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An Analysis of Anterior Cruciate Ligament Reconstruction in Middle-Aged Patients

Baylor College of Medicine, Department of Orthopedics, Houston, Texas

David R. Mack, MD

Baylor College of Medicine, Department of Orthopedics, Houston, Texas

J. Bruce Moseley, MD

Baylor College of Medicine, Department of Orthopedics, Houston, Texas

Russell Paine, RPT

Baylor College of Medicine, Department of Orthopedics, Houston, Texas

James R. Bocell, MD

Baylor College of Medicine, Department of Orthopedics, Houston, Texas

The purpose of this study was to evaluate the results and complications of anterior cruciate ligament surgery in middle-aged patients. Forty-five consecutive pa tients over 40 years old (average age, 44.6 years) who had arthroscopically assisted anterior cruciate liga ment reconstructions with midthird patellar tendon au tografts were evaluated. The patients returned for in terviews, physical examinations, radiographs, Biodex dynamometer strength testing, and KT-1000 arthrom eter testing at an average of 37 months after their surgeries (range, 24 to 96 months). The mean Lysholm and Gillquist score was 91, which corresponds to symptoms only with vigorous activity. The overall scores from the International Knee Documentation Committee form were 29 (64%) normal or nearly nor mal and 2 (4%) severely abnormal. Side-to-side differ ences as determined by the KT-1 000 arthrometer were 3 mm in 31 of 40 patients (78%), between 3 and 5 mm in 4 patients (10%), and >5 mm in 5 patients at 30 pounds of anterior displacement. Seventy-six percent of the patients (N = 34) returned to their preoperative activity levels. Three patients required repeat arthro scopic surgery for persistent knee pain and two pa tients had graft ruptures. This study shows that when middle-aged patients undergo surgery, their results can be successful and satisfying to a degree similar to those of younger patients.

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