{"title":"60 岁及以上患者的双束前十字韧带重建术","authors":"Kentaro Miyamoto , Kazutoshi Kurokouchi , Shinya Ishizuka , Shigeo Takahashi , Takashi Tsukahara , Ryosuke Kawai , Tadahiro Sakai , Hiroki Oba , Takefumi Sakaguchi , Shiro Imagama","doi":"10.1016/j.asmart.2023.11.003","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>This study aimed to examine the clinical outcomes of double-bundle (DB) anterior cruciate ligament (ACL) reconstruction in patients aged ≥60 years.</p></div><div><h3>Methods</h3><p>Anatomical DB-ACL reconstruction using hamstring tendon autografts was performed in 13 patients aged ≥60 years at our institution between June 2012 and May 2018. The patients included seven men and six women, and the mean age at surgery was 65.0 years (range, 60–73 years). The mean time from injury to surgery was 80.5 months (range, 1–480 months), and the mean follow-up time was 26.2 months (range, 24–42 months). All patients were assessed based on physical examination findings, clinical scores, Kellgren–Lawrence grades preoperatively and at the final postoperative follow-up, intraoperative meniscal or chondral lesions, and perioperative complications. Status of returning to sports for all patients was assessed at the final follow-up.</p></div><div><h3>Results</h3><p>The mean side-to-side differences by arthrometer improved from 4.3 mm (range, 2–8 mm) to 0.9 mm (range, 0–2 mm), and the positive pivot-shift test decreased from 100% to 8%. The mean extensor muscle strength was 93.3% (range, 74–116%) postoperatively. The mean Lysholm score improved from 71.1 (range, 27-85) to 95.2 (range, 89-100). Ten of the 13 patients (77%) returned to their pre-injury level of sports performance, and one patient (8%) returned to sports with less intensity. Intraoperatively, meniscal tears were observed in 10 patients (77%), and chondral lesions >grade 2 were observed in 11 (85%). One patient developed perioperative complications. At the final follow-up, the Kellgren–Lawrence grade worsened in only one patient. No re-injury or infection was observed, and revision surgery was not required for any patients.</p></div><div><h3>Conclusions</h3><p>Anatomical DB-ACL reconstruction could provide satisfactory clinical outcomes and knee function restoration in patients aged ≥60 years.</p></div><div><h3>Level of evidence</h3><p>A retrospective study, case series (IV).</p></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":null,"pages":null},"PeriodicalIF":1.5000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214687323000250/pdfft?md5=a4663ccd22266265f288ef1719347315&pid=1-s2.0-S2214687323000250-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Double-bundle anterior cruciate ligament reconstruction in patients aged 60 years and older\",\"authors\":\"Kentaro Miyamoto , Kazutoshi Kurokouchi , Shinya Ishizuka , Shigeo Takahashi , Takashi Tsukahara , Ryosuke Kawai , Tadahiro Sakai , Hiroki Oba , Takefumi Sakaguchi , Shiro Imagama\",\"doi\":\"10.1016/j.asmart.2023.11.003\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>This study aimed to examine the clinical outcomes of double-bundle (DB) anterior cruciate ligament (ACL) reconstruction in patients aged ≥60 years.</p></div><div><h3>Methods</h3><p>Anatomical DB-ACL reconstruction using hamstring tendon autografts was performed in 13 patients aged ≥60 years at our institution between June 2012 and May 2018. The patients included seven men and six women, and the mean age at surgery was 65.0 years (range, 60–73 years). The mean time from injury to surgery was 80.5 months (range, 1–480 months), and the mean follow-up time was 26.2 months (range, 24–42 months). All patients were assessed based on physical examination findings, clinical scores, Kellgren–Lawrence grades preoperatively and at the final postoperative follow-up, intraoperative meniscal or chondral lesions, and perioperative complications. Status of returning to sports for all patients was assessed at the final follow-up.</p></div><div><h3>Results</h3><p>The mean side-to-side differences by arthrometer improved from 4.3 mm (range, 2–8 mm) to 0.9 mm (range, 0–2 mm), and the positive pivot-shift test decreased from 100% to 8%. The mean extensor muscle strength was 93.3% (range, 74–116%) postoperatively. The mean Lysholm score improved from 71.1 (range, 27-85) to 95.2 (range, 89-100). Ten of the 13 patients (77%) returned to their pre-injury level of sports performance, and one patient (8%) returned to sports with less intensity. Intraoperatively, meniscal tears were observed in 10 patients (77%), and chondral lesions >grade 2 were observed in 11 (85%). One patient developed perioperative complications. At the final follow-up, the Kellgren–Lawrence grade worsened in only one patient. No re-injury or infection was observed, and revision surgery was not required for any patients.</p></div><div><h3>Conclusions</h3><p>Anatomical DB-ACL reconstruction could provide satisfactory clinical outcomes and knee function restoration in patients aged ≥60 years.</p></div><div><h3>Level of evidence</h3><p>A retrospective study, case series (IV).</p></div>\",\"PeriodicalId\":44283,\"journal\":{\"name\":\"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2024-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S2214687323000250/pdfft?md5=a4663ccd22266265f288ef1719347315&pid=1-s2.0-S2214687323000250-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2214687323000250\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2214687323000250","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Double-bundle anterior cruciate ligament reconstruction in patients aged 60 years and older
Background
This study aimed to examine the clinical outcomes of double-bundle (DB) anterior cruciate ligament (ACL) reconstruction in patients aged ≥60 years.
Methods
Anatomical DB-ACL reconstruction using hamstring tendon autografts was performed in 13 patients aged ≥60 years at our institution between June 2012 and May 2018. The patients included seven men and six women, and the mean age at surgery was 65.0 years (range, 60–73 years). The mean time from injury to surgery was 80.5 months (range, 1–480 months), and the mean follow-up time was 26.2 months (range, 24–42 months). All patients were assessed based on physical examination findings, clinical scores, Kellgren–Lawrence grades preoperatively and at the final postoperative follow-up, intraoperative meniscal or chondral lesions, and perioperative complications. Status of returning to sports for all patients was assessed at the final follow-up.
Results
The mean side-to-side differences by arthrometer improved from 4.3 mm (range, 2–8 mm) to 0.9 mm (range, 0–2 mm), and the positive pivot-shift test decreased from 100% to 8%. The mean extensor muscle strength was 93.3% (range, 74–116%) postoperatively. The mean Lysholm score improved from 71.1 (range, 27-85) to 95.2 (range, 89-100). Ten of the 13 patients (77%) returned to their pre-injury level of sports performance, and one patient (8%) returned to sports with less intensity. Intraoperatively, meniscal tears were observed in 10 patients (77%), and chondral lesions >grade 2 were observed in 11 (85%). One patient developed perioperative complications. At the final follow-up, the Kellgren–Lawrence grade worsened in only one patient. No re-injury or infection was observed, and revision surgery was not required for any patients.
Conclusions
Anatomical DB-ACL reconstruction could provide satisfactory clinical outcomes and knee function restoration in patients aged ≥60 years.
期刊介绍：
The Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilitation and Technology (AP-SMART) is the official peer-reviewed, open access journal of the Asia-Pacific Knee, Arthroscopy and Sports Medicine Society (APKASS) and the Japanese Orthopaedic Society of Knee, Arthroscopy and Sports Medicine (JOSKAS). It is published quarterly, in January, April, July and October, by Elsevier. The mission of AP-SMART is to inspire clinicians, practitioners, scientists and engineers to work towards a common goal to improve quality of life in the international community. The Journal publishes original research, reviews, editorials, perspectives, and letters to the Editor. Multidisciplinary research with collaboration amongst clinicians and scientists from different disciplines will be the trend in the coming decades. AP-SMART provides a platform for the exchange of new clinical and scientific information in the most precise and expeditious way to achieve timely dissemination of information and cross-fertilization of ideas.
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