Reconstruction of the anterior cruciate ligament in patients over 50 years
Reconstruction of the anterior cruciate ligament in patients over 50 years
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DOI：
10.1302/0301-620x.90b11.21210
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发表时间：
2008-11-01
影响因子：
--
通讯作者：
Stuart, M. A.
中科院分区：
文献类型：
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作者：
Dahm, D. L.;Wulf, C. A.;Stuart, M. A.
回顾1990年至2002年间50岁或以上接受前交叉韧带初次重建的患者的记录。34例患者的35个膝关节符合入选标准。患者的平均年龄为57岁（50至66岁），平均临床随访时间为72个月（25至173个月）。其中23例采用同种异体髌腱移植重建膝关节，12例采用自体髌腱移植重建膝关节。平均术前膝关节伸展度为1度（-5度至10度），屈曲度为129度（125度至150度），随访时这些值分别为0度（-5度至5度）和135度（120度至150度）。术前有31个膝关节（89%）的Lachman等级为2+或3+。术后，33例膝关节（94%）为Lachman 0级或1+级。术前和术后国际膝关节文献委员会的平均评分分别为39（23 - 72）和90（33 - 100）。术前和术后Lysholm平均评分分别为50（18 - 68）和92（28 - 100），加州洛杉矶大学的平均活动评分在损伤前为8.5（4 - 10），损伤后为4.3（3 - 6），术后为8.3（4 - 10）。有三个移植失败（8.6%）需要revision.We的结论，重建前交叉韧带在精心挑选的患者年龄在50岁或以上，可以达到类似的结果，在年轻的患者，没有增加并发症的风险。
The records of patients aged 50 years or over who underwent primary reconstruction of the anterior cruciate ligament between 1990 and 2002 were reviewed. There were 35 knees in 34 patients that met the inclusion criteria. The mean age of the patients was 57 years (50 to 66) and the mean clinical follow-up was for 72 months (25 to 173). A total of 23 knees were reconstructed with patellar tendon allograft, and 12 with patellar tendon autograft. The mean pre-operative knee extension was 1 degrees (-5 degrees to 10 degrees) and flexion was 129 degrees (125 degrees to 150 degrees) and at follow-up these values were 0 degrees (-5 degrees to 5 degrees) and 135 degrees (120 degrees to 150 degrees), respectively. Pre-operatively there were 31 knees (89%) with a Lachman grade 2+ or 3+. Post-operatively, 33 knees (94%) were Lachman grade 0 or 1+. The mean pre- and post-operative International Knee Documentation Committee scores were 39 (23 to 72) and 90 (33 to 100) respectively. The mean pre- and post-operative Lysholm scores were 50 (18 to 68) and 92 (28 to 100) respectively and the mean University of California Los Angeles activity scores were 8.5 before injury (4 to 10), 4.3 (3 to 6) after injury and 8.3 (4 to 10) post- operatively. There were three graft failures (8.6%) requiring revision.We conclude that reconstruction of the anterior cruciate ligament in carefully-selected patients aged 50 years or over can achieve similar results to those in younger patients, with no increased risk of complications.