Outcomes of autograft ACL reconstruction in the over 50's - a minimum 2 year follow up study
ESSKA Academy. Thakrar R. 11/08/19; 284439; epESMA-33 Topic: Arthroscopic Surgery
Mr. Raj Ramesh Thakrar
Mr. Raj Ramesh Thakrar
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Outcomes of autograft ACL reconstruction in the over 50's - a minimum 2 year follow up study

ePoster - epESMA-33

Topic: Sports Trauma

Thakrar R.R.1, Yasen S.2, Foster A.2, Risebury M.2, Wilson A.2
1Lister Hospital NHS Trust, Stevenage, United Kingdom, 2Basingstoke Hospital NHS Trust, Basingstoke, United Kingdom

Introduction: Anterior Cruciate Ligament (ACL) rupture remains one of the most common knee injuries in sports. In the young, athletic patient, reconstruction surgery is a routinely performed procedure. ACL injuries are becoming more frequent in the over-50s population. Despite this, the approach to management of this patient cohort remains controversial with many groups adopting a more conservative philosophy at the potential compromise of patient outcome.
Aim: In this study, we aim to assess the functional and patient reported outcomes following ACL reconstruction in the above 50 population at 2 year follow-up.
Methods: The trust ligament database was used to identify all individuals over the age of 50 whom had undergone ACL reconstruction surgery. A translateral, all inside technique using ipsilateral quadrupled semi-tendinosus autograft was utilised in all cases with double suspensory tight rope fixation on the femur and tibia. Routine post-operative care and physio rehabilitation was completed. Individuals were prospectively followed up at 6 month, 1 year and 2 year intervals with regular clinical assessment in the form of range of motion and KT1000 measurements. In addition, patient reported outcome measure was captured in the form of Knee injury and Osteoarthritis Outcome Score (KOOS), Lysholm and Tegner activity scores.
Results: A total of 26 (14 male, 12 female) patients with a mean age of 56 years (range 50 - 74 years) were identified having undergone ACL reconstruction using hamstring allograft. 46% had associated injuries to include meniscal tears (isolated medial 5, bilateral 5) and osteochondral chondral injury (15%). Comparison of pre-operative and 2 year postoperative outcome data demonstrated a significant improvement in KOOS (52 vs 85, p< 0.05), Lysholm (48 vs 85, p< 0.01) and Tegner activity (2 vs 4, p< 0.01) scores. Furthermore, mean post-operative range of motion demonstrated improved joint flexion at 2 years in comparison to pre-op.There were no reports of graft re-rupture at final follow-up.
Conclusion: ACL reconstruction in the above 50s population remains an issue of debate, however, treatment of ACL injury should fit the individual patient needs and not simply be influenced by chronological age. Our results demonstrate that, irrespective of age, in the appropriately selected patient group, ACL reconstruction using ipsilateral hamstring autograft remains a viable option with excellent reported results in terms of function and return to activity.
Outcomes of autograft ACL reconstruction in the over 50's - a minimum 2 year follow up study

ePoster - epESMA-33

Topic: Sports Trauma

Thakrar R.R.1, Yasen S.2, Foster A.2, Risebury M.2, Wilson A.2
1Lister Hospital NHS Trust, Stevenage, United Kingdom, 2Basingstoke Hospital NHS Trust, Basingstoke, United Kingdom

Introduction: Anterior Cruciate Ligament (ACL) rupture remains one of the most common knee injuries in sports. In the young, athletic patient, reconstruction surgery is a routinely performed procedure. ACL injuries are becoming more frequent in the over-50s population. Despite this, the approach to management of this patient cohort remains controversial with many groups adopting a more conservative philosophy at the potential compromise of patient outcome.
Aim: In this study, we aim to assess the functional and patient reported outcomes following ACL reconstruction in the above 50 population at 2 year follow-up.
Methods: The trust ligament database was used to identify all individuals over the age of 50 whom had undergone ACL reconstruction surgery. A translateral, all inside technique using ipsilateral quadrupled semi-tendinosus autograft was utilised in all cases with double suspensory tight rope fixation on the femur and tibia. Routine post-operative care and physio rehabilitation was completed. Individuals were prospectively followed up at 6 month, 1 year and 2 year intervals with regular clinical assessment in the form of range of motion and KT1000 measurements. In addition, patient reported outcome measure was captured in the form of Knee injury and Osteoarthritis Outcome Score (KOOS), Lysholm and Tegner activity scores.
Results: A total of 26 (14 male, 12 female) patients with a mean age of 56 years (range 50 - 74 years) were identified having undergone ACL reconstruction using hamstring allograft. 46% had associated injuries to include meniscal tears (isolated medial 5, bilateral 5) and osteochondral chondral injury (15%). Comparison of pre-operative and 2 year postoperative outcome data demonstrated a significant improvement in KOOS (52 vs 85, p< 0.05), Lysholm (48 vs 85, p< 0.01) and Tegner activity (2 vs 4, p< 0.01) scores. Furthermore, mean post-operative range of motion demonstrated improved joint flexion at 2 years in comparison to pre-op.There were no reports of graft re-rupture at final follow-up.
Conclusion: ACL reconstruction in the above 50s population remains an issue of debate, however, treatment of ACL injury should fit the individual patient needs and not simply be influenced by chronological age. Our results demonstrate that, irrespective of age, in the appropriately selected patient group, ACL reconstruction using ipsilateral hamstring autograft remains a viable option with excellent reported results in terms of function and return to activity.
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