Operative or conservative treatment of the acutely torn anterior cruciate ligament in middle-aged patients - A follow-up study of 133 patients between the ages of 40 and 59 years

In all, 133 patients with an acute rupture of the anterior cruciate ligamen t (ACL) were reviewed (aged 40 to 59 years). Average follow-up was 29 +/- 1 0 months. Thirty-one patients underwent conservative therapy, 35 patients w ere treated by primary suture, while in 67 the primary suture was augmented with the semitendinosus tendon. The patients with primary repair and semit endinosus tendon augmentation showed significantly better results according to OAK and Lysholm scores, the Lachman test, pivot-shift testing, and KT-1 000 arthrometer measurements than those treated conservatively or with prim ary suture. The physical activity level was significantly higher in the pat ients with augmented ACL repair than in the conservatively treated patients . There was no significant difference between the patients with augmented A CL repair and conservative treatment in the assessment of range of motion, while the patients with primary suture had a significantly greater loss of flexion than those in the other two treatment groups. Increasing age was no t found to have a negative effect on either operative or conservative treat ment. The results indicate that patients between the ages of 40 and 59 year s can be treated successfully by ACL surgery.