Reconstrucción del ligamento cruzado anterior en pacientes mayores de 40 años

Abstract

Aim. Assess the results of the reconstruction of the anterior cruciate ligament (ACL) in patients over 40 years after a minimum follow-up of 24 months. Material and Methods. Retrospective review of 37 patients undergoing surgery for ACL reconstruction between 2002-2013, over 40 years with a minimum follow-up of 24 months. 25 patients were available for clinical review, which consisted of physical examination, radiographic and arthrometric KT-1000 studies, functional tests and subjective assessment of the knee through surveys (International Knee Documentation Committee (IKDC), Tegner and Lysholm-Tegner). Results. At follow-up, at least 2 of the 3 knee instability maneuvers (Pivot-shift, Lachman, Anterior drawer test) were positive in 6 of 25 patients (24%). The difference of antero-posterior laxity compared with the healthy knee using KT-1000 arthrometer to 89N was greater than 3mm in 5 patients (20%). None had a greater difference of 5mm. Only 6 patients recovered their previous level of activity, according to the Tegner test. However, the average score on the Lysholm test was 81,40 ± 19,56 points, with good or excellent results in 15 patients (60%). IKDC test results were less conspicuous, with good or excellent results in 7 patients (28%). Conclusions. The results after ACL reconstruction in patients older than 40 years old are good, with a high degree of satisfaction and are comparable to those in younger patients. Although return to previous activity level is less than in younger groups, age should not be a limiting to indicate an ACL reconstruction factor in an unstable knee.