IS AN ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION OUTCOME AGE-DEPENDENT

Treatment of a torn anterior cruciate ligament (ACL) in older patients must be considered in relation to healing delays, rehabilitation diff iculties, stiffness, arthritis, and actual athletic demands. This stud y compares ACL reconstructions in patients 40-years old and older with those under 40-years old and contrasts these to published nonoperativ e data in the 40 and older patient. Patients undergoing ACL reconstruc tion between 1992 and 1994 were preoperatively and postoperatively ass essed with Lysholm, Tegner, KT, radiographic, and clinical examination s, They were divided into two groups: those 40 years and older (group 1) and those 39 years and younger (group 2). Group 1 had 33 patients w ith an average age of 44 years (range, 40 to 52 years). Radiographic F airbank changes were absent, Group 2 had 170 patients with an average age of 27 years (range, 16 to 39 years). Group 1 preoperative instabil ity and intake data were not statistically different from those of gro up 2. Average follow-up was 21 months for both groups. Both groups sho wed significant improvement in all parameters at 12- and 24-month foll ow-up examinations. Lysholm scores, Tegner Scores, average KT manual m aximum side-to-side differences, Lachman tests, and pivot shift testin g were not statistically different in either group. Using Lysholm crit eria, in group 1, 89% had excellent/good results, and 11% fair/poor re sults. This was not statistically different from group 2, which showed 91% excellent/good results and 9% fair/poor results at 24-month follo w-up examination. For this age group, nonoperative treatment reports i ndicate 57% excellent/good results and 43% fair/poor results, The outc omes between these groups are the same and fail to establish the age o f 40 years as a barrier to successful ACL reconstruction.