How old is too old to repair the ACL?

Newswise — Baby boomers and weekend warriors are staying active well into their later years, making them susceptible to injuring those aging frames-especially vulnerable to tearing their anterior cruciate ligament (ACL).

A new study presented today at the 75th Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS), found that “boomers” who undergo ACL surgery are about as likely to return to pre-injury levels of activity as much younger people.

These encouraging findings have led researchers to conclude that age itself should not be a factor when determining candidates for the increasingly common knee-ligament surgery.

“Twenty years ago we did not see older patients being so active later in life. ACL surgery was rarely considered for people in their 40s and 50s,” said Diane Dahm, MD, assistant professor of orthopaedic surgery at the Mayo Clinic in Minnesota. “Older patients today want to continue to run, play basketball and be active late into life, so they need a level of knee stability that will support an active lifestyle.”

The study followed the recovery of 34 patients aged 50 to 66 for an average of 48 months between 1990 and 2002 following ACL surgery at the Mayo Clinic. Patients with injuries to multiple knee ligaments were excluded.

The study found that after ACL surgery:
• 83 percent were rated as normal or near-normal
• 83 percent returned to playing sports
• patients went from 4.3 before surgery to 8.3 postoperatively on the UCLA ( University of California at Los Angeles), activity score
• five of the 34 patients required additional knee surgery

“Today’s active baby boomers are pushing the envelope for when people are considered to be too old for ACL surgery,” concluded Dr. Dahm. “When considering candidates for ACL surgery, people’s fitness levels and their desire to return to an active lifestyle should be taken into account rather than looking at age.”

The ACL is one of the most commonly injured ligaments of the knee. The incidence of ACL injuries is currently estimated at approximately 200,000 annually, with 100,000 ACL reconstructions performed each year. In general, the incidence of ACL injury is higher in people who participate in high-risk sports, such as basketball, football, skiing and soccer.

Disclosure: Dr. Dahm has received no compensation for this study.