative complications. At the final follow-up, the Kellgren–Lawrence grade worsened in only one patient. No re-injury or infection was observed, and revision surgery was not required for any patients.

Conclusions

Anatomical DB-ACL reconstruction could provide satisfactory clinical outcomes and knee function restoration in patients aged ≥60 years.

Level of evidence

A retrospective study, case series (IV).

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60 岁及以上患者的双束前十字韧带重建术

背景本研究旨在探讨双束（DB）前交叉韧带（ACL）重建术对年龄≥60岁患者的临床疗效。方法2012年6月至2018年5月期间，我院对13名年龄≥60岁的患者进行了使用腘绳肌腱自体移植的DB-ACL解剖重建术。患者包括 7 名男性和 6 名女性，手术时的平均年龄为 65.0 岁（范围为 60-73 岁）。从受伤到手术的平均时间为 80.5 个月（范围为 1-480 个月），平均随访时间为 26.2 个月（范围为 24-42 个月）。所有患者的评估均基于体格检查结果、临床评分、术前和术后最终随访时的 Kellgren-Lawrence 分级、术中半月板或软骨损伤以及围手术期并发症。结果关节测量仪显示的平均侧向差异从4.3毫米（范围为2-8毫米）缩小到0.9毫米（范围为0-2毫米），枢轴移位试验阳性率从100%下降到8%。术后平均伸肌肌力为93.3%（范围为74-116%）。Lysholm 评分的平均值从 71.1（范围：27-85）提高到 95.2（范围：89-100）。13名患者中有10名（77%）恢复到了受伤前的运动水平，1名患者（8%）恢复到了运动强度较低的水平。术中观察到，10 名患者（77%）出现半月板撕裂，11 名患者（85%）出现软骨损伤 2 级。一名患者出现了围手术期并发症。在最后的随访中，只有一名患者的 Kellgren-Lawrence 分级恶化。结论解剖型DB-ACL重建术可为年龄≥60岁的患者提供满意的临床效果并恢复膝关节功能。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology Multiple-

CiteScore

3.80

自引率

0.00%

发文量

审稿时长

98 days

期刊介绍： The Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilitation and Technology (AP-SMART) is the official peer-reviewed, open access journal of the Asia-Pacific Knee, Arthroscopy and Sports Medicine Society (APKASS) and the Japanese Orthopaedic Society of Knee, Arthroscopy and Sports Medicine (JOSKAS). It is published quarterly, in January, April, July and October, by Elsevier. The mission of AP-SMART is to inspire clinicians, practitioners, scientists and engineers to work towards a common goal to improve quality of life in the international community. The Journal publishes original research, reviews, editorials, perspectives, and letters to the Editor. Multidisciplinary research with collaboration amongst clinicians and scientists from different disciplines will be the trend in the coming decades. AP-SMART provides a platform for the exchange of new clinical and scientific information in the most precise and expeditious way to achieve timely dissemination of information and cross-fertilization of ideas.