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Senior Citizen Health & Medicine
Age Should Not be Factor in Who Gets ACL Repair,
Study Finds
Success achieved in anterior cruciate ligament repair
for Baby Boomers and older
 March
5, 2008 - Baby boomers and Weekend warriors Baby Boomers and senior
citizens - 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 and patients up to age 66, 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
Todays 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,
peoples 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.
More About ACL from MedlinePlus
 An
anterior cruciate ligament injury is extreme stretching or tearing of
the anterior cruciate ligament (ACL) in the knee. A tear may be partial
or complete.
Considerations
The knee is essentially a modified hinge joint
located where the end of the femur (thigh bone) meets the top of the
tibia (shin bone). Four main ligaments connect these two bones:
Medial collateral ligament(MCL) -- runs along
the inner part of the knee and prevents the knee from bending inward.
Lateral collateral ligament (LCL) -- runs
along the outer part of the knee and prevents the knee from bending
outward.
Anterior cruciate ligament (ACL) -- lies in
the middle of the knee. It prevents the tibia from sliding out in front
of the femur, and provides rotational stability to the knee.
Posterior cruciate ligament (PCL) -- works in
concert with the ACL. It prevents the tibia from sliding backwards under
the femur.
The ACL and PCL cross each other inside the knee
forming an "X." This is why they are called the cruciate (cross-like)
ligaments.
ACL injuries are often associated with other
injuries. The classic example is when the ACL is torn at the same time
as both the MCL and the medial meniscus (one of the shock-absorbing
cartilages in the knee). This type of injury often occurs in football
players and skiers.
Women are more likely to suffer an ACL tear than
men. The cause for this is not completely understood, but it may be due
to differences in anatomy and muscular function.
Adults usually tear their ACL in the middle of the
ligament or pull the ligament off the femur bone. These injuries do not
heal by themselves. Children are more likely to pull off their ACL with
a piece of bone still attached -- these injuries may heal on their own,
or they may require an operation to fix the bone.
When your doctor suspects an ACL tear, an MRI may
help confirm the diagnosis. This test may also help evaluate other knee
injuries, such as to the other ligaments or cartilage.
Some people are able to live and function normally
with a torn ACL. However, most people complain that their knee is
unstable and may "give out" with attempted physical activity. Unrepaired
ACL tears may also lead to early arthritis in the affected knee.
Causes
ACL tears may be due to contact or non-contact
injuries. A blow to the side of the knee, which can occur during a
football tackle, may result in an ACL tear.
Alternatively, coming to a quick stop, combined
with a direction change while running, pivoting, landing from a jump, or
overextending the knee joint (called hyperextended knee), can cause
injury to the ACL.
Basketball, football, soccer, and skiing are common
causes of ACL tears.
>>
Read more
at MedlinePlus
>>
American
Academy of Orthopaedic Surgeons (AAOS)
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