Anterior Cruciate Ligament Reconstruction in Patients Aged > 40 Years: A Case-Control Study

Purpose: To determine the outcomes of isolated anterior cruciate ligament (ACL) reconstruction in physically active patients aged. 40 years, and to compare these results with those of a younger patient cohort who underwent the same procedure. Methods: A retrospective review was performed on all patients aged. 40 years who underwent ACL reconstruction between 2000 and 2008. A consecutive series of patients aged <= 25 years who underwent the same procedure during this same time period were selected as a control group. Age, sex, graft type, concomitant injuries, complications, and a validated outcome measure (Lysholm Knee Scoring Scale) were assessed at final follow-up. Results: Forty-six patients (average age, 44.9 years; 28 men, 18 women) in the older group were identified and compared with 48 patients (average age, 21 years; 23 men, 25 women) in the younger group, with an average follow-up period of 5.4 and 5.1 years, respectively. There was no statistically significant difference between the groups in terms of associated injuries. The older group had a higher degree of cartilage degeneration (P = 0.0001). Lysholm scores averaged 90.3 in the older cohort compared with 88.7 in the younger cohort, with no statistical difference between groups. Conclusion: The older patients had outcomes comparable with the younger patients. Age alone should not exclude ACL-deficient patients from undergoing reconstructive surgery.