Late (≥60 years old) and middle adulthood (40–59 years old) patients achieve similar improvement in patient-reported outcomes following ACL reconstruction

IF 5 2区医学 Q1 ORTHOPEDICS Knee Surgery, Sports Traumatology, Arthroscopy Pub Date : 2024-09-26 DOI:10.1002/ksa.12491

Nicholas B. Pohl, Patrick Fitzgerald, Parker L. Brush, Daniel J. Fletcher, Joshua Hornstein

{"title":"Late (≥60 years old) and middle adulthood (40–59 years old) patients achieve similar improvement in patient-reported outcomes following ACL reconstruction","authors":"Nicholas B. Pohl, Patrick Fitzgerald, Parker L. Brush, Daniel J. Fletcher, Joshua Hornstein","doi":"10.1002/ksa.12491","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Purpose</h3>\n \n <p>This study aimed to compare the range of motion (ROM), surgical outcomes, and patient-reported outcome measures (PROMs) following anterior cruciate ligament (ACL) reconstruction outcomes in patients 60 years or older at the time of surgery to 40- to 59-year-old patients.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>In this retrospective cohort study from 2015 to 2022, a 3:1 propensity match was performed to match late adulthood patients (≥60 years old) undergoing ACL reconstruction with middle adulthood (40–59 years old) ACL reconstruction patients. Patients were matched based on sex, ACL graft utilized and concomitant procedures performed during ACL reconstruction. Statistical analysis compared demographics, preoperative injury management, surgical outcomes, PROMs, and minimal clinical important difference (MCID) and substantial clinical benefit (SCB) achievement rates for all ACL reconstruction patients included.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Twenty late adulthood and 60 middle adulthood patients who underwent ACL reconstruction were included in the final cohort. Patients who were 60 years or older experienced no difference in reoperation rate (n.s.), incidence of retears (n.s.) or ROM (n.s.) at 1 year post-operatively. There were also no differences in International Knee Documentation Committee (ΔIKDC) (31.3 ± 19.1 vs. 34.2 ± 18.2, n.s.) or ΔPCS-12 (12.4 ± 9.8 vs. 12.9 ± 10.8, n.s.) scores at 1 year post-operatively. Furthermore, the younger and older patient cohorts demonstrated similar rates of achieving the MCID (80.0% vs. 83.3%, n.s.) and SCB (50.0% vs. 61.7%, n.s.) scores for IKDC.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Patients 60 years or older and 40- to 59-year-old patients demonstrated similar outcomes after undergoing ACL reconstruction with allograft. This study concludes that ACL reconstruction in late adulthood can still be a successful treatment option and should allow surgeons to feel more comfortable when performing indicated surgical intervention for older patients who experience an ACL tear.</p>\n </section>\n \n <section>\n \n <h3> Level of Evidence</h3>\n \n <p>Level III, Therapeutic III, retrospective cohort study.</p>\n </section>\n </div>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"33 6","pages":"2019-2026"},"PeriodicalIF":5.0000,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Knee Surgery, Sports Traumatology, Arthroscopy","FirstCategoryId":"3","ListUrlMain":"https://esskajournals.onlinelibrary.wiley.com/doi/10.1002/ksa.12491","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose

This study aimed to compare the range of motion (ROM), surgical outcomes, and patient-reported outcome measures (PROMs) following anterior cruciate ligament (ACL) reconstruction outcomes in patients 60 years or older at the time of surgery to 40- to 59-year-old patients.

Methods

In this retrospective cohort study from 2015 to 2022, a 3:1 propensity match was performed to match late adulthood patients (≥60 years old) undergoing ACL reconstruction with middle adulthood (40–59 years old) ACL reconstruction patients. Patients were matched based on sex, ACL graft utilized and concomitant procedures performed during ACL reconstruction. Statistical analysis compared demographics, preoperative injury management, surgical outcomes, PROMs, and minimal clinical important difference (MCID) and substantial clinical benefit (SCB) achievement rates for all ACL reconstruction patients included.

Results

Twenty late adulthood and 60 middle adulthood patients who underwent ACL reconstruction were included in the final cohort. Patients who were 60 years or older experienced no difference in reoperation rate (n.s.), incidence of retears (n.s.) or ROM (n.s.) at 1 year post-operatively. There were also no differences in International Knee Documentation Committee (ΔIKDC) (31.3 ± 19.1 vs. 34.2 ± 18.2, n.s.) or ΔPCS-12 (12.4 ± 9.8 vs. 12.9 ± 10.8, n.s.) scores at 1 year post-operatively. Furthermore, the younger and older patient cohorts demonstrated similar rates of achieving the MCID (80.0% vs. 83.3%, n.s.) and SCB (50.0% vs. 61.7%, n.s.) scores for IKDC.

Conclusion

Patients 60 years or older and 40- to 59-year-old patients demonstrated similar outcomes after undergoing ACL reconstruction with allograft. This study concludes that ACL reconstruction in late adulthood can still be a successful treatment option and should allow surgeons to feel more comfortable when performing indicated surgical intervention for older patients who experience an ACL tear.

Level of Evidence

Level III, Therapeutic III, retrospective cohort study.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

前交叉韧带重建术后，晚期（≥60 岁）和成年中期（40-59 岁）患者在患者报告结果方面取得了相似的改善。

目的：本研究旨在比较前交叉韧带（ACL）重建术后60岁或以上患者与40至59岁患者的运动范围（ROM）、手术结果和患者报告的结果测量（PROMs）：在这项2015年至2022年的回顾性队列研究中，对接受前交叉韧带重建手术的成年晚期（≥60岁）患者与成年中期（40-59岁）前交叉韧带重建患者进行了3:1倾向匹配。患者的匹配基于性别、前交叉韧带移植的使用情况以及前交叉韧带重建过程中同时进行的手术。统计分析比较了所有前交叉韧带重建患者的人口统计学特征、术前损伤处理、手术结果、PROMs、最小临床重要差异（MCID）和实质性临床获益（SCB）达到率：20名晚期成年患者和60名中期成年患者接受了前交叉韧带重建术。60岁或以上的患者在术后1年的再手术率（正常值）、再撕裂发生率（正常值）或关节活动度（正常值）方面没有差异。术后1年，国际膝关节文献委员会（ΔIKDC）（31.3 ± 19.1 vs. 34.2 ± 18.2， n.s.）或ΔPCS-12（12.4 ± 9.8 vs. 12.9 ± 10.8， n.s.）评分也无差异。此外，年轻和年长患者组群的 IKDC MCID（80.0% vs. 83.3%，n.s.）和 SCB（50.0% vs. 61.7%，n.s.）评分达标率相似：结论：60 岁或以上的患者和 40 至 59 岁的患者在接受同种异体前交叉韧带重建术后的疗效相似。本研究得出结论，成年晚期的前交叉韧带重建仍然是一种成功的治疗选择，外科医生在对前交叉韧带撕裂的老年患者进行指定手术治疗时应更加放心：III级，治疗III级，回顾性队列研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Knee Surgery, Sports Traumatology, Arthroscopy 医学-外科

CiteScore

8.10

自引率

18.40%

发文量

418

审稿时长

2 months

期刊介绍： Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication. The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance. Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards. Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).