The Majority of Patients Aged 40 and Older Having Allograft Anterior Cruciate Ligament Reconstruction Achieve a Patient Acceptable Symptomatic State.
| Autor: | Sylvia SM; Tufts Medical Center, Boston, Massachusetts, U.S.A.. Electronic address: Ssylvia1@tuftsmedicalcenter.org., Perrone GS; Tufts Medical Center, Boston, Massachusetts, U.S.A., Stone JA; Orthopedic Institute of Wisconsin, Franklin, Wisconsin, U.S.A., Miltenberg B; School of Medicine, Tufts University, Boston, Massachusetts, U.S.A., Nezwek TA; School of Medicine, Tufts University, Boston, Massachusetts, U.S.A., Zhang Y; School of Medicine, Tufts University, Boston, Massachusetts, U.S.A., Golenbock SW; New England Baptist Hospital, Boston, Massachusetts, U.S.A., Richmond JC; New England Baptist Hospital, Boston, Massachusetts, U.S.A., Salzler MJ; Tufts Medical Center, Boston, Massachusetts, U.S.A. |
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| Jazyk: | angličtina |
| Zdroj: | Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association [Arthroscopy] 2022 May; Vol. 38 (5), pp. 1537-1543. Date of Electronic Publication: 2021 Oct 01. |
| DOI: | 10.1016/j.arthro.2021.09.024 |
| Abstrakt: | Purpose: To evaluate patient satisfaction, retear rates, and patient-reported outcomes (PROs) in patients aged 40 and older undergoing allograft anterior cruciate ligament reconstruction (ACLR). The secondary goal was to compare these parameters between groups of patients with intact versus failed grafts, and to evaluate these in relation to a historically reported International Knee Documentation Committee (IKDC) patient-acceptable symptoms state (PASS) score. Methods: Records of patients aged 40 and older who underwent ACLR between 2005 and 2016 at a single institution with a minimum 2-year follow-up were retrospectively reviewed. Patient-reported satisfaction, outcome scores, and failure rates were analyzed. The rate of achieving a previously defined IKDC PASS score based on younger cohorts was reported, and an updated PASS threshold for older patients was calculated. Results: 201 patients were included with a mean age of 48.6 years (range: 40-68) and mean follow-up of 6.2 years (range: 2.8-11.2). 182 (90.5%) patients reported satisfaction following surgery. 16 (8.0%) patients experienced failure of their ACLR, 10 of which underwent revision ACLR. The median IKDC score in the intact ACLR group was 86.2, compared to 66.7 in the failure group (P < .001). In total, 134 (72.4%) patients in the intact group achieved the historical PASS score of 75.9 on IKDC compared to only 4 (25%) in the failure group (χ 2 = 15.396, P < .001). An updated IKDC PASS threshold for older cohorts was calculated to be 66.7. Conclusion: Patients aged 40 and older who underwent allograft ACLR had an 8.0% failure rate at a mean follow-up of 6 years. Graft failure in patients aged 40 and older was associated with worse PROs. The majority of patients achieved the historically reported IKDC PASS threshold. Additionally, an updated age-appropriate IKDC PASS score of 66.7 was calculated to aid in future ACLR studies assessing older patients. Study Design: Level IV. (Copyright © 2021 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.) |
| Databáze: | MEDLINE |
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