Graft choice or drilling technique does not influence outcomes of ACL reconstruction in patients over forty-five.

Abstract

To evaluate whether graft-type and tunnel location in ACL reconstruction impact patient-reported outcomes in individuals over the age of 45. From 2015 to 2018, patients over 45years old undergoing primary ACL reconstruction without multi-ligamentous injuries were enrolled in an institutional registry. Baseline International Knee Documentation Committee (IKDC) subjective scores,KneeInjury and OsteoarthritisOutcome Scores(KOOS), Marx Activity Scale, and patient characteristics werecollected.Follow-up occurred at a minimum of two years toobtainpatient-reported outcomes. Of the 51 patients who qualified for the study, 44 (86.3%) patients were availableat a minimum of two years after surgery date(range 24-60months). Average age at time of surgery ofthe availablepatients was 51.6 ± 4.87 (range 45-66). Between femoral tunnel drilling methods, there were no differences in the proportion of patients achieving clinically significant improvement or post-operative outcome scores. While patients who received patellar tendon autografts were more likely to achieve clinically significant improvement in the KOOS sports subscale, there were no other differences in outcomes measures between graft types. Two patients had aretearof their graft, and an additionalfivepatients complained of subjective instability. In patients over the age of 45, neither the method used to create the femoral tunnel nor the graft type used in ACL reconstruction caused a significant difference in post-operative PROMs with a minimum of two years of follow-up. Therapeutic IV, Case Series.